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Sample records for aesthetic surgical procedures

  1. Aesthetic Surgical Crown Lengthening Procedure

    PubMed Central

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  2. [Nose surgical anatomy in six aesthetic subunits].

    PubMed

    Chaput, B; Lauwers, F; Lopez, R; Saboye, J; André, A; Grolleau, J-L; Chavoin, J-P

    2013-04-01

    The nose is a complex entity, combining aesthetic and functional roles. Descriptive anatomy is a fundamental science that it can be difficult to relate directly to our daily surgical activity. Reasoning in terms of aesthetic subunits to decide on his actions appeared to us so obvious. The aim of this paper is to resume the anatomical bases relevant to our daily practice in order to fully apprehend the restorative or cosmetic procedures. We discuss the limits of the systematization of these principles in nasal oncology.

  3. Rhinoplasty: surface aesthetics and surgical techniques.

    PubMed

    Çakir, Bariş; Doğan, Teoman; Öreroğlu, Ali Riza; Daniel, Rollin K

    2013-03-01

    Surface aesthetics of the attractive nose are created by certain lines, shadows, and highlights, with specific proportions and breakpoints. Our evaluation of the nasal surface aesthetics is achieved using the concept of geometric polygons as aesthetic subunits, both to define the existing deformity and the aesthetic goals. Surgical techniques have been developed and modified to achieve the desired surface appearance, and those are detailed in this article. The principles of geometric polygons allow the surgeon to analyze the deformities of the nose, to define an operative plan to achieve specific goals, and to select the appropriate operative technique. These aesthetic concepts and surgical techniques were used in 257 consecutive rhinoplasties performed in the past 3 years by the principal author (B.Ç.).

  4. Minimally invasive aesthetic procedures in young adults

    PubMed Central

    Wollina, Uwe; Goldman, Alberto

    2011-01-01

    Age is a significant factor in modifying specific needs when it comes to medical aesthetic procedures. In this review we will focus on young adults in their third decade of life and review minimally invasive aesthetic procedures other than cosmetics and cosmeceuticals. Correction of asymmetries, correction after body modifying procedures, and facial sculpturing are important issues for young adults. The implication of aesthetic medicine as part of preventive medicine is a major ethical challenge that differentiates aesthetic medicine from fashion. PMID:21673871

  5. [Skeletal discrepancies: could we avoid surgical procedures?].

    PubMed

    Bouletreau, Pierre; Raberin, Monique; Mayeux, Jean-François

    2014-12-01

    Orthodontic-surgical protocols are nowadays considered as the state-of-the-art in cases of skeletal dentomaxillary dysmorphosis. However, for some reasons, it may happen that unquestionable indications for orthodontic-surgical procedures are not respected, patients being treated by orthodontics alone. This kind of mistake in the treatment planning lay the patient open to various potential complications such as: abnormal duration of the orthodontic treatment, dental root resorptions, questionable tooth extraction, unfavorable facial aesthetics, treatment instability... The authors discuss these points illustrated by clinical cases. Although orthognathic surgery protocols became considerably simplified these last two decades, orthodontic-surgical protocols are still relevantly considered as heavy both by patients and practitioners. As a consequence, their indication must be carefully weighed by a multidisciplinary team, keeping in mind that these protocols represent the ultimate functional and aesthetic treatment for dento-skeletal dysmorphoses.

  6. Augmented reality in surgical procedures

    NASA Astrophysics Data System (ADS)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

    2008-02-01

    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  7. Facial aesthetic surgical goals in patients of different cultures.

    PubMed

    Rowe-Jones, Julian M

    2014-08-01

    The purpose of facial aesthetic surgery is to improve the patient's psychological well-being. To achieve this, the surgeon must understand the patient's body image and their aesthetic and psychological expectations. These factors must be judged in the context of their cultural background. The patient's cultural values must also be understood to optimize the doctor-patient relationship.

  8. Surgical Procedures. Second Edition. Teacher Edition.

    ERIC Educational Resources Information Center

    Baker, Beverly; And Others

    This teacher's guide contains 13 units of instruction for a course that will prepare students with the entry-level competencies needed by a surgical technologist. The course covers the following topics: introduction to surgical procedures; diagnostic procedures; general surgery; gastrointestinal surgery; obstetrics and gynecological surgery;…

  9. Surgical procedures in pinniped and cetacean species.

    PubMed

    Higgins, Jennifer L; Hendrickson, Dean A

    2013-12-01

    Significant advances in veterinary diagnostic and surgical techniques have been made over the past several decades. Many of these advances, however, have not reached the field of marine mammal medicine. A number of limitations exist: risks of anesthesia, anatomical challenges, difficulties with wound closure, environmental constraints, equipment limitations, and perceived risks. Despite these limitations, surgical treatments have been successfully utilized in marine mammals. While surgery is performed in pinnipeds more frequently than in cetaceans, studies conducted in the 1960s and 1970s on dolphin sleep and hearing demonstrated that general anesthesia can be successfully induced in cetaceans. Since this pioneering work, a small number of successful surgeries have been performed in dolphins under both general anesthesia and heavy sedation. While these surgical procedures in pinnipeds and cetaceans have typically been limited to wound management, dentistry, ophthalmic procedures, fracture repair, and superficial biopsy, a number of abdominal surgeries have also been performed. Recently there have been pioneering successes in the application of minimally invasive surgery in marine mammals. Many of the anatomical challenges that almost prohibit traditional laparotomies in cetacean species and present challenges in pinnipeds can be overcome through the use of laparoscopic techniques. Due to the limited number of pinnipeds and cetaceans in captivity and, thus, the limited case load for veterinarians serving marine mammal species, it is vital for knowledge of surgical procedures to be shared among those in the field. This paper reviews case reports of surgical procedures, both traditional and laparoscopic, in pinnipeds and cetaceans. Limitations to performing surgical procedures in marine mammals are discussed and surgical case reports analyzed in an effort to determine challenges that must be overcome in order to make surgery a more feasible diagnostic and treatment

  10. Characterization of aerosols produced by surgical procedures

    SciTech Connect

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K.; Turner, R.S.

    1994-07-01

    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  11. Guidelines for surgical procedures after liver transplantation.

    PubMed Central

    Testa, G; Goldstein, R M; Toughanipour, A; Abbasoglu, O; Jeyarajah, R; Levy, M F; Husberg, B S; Gonwa, T A; Klintmalm, G B

    1998-01-01

    OBJECTIVE: The first purpose of this study is to identify the types and incidences of surgical procedures in patients who have previously undergone liver transplantation, with particular focus on the complication rates and the lengths of hospital stay. The second purpose is to present the management guidelines for patients with liver transplants at the preoperative, intraoperative, and postoperative stages of surgical procedure. SUMMARY BACKGROUND DATA: The surgical literature on this issue is scant, and with the growing liver transplant patient population it is not unlikey for any surgery specialist to have to operate on a patient who has undergone liver transplantation. METHODS: A sample of 409 patients with available hospital records, with a minimum of a 2-year follow-up, and with telephone access for interviews was chosen. Type of surgery, time from the liver transplant, hospital stay, immunosuppressive regimen, and complications were recorded. RESULTS: A large proportion of patients (24.2%) underwent some type of surgical procedure 2 to 10 years after liver transplantation. The authors demonstrate that most of the elective procedures can be safely carried out without an increased incidence of complication and without longer hospital stay than the general population. Conversely, emergent procedures are plagued by a greater incidence of complications that not only affect the function of the liver graft but may risk the life of the patient. PMID:9563551

  12. Immersive Learning Experiences for Surgical Procedures.

    PubMed

    Cha, Young-Woon; Dou, Mingsong; Chabra, Rohan; Menozzi, Federico; State, Andrei; Wallen, Eric; Fuchs, Henry

    2016-01-01

    This paper introduces a computer-based system that is designed to record a surgical procedure with multiple depth cameras and reconstruct in three dimensions the dynamic geometry of the actions and events that occur during the procedure. The resulting 3D-plus-time data takes the form of dynamic, textured geometry and can be immersively examined at a later time; equipped with a Virtual Reality headset such as Oculus Rift DK2, a user can walk around the reconstruction of the procedure room while controlling playback of the recorded surgical procedure with simple VCR-like controls (play, pause, rewind, fast forward). The reconstruction can be annotated in space and time to provide more information of the scene to users. We expect such a system to be useful in applications such as training of medical students and nurses.

  13. Surgical Procedures in Predoctoral Periodontics Programs.

    ERIC Educational Resources Information Center

    Radentz, William H.; Caffesse, Raul G.

    1991-01-01

    A survey of 58 dental school periodontics departments revealed the frequency of predoctoral dental students performing surgery, the frequency of specific procedures, the degree of participation or performance of students, incidence of preclinical surgical laboratories in the curricula, and materials and anesthesia used. A wide range in…

  14. Major surgical complications from minor urological procedures.

    PubMed Central

    Eke, N.

    2000-01-01

    Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious complications from urological procedures considered minor or simple were identified from a Medline search (1966 through 1999) and reference lists of relevant publications. The operations regarded as minor were carried out by medical personnel of all grades as well as by nonmedical persons. The complications can be classified as mutilatory, infective, hemorrhagic, or obstructive. Although the mutilatory complications affect mainly procedures on the penis, infective and hemorrhagic complications affect almost all the procedures. Tumor implantation has occurred along needle biopsy tracts. Although many of the complications are not related to technique or competence, a plea is made for the awareness of their occurrence to encourage preventive strategies. Adequate training of surgical personnel remains essential worldwide. PMID:10976176

  15. Surgical Procedures for Renal Artery Aneurysms

    PubMed Central

    Inoue, Yoshinori; Kudo, Toshifumi; Toyofuku, Takahiro

    2012-01-01

    Objective: The aim of this study was to assess the strategy and surgical procedures for treating a renal artery aneurysm (RAA). Patients and Methods: We retrospectively reviewed the surgical strategy for 21 cases with RAA between 2001 and 2010 at this institution. Treatment was indicated for patients with an RAA larger than 2 cm and/or symptoms. Surgical treatment was the initial strategy, and coil embolization was indicated in the case of narrow-necked, saccular, extraparenchymal aneurysms. Results: Fifteen patients in 21 cases received an aneurysmectomy and renal artery reconstruction with an in-situ repair. One patient underwent an unplanned nephrectomy, and coil embolization was performed in 5 patients. Conclusion: In-situ repair was safe and minimally invasive. RAA, even in the second bifurcation, could be exposed by a subcostal incision, and the transperitoneal approach permitted the safe treatment of an RAA with acceptable results, in our simple preservation of renal function. PMID:23555504

  16. Fundamental Ethical Issues in Unnecessary Surgical Procedures.

    PubMed

    Tayade, Motilal Chandu; Dalvi, Shashank D

    2016-04-01

    In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don't really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient's lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario.

  17. Wound infection after arterial surgical procedures.

    PubMed

    van Himbeeck, F J; van Knippenberg, L A; Niessen, M C; van Griethuysen, A J

    1992-09-01

    During the period October 1983 to March 1987, 603 patients who underwent arterial surgical procedures were studied to determine the incidence and treatment of wound infections. Bypass procedures were performed in 395 patients (65.5%), in which autogenous vein was used for 158 grafts (26%), synthetic Dacron for 216 grafts (36%), and umbilical vein for 21 grafts (3.5%). Thrombo-endarterectomies, embolectomies and patch-grafts were performed in 208 patients (34.5%). An Infection Control Nurse examined and registered the wounds. The definition of wound infection used in our study is equivalent to Szilagyi grade II infection. Vascular surgery is classified as clean surgery, the clean wound infection rate being a useful measurement to evaluate preventative measures and surgical technique. Thirty-one patients (5.1%) developed a wound infection as a postoperative complication. The overall incidence of wound complications including haematoma and seroma following arterial reconstruction was 13%. The site of wound infection was predominantly the groin. The most common pathogen was Staphylococcus aureus which was found in 17 patients (2.8%). All infections resolved without further surgical intervention. The influence of possible aetiological factors is considered and the importance of prophylactic antibiotics and good surgical technique is stressed.

  18. The challenge of evaluating surgical procedures.

    PubMed Central

    Stirrat, G. M.; Farrow, S. C.; Farndon, J.; Dwyer, N.

    1992-01-01

    All new interventions and procedures must be properly assessed in comparison to the currently accepted method(s). It is unethical not to do so. The optimum method is by Randomised Controlled Trial (RCT). This is ideally suited to the testing of drugs because the trial can usually be double blind and placebo controlled. RCTs are less commonly used for the evaluation of new surgical techniques. There are valid and invalid reasons for this and these are discussed. PMID:1567147

  19. Skin simulation for minor surgical procedures.

    PubMed

    Munro, A; Park, K G; Atkinson, D; Day, R P; Capperauld, I

    1994-06-01

    A simulated skin preparation is described which is made by bonding siliconized rubber to a latex foam base. This composite material, which simulates both the dermis/epidermis and subcutaneous fat, provides a realistic model which can be used to teach excision of skin lesions and a variety of suturing methods. We believe that this simulator is of value not only for surgeons in-training but also will allow general practitioners to improve their technical skills in performing minor surgical procedures.

  20. 42 CFR 416.65 - Covered surgical procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered surgical procedures may not be of a...

  1. 42 CFR 416.65 - Covered surgical procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered surgical procedures may not be of a...

  2. Shapes, Proportions, and Variations in Breast Aesthetic Ideals: The Definition of Breast Beauty, Analysis, and Surgical Practice.

    PubMed

    Mallucci, Patrick; Branford, Olivier Alexandre

    2015-10-01

    There are few objective analyses in the plastic surgical literature to define an aesthetically pleasing template for breast shape and proportion. The authors previously identified key objective parameters that define breast aesthetic ideals in 2 studies: an observational analysis of 100 models with natural breasts, and a population analysis with 1315 respondents. From these data a simple yet reproducible formula for surgical planning in breast augmentation has been developed to consistently achieve beautiful breasts, namely the ICE principle. This article proposes that this principle be used as the basis for design in aesthetic breast surgery.

  3. Two stage surgical procedure for root coverage.

    PubMed

    George, Anjana Mary; Rajesh, K S; Hegde, Shashikanth; Kumar, Arun

    2012-07-01

    Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva.

  4. Fundamental Ethical Issues in Unnecessary Surgical Procedures

    PubMed Central

    Dalvi, Shashank D.

    2016-01-01

    In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don’t really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient’s lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario. PMID:27190833

  5. Costs of surgical procedures in Indian hospitals

    PubMed Central

    Chatterjee, Susmita; Laxminarayan, Ramanan

    2013-01-01

    Objective Despite a growing volume of surgical procedures in low-income and middle-income countries, the costs of these procedures are not well understood. We estimated the costs of 12 surgical procedures commonly conducted in five different types of hospitals in India from the provider perspective, using a microcosting method. Design Cost and utilisation data were collected retrospectively from April 2010 to March 2011 to avoid seasonal variability. Setting For this study, we chose five hospitals of different types: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed district hospital, a 655-bed private teaching hospital and a 778-bed tertiary care teaching hospital based on their willingness to cooperate and data accessibility. The hospitals were from four states in India. The private, charitable and tertiary care hospitals serve urban populations, the district hospital serves a semiurban area and the private teaching hospital serves a rural population. Results Costs of conducting lower section caesarean section ranged from rupees 2469 to 41 087; hysterectomy rupees 4124 to 57 622 and appendectomy rupees 2421 to 3616 (US$1=rupees 52). We computed the costs of conducting lap and open cholecystectomy (rupees 27 732 and 44 142, respectively); hernia repair (rupees 13 204); external fixation (rupees 8406); intestinal obstruction (rupees 6406); amputation (rupees 5158); coronary artery bypass graft (rupees 177 141); craniotomy (rupees 75 982) and functional endoscopic sinus surgery (rupees 53 398). Conclusions Estimated costs are roughly comparable with rates of reimbursement provided by the Rashtriya Swasthya Bima Yojana (RSBY)—India's government-financed health insurance scheme that covers 32.4 million poor families. Results from this type of study can be used to set and revise the reimbursement rates. PMID:23794591

  6. Finishing procedures in orthodontic-surgical cases.

    PubMed

    Brunel, Jean-Michel

    2015-09-01

    To ensure optimal results, we must do our utmost to achieve targets based on order, symmetry and precision, our ultimate aim being to strive towards the desired harmony, planned contrast and exact proportions. Orthodontic-surgical treatments require specific finishing procedures, which most often call for multidisciplinary, or even transdisciplinary, collaboration. Finishing will involve the dental arches just as much as the orofacial environment. Above all, treatment of this kind demands a highly targeted approach in combination with well-defined and perfectly executed techniques. To finish a case satisfactorily, reasonable targets should be aimed for to ensure they are achieved. One must be ambitious and yet wise. A tight alliance of surgeon and orthodontist will nurture convincing and achievable projects and good, lifelong outcomes. Following the consolidation phase, roughly 4 to 6 weeks post-surgery, we can initiate the final orthodontic treatment, which, in effect, constitutes a mini-treatment in its own right. "Details make perfection, but perfection is not a detail" (Leonardo Da Vinci). "A lucid mind is the ante-chamber of intelligence" (Léo Ferré). In the order of life, every form of unity is always unique, and if each of us is unique, it is because everyone else is too. Ambition, wisdom, lucidity and efficiency will guarantee a successful result, the successful result. We must not be mere observers of our treatments, but the architect, project manager and site foreman at one and the same time. One could talk ad infinitum about finishing orthodontic-surgical cases because everything else leads up to the case-finishing and even the fullest description could never be exhaustive.

  7. Aesthetic Surgical Approach for Bone Dehiscence Treatment by Means of Single Implant and Interdental Tissue Regeneration: A Case Report with Five Years of Follow-Up

    PubMed Central

    Lombardo, Giorgio; Pighi, Jacopo; Corrocher, Giovanni; Mascellaro, Anna; Lehrberg, Jeffrey; Marincola, Mauro; Nocini, Pier Francesco

    2016-01-01

    The replacement of single anterior teeth by means of endosseous implants implies the achievement of success in restoring both aesthetic and function. However, the presence of wide endoperiodontal lesions can lead to horizontal hard and soft tissues defects after tooth extraction, making it impossible to correctly place an implant in the compromised alveolar socket. Vertical augmentation procedures have been proposed to solve these clinical situations, but the amount of new regenerated bone is still not predictable. Furthermore, bone augmentation can be complicated by the presence of adjacent teeth, especially if they bring with them periodontal defects. Therefore, it is used to restore periodontal health of adjacent teeth before making any augmentation procedures and to wait a certain healing period before placing an implant in vertically augmented sites, otherwise risking to obtain a nonsatisfactory aesthetic result. All of these procedures, however, lead to an expansion of treatment time which should affect patient compliance. For this reason, this case report suggests a surgical technique to perform vertical bone augmentation at a single gap left by a central upper incisor while placing an implant and simultaneously to regenerate the periodontal attachment of an adjacent lateral incisor, without compromising the aesthetic result. PMID:27119031

  8. Surgical care burden in orbito-temporal neurofibromatosis: Multiple procedures and surgical care duration analysis in 47 consecutive adult patients.

    PubMed

    Pessis, Rachel; Lantieri, Laurent; Britto, Jonathan A; Leguerinel, Caroline; Wolkenstein, Pierre; Hivelin, Mikaël

    2015-10-01

    Patients with orbito-temporal neurofibromatosis (OTNF) bear a heavy burden of surgical care. We studied 47 consecutive patients with OTNF from the French Neurofibromatosis 1 Referral Center cohort (n > 900), over a 15-year period to determine the clinical features most likely to predict repeat surgery and longer duration of surgical care. Forty-seven patients (5.2% of the NF1 patients' cohort) underwent 79 procedures with a 4.8 years average follow-up. Soft-tissue surgery had a high revision rate (19/45 patients), skeletal surgery did not (2/13 patients). Transosseous wire canthopexy and facial aesthetic unit remodeling were associated with stable outcome. Ptosis repair carried an unfavorable outcome, particularly in the presence of sphenoid dysplasia. Stable skeletal remodeling was achieved with polyethylene implants and/or cementoplasty. Multiple procedures were undertaken in 70% of patients and were predicted by the NF volume, canthopexy, skeletal dysplasia, or a Jackson's classification 2 and/or 3; but not by declining visual acuity. A classification based upon predictive risk of repeated procedures is proposed: Group 1: Isolated soft tissue infiltration not requiring levator palpebrae or canthal surgery; Group 2: Soft tissue involvement requiring ptosis repair or canthopexy, or NF great axis over 4.5 cm; Group 3: Presence of sphenoid dysplasia with pulsatile proptosis, regardless of visual acuity.

  9. Historical perspectives on the evolution of surgical procedures in endodontics.

    PubMed

    Gutmann, James L; Gutmann, Marylou S

    2010-01-01

    The historical pathway to current surgical endodontic procedures and their applications has been tortuous and tumultuous. Influenced heavily in their development by the European sector, these surgical procedures faced many challenges over the decades. Fortunately for today's practitioners, influential members of the oral surgery community, and a few staunch believers in retaining devitalized teeth, persisted in their investigation of and search for improved procedures that had predictable outcomes. Many so-called "revolutionary" or newer techniques practiced today are but a re-emergence of surgical concepts that were lost in the archives of time. With the advent of evidence-based endodontics, these procedures are now supported extensively by science and by the integration of science into materials usage, technique applications and outcomes research. However, in many respects, this story is just beginning, as the "roots" of surgical endodontics are explored.

  10. [Aesthetic surgery].

    PubMed

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  11. Modeling surgical procedures to assist in understanding surgical approach

    NASA Astrophysics Data System (ADS)

    Ha, Kevin; Dumpuri, Prashanth; Miga, Michael I.; Thompson, Reid C.

    2007-03-01

    Often within the clinical environment of a neurosurgical brain tumor procedure, the surgeon is faced with the difficulty of orienting the patient's head to maximize the success of removing the pathology. Currently, these decisions are based on the experience of the surgeon. The primary objective of this paper is to demonstrate how a mathematical model can be used to evaluate the different patient positioning for tumor resection therapies. Specifically, therapies involving gravity-induced shift are used to demonstrate how a series of candidate approaches to the tumor can result in significantly different deformation behavior of brain tissue. To quantitatively assess the advantages and disadvantages of potential approaches, three different midline tumor locations were used to evaluate for the extent of tumor exposure and the magnitude of tensile stress at the brain-tumor interface, both of which are reliable indicators of the ease of resection. Preliminary results indicate that the lateral decubitus position is best suited for midline tumors.

  12. Is any surgical procedure ideal for chronic pancreatitis?

    PubMed

    Wani, Nazir A; Parray, Fazl Q; Wani, Mehmood A

    2007-02-01

    Chronic pancreatitis continues to be a major therapeutic challenge for all pancreatic surgeons. This article is written with a purpose to review various surgical procedures developed from time to time for the relief of pain in these patients. Since no single procedure can be labeled as "ideal" because of the problems of the inability to address the whole pathology at the initial procedure, failure or recurrence of the pain; most of the pancreatic and practicing surgeons may benefit from knowledge of the various procedures being performed, even though the personal experience of the surgeon most of the time ultimately dictates the final choice of the procedure for the patient.

  13. [Surgical procedures improvements thanks to navigators and robots].

    PubMed

    Chouard, Claude-Henri; Dubois, François

    2002-01-01

    Navigator is a three-dimensional C-T scan image localization device, which supplies the surgeon with a real time relationship of surgical instruments with pathological lesion and vital organs. Robot controls surgical devices movements according to a various sophisticated programming, in order to palliate the imperfection of their manual use. Navigators and robots, frequently connected, allow a precise control of the instruments course, improving accuracy and efficiency of most surgical procedures. It is necessary to contribute to their improvement and development, taking in count the economic, ethic and legal problems which may be encountered.

  14. 42 CFR 416.65 - Covered surgical procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... performed in an ASC; (2) Are not of a type that are commonly performed, or that may be safely performed, in... minutes or less duration. (3) Covered surgical procedures may not be of a type that— (i) Generally result in extensive blood loss; (ii) Require major or prolonged invasion of body cavities; (iii)...

  15. 42 CFR 416.65 - Covered surgical procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., but may be safely performed in an ASC; (2) Are not of a type that are commonly performed, or that may...) General anesthesia of 90 minutes or less duration. (3) Covered surgical procedures may not be of a type that— (i) Generally result in extensive blood loss; (ii) Require major or prolonged invasion of...

  16. 42 CFR 416.65 - Covered surgical procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... performed in an ASC; (2) Are not of a type that are commonly performed, or that may be safely performed, in... minutes or less duration. (3) Covered surgical procedures may not be of a type that— (i) Generally result in extensive blood loss; (ii) Require major or prolonged invasion of body cavities; (iii)...

  17. Radiation exposure from fluoroscopy during orthopedic surgical procedures

    SciTech Connect

    Riley, S.A. )

    1989-11-01

    The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of this study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.

  18. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    PubMed

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  19. Suppression of Surgeons' Bacterial Hand Flora during Surgical Procedures with a New Antimicrobial Surgical Glove

    PubMed Central

    Kramer, Axel; Ouriel, Kenneth; Suchomel, Miranda; McLaws, Mary-Louise; Rottman, Martin; Leaper, David; Assadian, Afshin

    2014-01-01

    Abstract Background: Perforations of surgical gloves are common and increase with the duration of glove wear. Skin flora, re-grown after pre-operative disinfection of the hands, may contaminate a surgical site. An antimicrobial surgical glove with chlorhexidine on its inner surface has been developed. We hypothesized that by suppressing the re-growth of skin flora during the complete course of a surgical procedure, antimicrobial gloves may reduce the risk of surgical site contamination in the event of an intra-operative glove breach. Methods: We conducted a randomized, double-blind, single-center trial, to measure any differences in the bacterial skin populations of surgeons' hands during surgical procedures done with antimicrobial and non-antimicrobial surgical gloves [ISRCTN71391952]. In this study, 25 pairs of gloves were retrieved from 14 surgeons who donned them randomly on their dominant or non-dominant hand. The number of bacteria retrieved from glove fluid was measured and expressed as colony forming units (CFU)/mL. Results: The median cfu/mL of antimicrobial gloves was 0.00 (LQ: 0.00 CFU/mL; UQ: 0.00 cfu/mL), with a mean log10 cfu/mL=0.02 (range: 0.00–0.30). The median CFU/mL of non-antimicrobial gloves was 54.00 (LQ: 3.00 cfu/mL; UQ: 100.00 cfu/mL) with a mean log10 CFU/mL=1.32 (range: 0.00–2.39). After a mean operating time of 112 min, the difference in the log10 CFU/mL was 1.30 (p<0.001). Conclusions: A new antimicrobial surgical glove suppressed surgeons' hand flora during operative procedures. In the event of a glove breach, the use of such a glove may have the potential to prevent bacterial contamination of a sterile surgical site, thereby decreasing the risk of surgical site infection (SSI) and increasing patient safety. Further clinical studies are needed to confirm this concept. PMID:24116857

  20. SPRENGEL'S DEFORMITY: SURGICAL CORRECTION BY A MODIFIED GREEN PROCEDURE

    PubMed Central

    da Silva Reginaldo, Sandro; de Macedo, Ruy Rocha; de Andrade Amaral, Rogério; Cardoso, André Luiz Passos; Araújo, Helder Rocha Silva; Daher, Sergio

    2015-01-01

    Objective: To evaluate the cosmetic and functional results of patients submitted to surgical correction of Congenital High Scapula (Sprengel's Deformity) using modified Green's Procedure, as well as patients' satisfaction and complications. Methods: Nine patients submitted to surgical treatment from September 1993 to April 2008 have been assessed. The modification from original technique was: subperiosteal muscle detachment, resection of superomedial scapular portion and fixation of medial portion of scapular spine to contralateral posterior iliac crest instead of skeletal traction, with subcutaneous wire. The mean age was 7 years and 3 months. The mean follow-up time was 3 years and 7 months. Results: The mean improvement in forward elevation was 39o (range 0 to 80o). According to the Cavendish Classification, cosmetic improvement of two degrees was achieved in eight cases, and three degrees in one. All patients were satisfied with results. Conclusions: Surgical correction of Sprengel's Deformity by a modified Green's procedure with contralateral posterior iliac crest fixation instead of skeletal traction, showed both cosmetic and functional improvements; all patients and/or family members were satisfied with the results, and the complications associated to the surgical technique did not interfere on end results. PMID:27004174

  1. Acute skin lesions after surgical procedures: a clinical approach.

    PubMed

    Borrego, L

    2013-11-01

    In the hospital setting, dermatologists are often required to evaluate inflammatory skin lesions arising during surgical procedures performed in other departments. These lesions can be of physical or chemical origin. Povidone iodine is the most common reported cause of such lesions. If this antiseptic solution remains in contact with the skin in liquid form for a long period of time, it can give rise to serious irritant contact dermatitis in dependent or occluded areas. Less common causes of skin lesions after surgery include allergic contact dermatitis and burns under the dispersive electrode of the electrosurgical device. Most skin lesions that arise during surgical procedures are due to an incorrect application of antiseptic solutions. Special care must therefore be taken during the use of these solutions and, in particular, they should be allowed to dry.

  2. Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study

    PubMed Central

    Cota, Luís Otávio Miranda; Cyrino, Renata Magalhães; Lages, Eugênio José Pereira

    2015-01-01

    Background and Objective Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT. Materials and Methods A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression. Results Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT. Conclusions Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures. PMID:26496187

  3. Alterations in respiratory mechanics after laparoscopic and open surgical procedures

    PubMed Central

    Kimberley, Nicholas A.; Kirkpatrick, Susan M.; Watters, James M.

    1996-01-01

    Objective To compare the effects of laparoscopic and open surgical procedures on postoperative strength and respiratory mechanics. Design Prospective cohort study. Setting Adult university hospital. Participants Fifty-one women aged 21 to 62 years scheduled to undergo elective cholecystectomy or hysterectomy (or related procedures), otherwise in good health. Intervention Open or laparoscopic cholecystectomy or hysterectomy (or related procedures). Main Outcome Measures Maximum voluntary handgrip strength (HGS), forced vital capacity (VC), forced expiratory volume in 1 second (FEV1), and maximal inspiratory pressure (MIP) were each measured preoperatively and on the first postoperative morning. A visual analogue pain scale score was evaluated in relation to performance of the postoperative strength and respiratory measurements. Results VC, FEV1 and MIP, but not HGS, were decreased after surgery. Postoperative VC, FEV1 and MIP were lower after open procedures than after laparoscopic procedures and after cholecystectomy than after hysterectomy (all p < 0.001). Pain scores were lower after laparoscopic than after open procedures (p < 0.005) and could account in part for differences in postoperative respiratory mechanics. Conclusions Cholecystectomy and hysterectomy do not result in generalized muscle weakness, unlike more major abdominal procedures. Postoperative alterations in respiratory mechanics are related to the site of the surgery, the use of an open versus a laparoscopic approach and postoperative pain. PMID:8697322

  4. Aesthetic satisfaction scoring - introducing an aesthetic numeric analogue scale (ANA-scale).

    PubMed

    Funk, Wolfgang; Podmelle, Fred; Guiol, Claudia; Metelmann, Hans Robert

    2012-07-01

    To objectively and reproducibly assess the outcome of aesthetic procedures remains one of the major, unmet challenges in maxillo-facial and plastic surgery. Frequently employed scoring systems for the evaluation of aesthetic procedures are confounded by observer bias, be it that of the patient or of the surgeon. A new approach of pragmatic and simple scoring is the ANA [Aesthetic Numeric Analogue] scale, which facilitates the objective, reproducible, standardized and internationally uniform evaluation of aesthetic procedure outcome by converting all ratings for any kind of aesthetic procedures from a subjective value to an objective figure. The intention of the ANA-scale is to relate aesthetic satisfaction from wording to figures and by this create a rating system. The study is arranging matching pairs of verbal description and figures to finally queue up generating a scale. The clinical feasibility of this rating system is demonstrated in a surgical case. As a detail of the results the influence of the viewer's age to the aesthetic benefit assessment is obvious. In summary the ANA-scale looks to be a tool useful in individual treatment protocols as well as analysis of different techniques of aesthetic surgery for rating of the pure aesthetic satisfaction of the patients.

  5. Laparoscopic tube-preserving surgical procedures for ectopic tubal pregnancy

    PubMed Central

    Lee, Dong Hee; Kim, Hwa Cheung; Seong, Seok Ju

    2016-01-01

    Objective To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. Methods This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates. Results Of the 57 surgical procedures, 55 (96.4%) were performed successfully without any additional intervention. The number of patients receiving salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking were 24 (42.1%), 25 (43.9%), 4 (7.0%), and 2 (3.5%), respectively. Two case was switched to salpingectomy because excessive bipolar coagulation was required to obtain hemostasis at the tubal bleeding bed. Over a mean β-human chorionic gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15). Conclusion Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical procedures is not the treatment success, some caution is warranted in interpreting results of this study. PMID:27896254

  6. Nitrousoxide as a conscious sedative in minor oral surgical procedure

    PubMed Central

    Mohan, Rakesh; Asir, Vigil Dev; Shanmugapriyan; Ebenezr, Vijay; Dakir, Abu; Balakrishnan; Jacob, Jeffin

    2015-01-01

    Nitrous oxide (N2O) is the most commonly used inhalation anesthetic in dentistry and is commonly used in emergency centers and ambulatory surgery centers as well. When used alone, it is incapable of producing general anesthesia reliably. However, as a single agent, it has an impressive safety and is excellent for providing minimal and moderate sedation for apprehensive minor oral surgical procedure. In this article, action of N2O in overcoming the anxiety and pain of the patient during the minor oral surgery and its advantages and disadvantages, have been reviewed. PMID:26015724

  7. [Mammary prosthesis: considerations about a choreography of the surgical procedure].

    PubMed

    Grolleau, J-L; Gangloff, D; Garrido, I; Chavoin, J-P

    2005-10-01

    Breast augmentation offers a high rate of satisfaction but the local complications remain frequent. These are mainly capsular contracture, malpositions of implant, acute or infraclinical infections. The causes of these complications are multifactorials. The goal of this chapter is to determine the effect of the surgical technique on the result. We think that if no routine procedure can be proposed, a reflexion on the objectives of the breast augmentation and the adaptation of the surgical technique is necessary for each surgeon. We identify twelve aims and discuss them: rigorous preoperative planning, determination of the position of the implant, creation of an adapted implant pocket, as much atraumatic as possible dissection, no bacterial contamination, no foreign particles, respect of the implant, drainage or not, efficient suture, pain and discomfort control, need for contension and clear postoperative advices. These objectives being precised, we integrate them in a chronological surgical process under the form of questions. Each surgeon can then choose his answers by evaluating the arguments, which led to his choices.

  8. Pressure ulcer prevalence and risk factors during prolonged surgical procedures.

    PubMed

    Primiano, Mike; Friend, Michael; McClure, Connie; Nardi, Scott; Fix, Lisa; Schafer, Marianne; Savochka, Kathlyn; McNett, Molly

    2011-12-01

    Pressure ulcer formation related to positioning while in the OR increases the length of hospital stay and hospital costs, but there is little evidence documenting how positioning devices used in the OR influence pressure ulcer development when examined with traditional risk factors. The aim of this prospective cohort study was to identify the prevalence of and risk factors associated with pressure ulcer development among patients undergoing surgical procedures lasting longer than three hours. Participants included all adult same-day admission patients scheduled for a three-hour surgical procedure during an eight-month period (N = 258). Data were gathered preoperatively, intraoperatively, and postoperatively on pressure ulcer risk factors. Bivariate analyses indicated that the type of positioning (ie, heels elevated) (χ(2) = 7.897, P = .048), OR bed surface (ie, foam table pad) (χ(2) = 15.848, P = .000), skin assessment in the postanesthesia care unit (χ(2) = 41.652, P = .000), and male gender (χ(2) = 6.984, P = .030) were associated with pressure ulcer development. Logistic regression analyses indicated that the use of a foam pad (β = 2.691, P = .024) and a lower day-one Braden score (β = .244, P = .003) were predictive of pressure ulcers.

  9. Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures

    PubMed Central

    Kim, Won-Serk; Ohshiro, Toshio; Trelles, Mario A; Vasily, David B

    2015-01-01

    Background: Aggressive, or even minimally aggressive, aesthetic interventions are almost inevitably followed by such events as discomfort, erythema, edema and hematoma formation which could lengthen patient downtime and represent a major problem to the surgeon. Recently, low level light therapy with light-emitting diodes (LED-LLLT) at 830 nm has attracted attention in wound healing indications for its anti-inflammatory effects and control of erythema, edema and bruising. Rationale: The wavelength of 830 nm offers deep penetration into living biological tissue, including bone. A new-generation of 830 nm LEDs, based on those developed in the NASA Space Medicine Laboratory, has enabled the construction of planar array-based LED-LLLT systems with clinically useful irradiances. Irradiation with 830 nm energy has been shown in vitro and in vivo to increase the action potential of epidermal and dermal cells significantly. The response of the inflammatory stage cells is enhanced both in terms of function and trophic factor release, and fibroblasts demonstrate superior collagenesis and elastinogenesis. Conclusions: A growing body of clinical evidence is showing that applying 830 nm LED-LLLT as soon as possible post-procedure, both invasive and noninvasive, successfully hastens the resolution of sequelae associated with patient downtime in addition to significantly speeding up frank wound healing. This article reviews that evidence, and attempts to show that 830 nm LED-LLLT delivers swift resolution of postoperative sequelae, minimizes downtime and enhances patient satisfaction. PMID:26877592

  10. Examining Noncardiac Surgical Procedures in Patients on Extracorporeal Membrane Oxygenation.

    PubMed

    Taghavi, Sharven; Jayarajan, Senthil N; Mangi, Abeel A; Hollenbach, Kathryn; Dauer, Elizabeth; Sjoholm, Lars O; Pathak, Abhijit; Santora, Thomas A; Goldberg, Amy J; Rappold, Joseph F

    2015-01-01

    As extracorporeal membrane oxygenation (ECMO) is increasingly used for patients with cardiac and/or pulmonary failure, the need for noncardiac surgical procedures (NCSPs) in these patients will continue to increase. This study examined the NCSP required in patients supported with ECMO and determined which variables affect outcomes. The National Inpatient Sample Database was examined for patients supported with ECMO from 2007 to 2010. There were 563 patients requiring ECMO during the study period. Of these, 269 (47.8%) required 380 NCSPs. There were 149 (39.2%) general surgical procedures, with abdominal exploration/bowel resection (18.2%) being most common. Vascular (29.5%) and thoracic procedures (23.4%) were also common. Patients requiring NCSP had longer median length of stay (15.5 vs. 9.2 days, p = 0.001), more wound infections (7.4% vs. 3.7%, p = 0.02), and more bleeding complications (27.9% vs. 17.3%, p = 0.01). The incidences of other complications and inpatient mortality (54.3% vs. 58.2%, p = 0.54) were similar. On logistic regression, the requirement of NCSPs was not associated with mortality (odds ratio [OR]: 0.91, 95% confidence interval [CI]: 0.68-1.23, p = 0.17). However, requirement of blood transfusion was associated with mortality (OR: 1.70, 95% CI: 1.06-2.74, p = 0.03). Although NCSPs in patients supported with ECMO does not increase mortality, it results in increased morbidity and longer hospital stay.

  11. Small Mammals: Common Surgical Procedures of Rodents, Ferrets, Hedgehogs, and Sugar Gliders.

    PubMed

    Miwa, Yasutsugu; Sladky, Kurt K

    2016-01-01

    Small mammal surgical procedures are a part of clinical veterinary practice and are performed with regularity. Anesthetic and analgesic techniques are important components of any successful small mammal surgical procedure. Many basic surgical principles used in dogs and cats can be directly applied to small mammals, but tissues tend to be smaller and thinner, and hemostasis is critical with small patients due to risk of death with minimal blood loss. Common surgical procedures in small mammals include integumentary mass and abscess excision, reproductive procedures, gastrointestinal foreign body removal, urolith removal, prolapsed tissues associated with the gastrointestinal tract, intra-abdominal mass excision, and hepatic surgery.

  12. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    PubMed Central

    Ioannou, Andreas L.; Kotsakis, Georgios A.; McHale, Michelle G.; Lareau, Donald E.; Hinrichs, James E.; Romanos, Georgios E.

    2015-01-01

    Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon's rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth. PMID:26124837

  13. Aesthetic Experience and Aesthetic Analysis

    ERIC Educational Resources Information Center

    Fenner, David E. W.

    2003-01-01

    The "raw data" that aesthetics is meant to explain is the aesthetic experience. People have experiences that they class off from other experiences and label, as a class, the aesthetic ones. Aesthetic experience is basic, and all other things aesthetic--aesthetic properties, aesthetic objects, aesthetic attitudes--are secondary in their importance…

  14. The stream of experience when watching artistic movies. Dynamic aesthetic effects revealed by the Continuous Evaluation Procedure (CEP)

    PubMed Central

    Muth, Claudia; Raab, Marius H.; Carbon, Claus-Christian

    2015-01-01

    Research in perception and appreciation is often focused on snapshots, stills of experience. Static approaches allow for multidimensional assessment, but are unable to catch the crucial dynamics of affective and perceptual processes; for instance, aesthetic phenomena such as the “Aesthetic-Aha” (the increase in liking after the sudden detection of Gestalt), effects of expectation, or Berlyne's idea that “disorientation” with a “promise of success” elicits interest. We conducted empirical studies on indeterminate artistic movies depicting the evolution and metamorphosis of Gestalt and investigated (i) the effects of sudden perceptual insights on liking; that is, “Aesthetic Aha”-effects, (ii) the dynamics of interest before moments of insight, and (iii) the dynamics of complexity before and after moments of insight. Via the so-called Continuous Evaluation Procedure (CEP) enabling analogous evaluation in a continuous way, participants assessed the material on two aesthetic dimensions blockwise either in a gallery or a laboratory. The material's inherent dynamics were described via assessments of liking, interest, determinacy, and surprise along with a computational analysis on the variable complexity. We identified moments of insight as peaks in determinacy and surprise. Statistically significant changes in liking and interest demonstrated that: (i) insights increase liking, (ii) interest already increases 1500 ms before such moments of insight, supporting the idea that it is evoked by an expectation of understanding, and (iii) insights occur during increasing complexity. We propose a preliminary model of dynamics in liking and interest with regard to complexity and perceptual insight and discuss descriptions of participants' experiences of insight. Our results point to the importance of systematic analyses of dynamics in art perception and appreciation. PMID:25873907

  15. A study on total intravenous anesthesia in orthognathic surgical procedures

    PubMed Central

    Vasundhar, P. L.; Sadhasivam, Gokkulakrishnan; Bhushan, Satya; Kalyan, Siva; Chiang, Kho Chai

    2016-01-01

    Aims and Objective: To assess the use of propofol for induction and maintenance of anaesthesia among patients undergoing various combinations of orthognathic surgical procedures. Materials and Methods: Following Preoperative evaluation, patients were given Fentanyl (2 micrograms/kg) intravenously. Induction (2 mg/kg) and maintenance (10 mg/kg/hr) of anaesthesia was achieved by Propofol infusion. Blood Pressure and heart rate were maintained at >70 or 80 mm Hg and >50 respectively and were monitored continuously. Infusion was stopped approximately 30 to 40 minutes before the end of surgery. Immediate recovery recorded and was assessed. Results: The average duration of anaesthesia and surgery were found to be 4 hrs 28 min (SD= 1 hr. 35 min) and 4 hrs 3 min (SD=1 hr 38 min). None of the patients experienced pain on injection of induction agent. No significant change was observed in the mean heart rate and mean BP at different time intervals from baseline value to 30 minutes after the recovery. The average time taken to obey simple commands after stopping Propofol infusion was 42.60 ± 9.09 min. Time taken for spontaneous eye opening, full orientation and to count backwards was 43.45 ± 9.11, 47.85 ± 8.18 and 50.9 ± 9.14 respectively. Face-Hand test performed at 15 min after extubation was positive in all the patients. The mean Aldrete score at 15 min after extubation was 11.65 ± 0.75. The mean value of unaided sitting time for at least 2 min was after 119.00 ± 20.56 min. The average score of picture card test, time taken in “picking up matches” test, Ball bearing test, time taken to walk and to void urine were 5.80 ± 1.47, 67.95 ± 5.72, 9.80 ± 2.57, 172.75 ± 39.25 and 163.75 ± 55.96 respectively. Ninety percent of the patients were amenable for a repeat of this anaesthetic using the same regime but 10% of them did not answer anything. Seven patients (35%) had chills post-operatively. Conclusion: Propofol is an excellent anaesthetic for day care procedures

  16. 42 CFR 416.166 - Covered surgical procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....166 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Prospective Payment System for ASC Services Furnished on or After January 1, 2008 § 416.166 Covered surgical... prolonged invasion of body cavities; (3) Directly involve major blood vessels; (4) Are generally emergent...

  17. 42 CFR 416.166 - Covered surgical procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....166 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Payment System for ASC Services Furnished on or After January 1, 2008 § 416.166 Covered surgical...) Generally result in extensive blood loss; (2) Require major or prolonged invasion of body cavities;...

  18. Catheter for Cleaning Surgical Optics During Surgical Procedures: A Possible Solution for Residue Buildup and Fogging in Video Surgery.

    PubMed

    de Abreu, Igor Renato Louro Bruno; Abrão, Fernando Conrado; Silva, Alessandra Rodrigues; Corrêa, Larissa Teresa Cirera; Younes, Riad Nain

    2015-05-01

    Currently, there is a tendency to perform surgical procedures via laparoscopic or thoracoscopic access. However, even with the impressive technological advancement in surgical materials, such as improvement in quality of monitors, light sources, and optical fibers, surgeons have to face simple problems that can greatly hinder surgery by video. One is the formation of "fog" or residue buildup on the lens, causing decreased visibility. Intracavitary techniques for cleaning surgical optics and preventing fog formation have been described; however, some of these techniques employ the use of expensive and complex devices designed solely for this purpose. Moreover, these techniques allow the cleaning of surgical optics when they becomes dirty, which does not prevent the accumulation of residue in the optics. To solve this problem we have designed a device that allows cleaning the optics with no surgical stops and prevents the fogging and residue accumulation. The objective of this study is to evaluate through experimental testing the effectiveness of a simple device that prevents the accumulation of residue and fogging of optics used in surgical procedures performed through thoracoscopic or laparoscopic access. Ex-vivo experiments were performed simulating the conditions of residue presence in surgical optics during a video surgery. The experiment consists in immersing the optics and catheter set connected to the IV line with crystalloid solution in three types of materials: blood, blood plus fat solution, and 200 mL of distilled water and 1 vial of methylene blue. The optics coupled to the device were immersed in 200 mL of each type of residue, repeating each immersion 10 times for each distinct residue for both thirty and zero degrees optics, totaling 420 experiments. A success rate of 98.1% was observed after the experiments, in these cases the device was able to clean and prevent the residue accumulation in the optics.

  19. U.S. survey of surgical capabilities and experience with surgical procedures in patients with congenital haemophilia with inhibitors.

    PubMed

    Shapiro, A; Cooper, D L

    2012-05-01

    General guidelines exist for the use of recombinant activated factor VII (rFVIIa) to maintain haemostasis during surgery in congenital haemophilia A and B patients with high responding inhibitors (CHwI). Individual surgical plans are required and based upon historical therapy response, adverse events and anticipated procedure. Surgical interventions are feasible, yet it remains unclear how many US hemophilia treatment centres (HTCs) perform procedures in this fragile population. To better understand the US HTC surgical experience in CHwI patients and the number/types of procedures performed, a 21-question survey was sent to 133 US HTCs, with follow-up for response clarification and to non-responders. 98/133 HTCs (74%) responded, with 87 currently treating CHwI patients. In the last decade, 76/85 HTCs performed 994 surgeries on CHwI patients. Sites were experienced in the following procedures: central line insertion/removal (73 HTCs), dental (58), orthopaedic (52), abdominal (23), cardiovascular (14) and otolaryngologic (11). Experience with orthopaedic surgeries included synovectomies - arthroscopic (23 HTCs), radioisotopic (22), and open (7); joint replacement (18); fracture repair (14); and arthrodesis (8). Treatment modalities included rFVIIa bolus (83 HTCs) or continuous infusions (9), plasma-derived activated prothrombin complex concentrate (pd-aPCC) (55), antifibrinolytics (51), topical haemostatic agents (29), factor VIII (16) and fibrin sealants (14). Protocols for bypassing agents were used by 31/92 (33%) HTCs. Most US HTCs surveyed care for CHwI patients (74%) and have experience in minor surgery; fewer HTCs reported complex orthopaedic surgical experience. Identification of best practices and surgical barriers is required to guide future initiatives to support these patients.

  20. Troiage Aesthetics

    NASA Astrophysics Data System (ADS)

    Brown, Sheldon

    As the world around us is transformed into digitally enabled forms and processes, aesthetic strategies are required that articulate this underlying condition. A method for doing so involves a formal and conceptual strategy that is derived from collage, montage and assemblage. This triple "age" is termed "troiage", and it uses a style of computational apparency which articulates the edges of our current representational forms and processes as the semantic elements of culture. Each of these component aesthetics has previously had an important effect upon different areas of contemporary art and culture. Collage in painting, montage in film, assemblage in sculpture and architecture, are recombined via algorithmic methods, forefronting the structure of the algorithmic itself. The dynamic of the aesthetic is put into play by examining binary relationships such as: nature/culture, personal/public, U.S/Mexico, freedom/coercion, mediation/experience, etc. Through this process, the pervasiveness of common algorithmic approaches across cultural and social operations is revealed. This aesthetic is used in the project "The Scalable City" in which a virtual urban landscape is created by users interacting with data taken from the physical world in the form of different photographic techniques. This data is transformed by algorithmic methods which have previously been unfamiliar to the types of data that they are utilizing. The Scalable City project creates works across many media; such as prints, procedural animations, digital cinema and interactive 3D computer graphic installations.

  1. Surgical Treatment of Canine Glaucoma: Filtering and End-Stage Glaucoma Procedures.

    PubMed

    Maggio, Federica; Bras, Dineli

    2015-11-01

    Canine glaucoma is a common cause of vision loss associated with raised intraocular pressure, and leads to damage of the retina and optic nerve head. In most cases, medical treatment alone cannot provide long-term management of intraocular pressure control and preservation of vision. Surgical intervention is usually recommended to either decrease aqueous humor production, or increase its outflow. Among the current available procedures, filtering techniques are aimed at increasing aqueous humor outflow. Proper surgical timing and a combination of cyclodestructive and filtering procedures have been recently suggested to improve the long-term success of surgical treatment in dogs. Bleb fibrosis and surgical failure are still common occurrences in filtration surgery with relapse of glaucoma and vision loss. End stage procedures, such as enucleation, evisceration with intrascleral prosthesis, and chemical ablation of the ciliary bodies are then recommended to address chronic discomfort in buphthalmic and blind eyes.

  2. Surgical procedure logging with use of a hand-held computer

    PubMed Central

    Fischer, Sandra; Lapinsky, Stephen E.; Weshler, Jason; Howard, Frazer; Rotstein, Lorne E.; Cohen, Zane; Stewart, Thomas E.

    2002-01-01

    Objective To evaluate the feasibility of incorporating hand-held computing technology in a surgical residency program, by means of hand-held devices for surgical procedure logging linked through the Internet to a central database. Setting Division of General Surgery, University of Toronto. Design A survey of general surgery residents. Methods The 69 residents in the general surgery training program received hand-held computers with preinstalled medical programs and a program designed for surgical procedure logging. Procedural data were uploaded via the Internet to a central database. Survey data were collected regarding previous computer use as well as previous procedure logging methods. Main outcome measure Utilization of the procedure logging system. Results After a 5-month pilot period, 38% of surgical residents were using the procedure-logging program successfully and on a regular basis. Program use was higher among more junior trainees. Analysis of the database provided valuable information on individual trainees, hospital programs and supervising surgeons, data that would assist in program development. Conclusions Hand-held devices can be implemented in a large division of general surgery to provide a reference database and a procedure-logging platform. However, user acceptance is not uniform and continued training and support are necessary to increase acceptance. The procedure database provides important information for optimizing trainees’ educational experience. PMID:12387537

  3. The Sauvé-Kapandji procedure: indications and tips for surgical success.

    PubMed

    Lluch, Alberto

    2010-11-01

    Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, with the main disadvantage of loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji procedure. This procedure is not void of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these can be prevented if a careful surgical technique is used.

  4. Use of Articaine in loco-regional anesthesia for day care surgical procedures

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Jindal, Ravi

    2012-01-01

    The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures. PMID:23225921

  5. [Bladder drainage in patients undergoing the Pereyra surgical procedure].

    PubMed

    Rodríguez-Colorado, S; Villagrán, R; Escobar-Del Barco, L; Villalobos-Acosta, S; Kunhardt-Rasch, J; Delgado-Urdapilleta, J

    1996-07-01

    Postoperative acute urinary retention was evaluated in the patients who underwent Pereyra procedure. Comparison of suprapubic and urethral catheterization. Between January 1994 and July 1995, fifty two patients with urinary stress incontinence underwent Pereyra procedure, 31 female patient with suprapubic drainage (cistofix Ch 15) and 17 urethral catherization with a latex foley catheter. Sponatneous micturition and urinary retention was evaluated until the catheter was removed. Mean age was 43.8 years (32 a 66), the duration of suprapubic vesical drainage with suprapubic catheter were 3 days in 58.6% of the patients, and more than 3 days in 41.29%. Recatheterizacion in the patients with urethral drainage was more frequent. Urinary retention after 7 days was present in 23.99% with suprapubic vesical drainage and 28.5% with urethral catheter. Recatheterization is more frequent in patients with urethral catheter.

  6. [Laparoscopic cholecystectomy--1,000 procedures in a surgical department].

    PubMed

    Freund, U; Mayo, A; Schwartz, I; Neufeld, D; Paran, H

    2000-11-01

    The first 1,000 laparoscopic cholecystectomies performed in our department were reviewed. There was no operative mortality; conversion to open cholecystectomy was necessary in 2%. In the last 600 cases the rate of conversion had decreased to 0.5%. There was common bile duct injury in 0.3%, with the injuries identified during primary surgery. This clinical experience is consistent with previous studies, which proved that laparoscopic cholecystectomy is safe and should replace open operation as the procedure of choice.

  7. Temporalis muscle hypertrophy: a new plastic surgery procedure.

    PubMed

    Morselli, P G

    2000-10-01

    Bilateral hypertrophy of the temporal muscle can give the impression of a harsh facial appearance that manifests itself as a morphopsychological conflict for the subject involved (Minotaur syndrome). This article describes a new facial aesthetic surgical procedure in the area of the temporal muscle. The author describes the surgical technique and the surgical instrument that he developed specifically for performing aesthetic contouring of the temporal area by reducing the muscle volume discrepancy ("myosuction"). The follow-up results of 11 cases demonstrated that this procedure renders valid results in the overall aesthetic reharmonization of the face and an improvement of individual psychological well-being.

  8. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure.

    PubMed

    Ganji, Kiran Kumar; Patil, Veena Ashok; John, Jiji

    2012-01-01

    Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student "t" Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  9. [Safety and accuracy of surgical procedures: case law evolution].

    PubMed

    Rougé-Maillart, C; Gaudin, A; Lermite, E; Arnaud, J-P; Penneau, M

    2008-01-01

    Surgeons, like other doctors, practice their profession within a framework of contractual liability defined by statute in 1936. This established that the doctor was subject to a contractual obligation to provide appropriate and diligent care. Care and technical acts should conform to those which would have been provided by a prudent doctor within the standards of knowledge and practice of his field; care which deviates from this standard would be considered medical error or fault. This standard of care is referred to as "sound professional conduct". However, while not calling this basic principle into question, civil jurisdictions have progressively held surgeons liable whenever injury has occurred following surgical acts, without considering whether care deviates from sound professional conduct. Since 2000, judges have begun to attribute a requirement for absolute safety of results in cases where the surgeon had injured an organ unrelated to the planned operation. However it seems that the rare judgments given on this topic in the last 2-3 years have become less frequent. The creation of a compensation regime for medical accidents, via the law dated March 4, 2002, has contributed to this evolution. It is to be hoped that the flaws described in this system do not encourage jurisdictions to reconsider previous case law decisions.

  10. [Web-based education: learning surgical procedures step-by-step with 3D visualization].

    PubMed

    van der Velde, Susanne; Maljers, Jaap; Wiggers, Theo

    2014-01-01

    There is a need for more uniform, structured education focused on surgical procedures. We offer a standardized, step-by-step, web-based procedural training method with which surgeons can train more interns efficiently. The basis of this learning method is formed by 3D films in which surgical procedures are performed in clearly defined steps and the anatomic structures behind the surgical operating planes are further dissected. This basis is supported by online modules in which, aside from the operation, preparation and postoperative care are also addressed. Registrars can test their knowledge with exams. Trainers can see what the registrars studied, how they scored and how they progressed with their clinical skills. With the online portfolio we offer building blocks for certification and accreditation. With this clearly structured research method of constant quality, registrars are less dependent on the local trainer. In addition, through better preparation, the operation capacity can be used more efficiently for the training.

  11. Prevalence of Neoplastic Diseases in Pet Birds Referred for Surgical Procedures

    PubMed Central

    Castro, Patrícia F.; Fantoni, Denise T.; Miranda, Bruna C.; Matera, Julia M.

    2016-01-01

    Neoplastic disease is common in pet birds, particularly in psittacines, and treatment should be primarily aimed at tumor eradication. Nineteen cases of pet birds submitted to diagnostic and/or therapeutic surgical procedures due to neoplastic disease characterized by the presence of visible masses were retrospectively analyzed; affected species, types of neoplasms and respective locations, and outcomes of surgical procedures were determined. All birds undergoing surgery belonged to the order Psittaciformes; the Blue-fronted parrot (Amazona aestiva) was the prevalent species. Lipoma was the most frequent neoplasm in the sample studied. Most neoplasms affected the integumentary system, particularly the pericloacal area. Tumor resection was the most common surgical procedure performed, with high resolution and low recurrence rates. PMID:26981315

  12. Distraction techniques for face and smile aesthetic preventing ageing decay

    PubMed Central

    Barbaro, Roberto; Troisi, Donato; D’Alessio, Giuseppe; Amato, Maurizio; Lo Giudice, Roberto; Paolo Claudio, Pier

    2016-01-01

    Abstract Modern concepts in the world of beauty arise from popular models, beautiful faces of actors document a bi-protrusive asset with high tension for soft tissues. Facial symmetry has been proposed as a marker of development and stability that may be important in human mate choice. For various traits any deviation from perfect symmetry can be considered a reflection of imperfect development. Additionally, bi-protrusive profile is dependent on the hormonal level regardless of male or female sex. The goal of maxillofacial surgery is to provide best results both for aesthetic and functional aspects. Following these new concepts of aesthetic of the face, new surgical procedure by osteodistraction techniques will lead to a very natural result by harmonizing the face also preventing aesthetic decay in aging faces. Ten cases with a feedback on the aesthetic results using the fivepoint scale of Likert after orthognatic surgery performed following distraction new techniques in combination with ancillary surgical procedures. The aesthetic results in all patients were highly satisfactory. All the patients accepted the new aesthetic of the face avoiding elements of discrepancy and consequently medico-legal problems. PMID:28352833

  13. Recession Vs Myotomy–Comparative Analysis of Two Surgical Procedures of Weakening Inferior Oblique Muscle Overaction

    PubMed Central

    Alajbegovic-Halimic, Jasmina; Zvizdic, Denisa; Sahbegovic-Holcner, Amra; Kulanic-Kuduzovic, Amira

    2015-01-01

    Introduction: Inferior oblique overaction (IOOA) can be primary or secondary, isolated or combined to other types of horizontal deviation, mostly with esotropias. Surgical weakening of IOOA means several techniques like; recession, myotomy, myectomy, anteroposition etc. Goals: we analyzed the effect of inferior oblique muscle surgical weakening comparing two groups of patients with primary hypertropia. Material and methods: In 5-years retrospective study, we observed 33 patients on which we did the surgical procedure of weakening inferior muscle overaction by two methods; recession and myotomy. Results: In total number of 33 patients, there were 57,6% male and 42,4% female patients with average age of 10,6±7,5 (in range of 4–36). There was 33,3% of isolated primary hypertropias, and 66,7% combined with esotropias. At 23 (69,9%) patients the recession surgical procedure was done, and with 10 (30,1%) myotomy. Better effect and binocularity was in 65,2% of patients in recession group which was statistically significant with significance level of p<0,0, χ2=5,705; p=0,021. Conclusion: Comparing of two surgical procedures of weakening inferior oblique muscles overaction, recession is better procedure than myotomy. PMID:26261384

  14. "Reality surgery"--a research ethics perspective on the live broadcast of surgical procedures.

    PubMed

    Williams, Judson B; Mathews, Robin; D'Amico, Thomas A

    2011-01-01

    In recent years, the live broadcasting of medical and surgical procedures has gained worldwide popularity. While the practice has appropriately been met with concerns for patient safety and privacy, many physicians tout the merits of real time viewing as a form of investigation, accelerating the process leading to adoption or abolition of newer techniques or technologies. This view introduces a new series of ethical considerations that need to be addressed. As such, this article considers, from a research ethics perspective, the use of live surgical procedure broadcast for investigative purposes.

  15. “Reality Surgery” — A Research Ethics Perspective on the Live Broadcast of Surgical Procedures

    PubMed Central

    Williams, Judson B.; Mathews, Robin; D'Amico, Thomas A.

    2013-01-01

    In recent years, the live broadcasting of medical and surgical procedures has gained worldwide popularity. While the practice has appropriately been met with concerns for patient safety and privacy, many physicians tout the merits of real time viewing as a form of investigation, accelerating the process leading to adoption or abolition of newer techniques or technologies. This view introduces a new series of ethical considerations that need to be addressed. As such, this article considers, from a research ethics perspective, the use of live surgical procedure broadcast for investigative purposes. PMID:21292217

  16. Towards robotic heart surgery: introduction of autonomous procedures into an experimental surgical telemanipulator system.

    PubMed

    Bauernschmitt, R; Schirmbeck, E U; Knoll, A; Mayer, H; Nagy, I; Wessel, N; Wildhirt, S M; Lange, R

    2005-09-01

    The introduction of telemanipulator systems into cardiac surgery enabled the heart surgeon to perform minimally invasive procedures with high precision and stereoscopic view. For further improvement and especially for inclusion of autonomous action sequences, implementation of force-feedback is necessary. The aim of our study was to provide a robotic scenario giving the surgeon an impression very similar to open procedures (high immersion) and to enable autonomous surgical knot tying with delicate suture material. In this experimental set-up the feasibility of autonomous surgical knot tying is demonstrated for the first time using stereoscopic view and force feedback.

  17. Endoscopic goniotomy: a potential surgical procedure for primary infantile glaucoma

    NASA Astrophysics Data System (ADS)

    Joos, Karen M.; Alward, Wallace L. M.; Folberg, Robert

    1993-06-01

    Goniotomy is an effective treatment for primary infantile glaucoma. Unlike trabeculotomy, goniotomy facilitates the visualization of the trabecular meshwork and does not disturb the conjunctiva. Because a cloudy cornea may prevent a clear view of the anterior chamber angle through the operating microscope, we investigated whether an endoscope would improve visualization during goniotomy in pig cadaver eyes. We deepened the anterior chamber of each pig eye with viscoelastic material. A modified 23-gauge needle attached to an Olympus 0.8 mm diameter flexible fiberoptic endoscope entered the anterior chamber through a 3 mm limbal incision. The angle was clearly seen on a videoscreen as the needle approached and incised the trabecular pillars for 120 degree(s); the iris immediately fell back. Following the procedure, the eyes were fixed in formalin and sectioned for light microscopy, or fixed in 2% glutaraldehyde for scanning electron microscopy. Trabecular pillars were present from the iris root to Schwalbe's line in the untreated region of the anterior chamber angle. The treated area demonstrated incision of the trabecular pillars with opening of the underlying trabecular meshwork.

  18. A new approach to aesthetic maxillofacial surgery: surgical treatment of unilateral exophthalmos due to maxillary sinus mucocele.

    PubMed

    Costan, Victor Vlad; Popescu, Eugenia; Stratulat, Sorin Ioan

    2013-05-01

    Maxillary sinus mucocele, known as a rare condition, can cause major therapeutic difficulties, especially when it invades the orbit leading to exophthalmia. Treatment is very difficult because the eye globe has to be repositioned, and the facial symmetry needs to be reconstructed as a result of malar bone invasion. This article reports the case of a 54-year-old patient with unilateral exophthalmia caused by the evolution of a maxillary mucocele that extended toward the orbit after destroying the malar bone and the orbital floor. The treatment consisted of a 1-step restoration of both the orbit floor and the malar bone using a temporomandibular flap composed of 2 bone fragments. Lipostructure and a titanium mesh to reconstruct the calvarial defect were necessary to restore facial aesthetics after placing back the eye globe in its initial site. After surgery, the patient followed a complex rehabilitation program including massage kinesiotherapy and psychological consultation and support. These had an essential contribution to the successful final outcome in terms of psychological impact, functionality, and aesthetics.

  19. Technical procedures for implementation of aesthetics site studies, Deaf Smith County site, Texas: Environmental Field Program

    SciTech Connect

    Not Available

    1987-06-01

    This chapter introduces the purpose and scope of the visually affected areas determination, as well as definitions, interfaces, and concurrent data needs. This procedure provides a method for determining the extent of visibility of the project. This area is identified as the visually affected area, and becomes the area within which all visual analysis is conducted. The visually affected area analysis of the Deaf Smith County site will involve identifying and mapping the visibility of all major proposed project features. Baseline analysis will be conducted within the overall visually affected area; impact assessment will be conducted within the visually affected area of each major project feature. This procedure presents the guidelines for determining the visually affected area will be in computer data base construction; viewshed modeling, and site visit and verification of results. Computer data base construction will involve digitizing topographic and project facility data from available data source. The extent of the visible area from each major project feature will then be plotted. Finally, these computer-generated visibility plots will be verified in the field.

  20. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures

    PubMed Central

    Souza, Juliana; Santos-Pinto, Lourdes; Pansani, Cyneu

    2014-01-01

    ABSTRACT Aim: This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children. How to cite this article: Paschoal M, Souza J, Santos-Pinto L, Pansani C. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures. Int J Clin Pediatr Dent 2014;7(2):125-129. PMID:25356012

  1. Hemopatch Application for Ventricular Wall Laceration in Redo Cardiac Surgical Procedures.

    PubMed

    Sandrio, Stany; Purbojo, Ariawan; Cesnjevar, Robert A; Rüffer, André

    2016-02-01

    As survival among patients with complex congenital heart disease continues to improve, long-term survivors frequently require redo surgical procedures, with potentially escalating technical difficulty and bleeding risk. This report describes our experience with a new hemostatic pad, Hemopatch (Baxter Deutschland GmbH, Unterschleissheim, Germany) in redo cardiac surgery.

  2. Partial fingertip necrosis following a digital surgical procedure in a patient with primary Raynaud's phenomenon.

    PubMed

    Uygur, Safak; Tuncer, Serhan

    2014-12-01

    Raynaud's phenomenon is a common clinical disorder consisting of recurrent, long-lasting and episodic vasospasm of the fingers and toes often associated with exposure to cold. In this article, we present a case of partial fingertip necrosis following digital surgical procedure in a patient with primary Raynaud's phenomenon.

  3. Television Aesthetics as Aesthetics.

    ERIC Educational Resources Information Center

    Burns, Gary

    In opposition to popular disparaging of television as an artistic medium, television can be considered as having its own aesthetics and can be placed in the category of fine arts (as opposed to folk arts). Television art can and should be distinguished from video art and film art in the ways in which it imitates reality; program content and…

  4. Improvements after mod Quad and triangle tilt revision surgical procedures in obstetric brachial plexus palsy

    PubMed Central

    Nath, Rahul K; Somasundaram, Chandra

    2016-01-01

    AIM To compare outcomes of our revision surgical operations in obstetric brachial plexus palsy (OBPP) patients to results of conventional operative procedures at other institutions. METHODS We analyzed our OBPP data and identified 10 female and 10 male children aged 2.0 to 11.8 years (average age 6.5 years), who had prior conventional surgical therapies at other clinics. Of the 20 patients, 18 undergone triangle tilt, 2 had only mod Quad. Among 18 patients, 8 had only triangle tilt and 10 had also mod Quad as revision surgeries with us. We analyzed the anatomical improvements and functional modified Mallet statistically before and after a year post-revision operations. RESULTS Pre-revision surgery average modified Mallet score was 12.0 ± 1.5. This functional score was greatly improved to 18 ± 2.3 (P < 0.0001) at least one-year after revision surgical procedures. Radiological scores (PHHA and glenoid version) were also improved significantly to 31.9 ± 13.6 (P < 0.001), -16.3 ± 11 (P < 0.0002), at least one-year after triangle tilt procedure. Their mean pre-triangle tilt (yet after other surgeon’s surgeries) PHHA, glenoid version and SHEAR were 14.6 ± 21.7, -31.6 ± 19.3 and 16.1 ± 14.7 respectively. CONCLUSION We demonstrate here, mod Quad and triangle tilt as successful revision surgical procedures in 20 OBPP patients, who had other surgical treatments at other clinics before presenting to us for further treatment. PMID:27900273

  5. Prevalence and Characteristics of Surgical Site Infections Caused by Gram-negative Rod-shaped Bacteria from the Family Enterobacteriacae and Gram-positive Cocci from the Genus Staphylococcus in Patients who Underwent Surgical Procedures on Selected Surgical Wards.

    PubMed

    Tomaszewska-Kowalska, Małgorzata; Kołomecki, Krzysztof; Wieloch-Torzecka, Maria

    2016-10-01

    Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections. The aim of the study was to assess prevalence and characteristics of surgical site infections caused by Gram-negative rod-shaped bacteria from the family Eneterobacteriacae and Gram-positive cocci from the genus Staphylococcus in patients who underwent surgical procedures at the Regional Specialist Hospital named after M. Copernika in Łódź on selected surgical wards.

  6. [Surgical treatment for aortic arch aneurysm: newly developed procedures and their outcomes].

    PubMed

    Ogino, Hitoshi

    2011-01-01

    The surgical treatment of aortic arch aneurysm including newly developed procedures and their outcomes is reviewed. Major advances in aortic arch repair have been made by meticulous brain protection with antegrade-selective and retrograde cerebral perfusion in addition to hypothermia circulatory arrest and refinement of surgical techniques. Total arch replacement using a multibranched prosthetic graft with antegrade-selective cerebral perfusion (SCP) under hypothermia through a median sternotomy has been standardized, resulting in lower mortality and cerebral mortality rates. In particular, the impact of the use of the axillary artery for cardiopulmonary bypass and of the stepwise or elephant trunk technique for distal anastomosis has recently been assessed. In addition, arch repair under moderate hypothermia in conjunction with SCP has been attempted without any serious problems. The surgical strategy for extended aortic aneurysms is also of concern. A two-stage approach with an elephant trunk procedure is employed predominantly for high-risk patients, while one-stage repair is aggressively applied for relatively young, low-risk patients. In contrast, there has been great progress in stent graft therapy for aortic arch lesions. Arch stent graft repairs including hybrid procedures have been attempted in elderly, high-risk patients. Consequently, these comorbid procedures can be used satisfactorily.

  7. Aesthetic septorhinoplasty in the burned nose.

    PubMed

    Hafezi, Farhad; Karimi, Hamid; Nouhi, Amirhosein

    2005-03-01

    Patients who have survived thermal injuries to the face suffer severe disfigurement from the devastating deformities of full-thickness facial burns. The nose is the prominent central organ of the face, which has crucial effect on Aesthetic appearance. The plastic surgeon's role to deal with such cases is to undertake procedures to produce a more pleasant look although the target organ could be the non-burned areas of the face. It is a common belief that surgical intervention under the scarred or grafted nose is risky and may result in skin or covering graft necrosis. For this reason, plastic surgeons are cautious and hesitate to perform Aesthetic surgery on burn scarred tissue. We present 13 cases, 10 women and three men with complete or subtotal nasal burn. Classic Aesthetic Rhinoplasty operations were performed to create a better appearance and correct any internal or external deviations. These procedures are carried out under severely burned skins, or previously grafted and reconstructed noses. Cases were followed for about a one-year period. There was no necrosis in any part of skin after surgery. We believe that Aesthetic rhinoplasty can be done safely in these victims with pleasing outcome. The problems that we encountered in these cases were irregularities of burned alar margins, multiple operations and intractable nasal deviation in severe cases.

  8. [The Significance of Resection of the Cricoid Cartilage as a Surgical Procedure in Laryngotracheal Surgery].

    PubMed

    Hirai, Tomohisa; Fukushima, Noriyuki; Kano, Makoto; Miyahara, Nobuyuki; Miyoshi, Ayako; Ariki, Masahiko; Masuda, Shin; Nagamine, Hisayo

    2015-10-01

    The cricoid cartilage has been regarded as an extremely important organ because it plays important role in both of phonation and breathing. We herein report on two different types of surgical procedure for laryngotracheal diseases with aggressive resection of the cricoid cartilage. The first procedure is a tracheostomaplasty by partial resection of the cricoid cartilage. A tracheostoma is made by resection of the cricoid cartilage in the range of approximately a one-third front. This method is effective for such cases having difficulty in tracheostomy owing their backgrounds with such condition as neck stiffness, obesity, higher displacement of the brachiocephalic artery, short neck, thyroid disease and so on. We applied this procedure for eight cases with such difficult backgrounds. In all cases, we were able to make a good tracheostoma and the postoperative courses were uneventful. The second procedure is a glottic closure with resection of the cricoid cartilage and thyroid cartilage. We applied this procedure for six cases with intractable dysphagia. One case had a postoperative bleeding. We were able to make good conditions in all cases with a large tracheostoma and no pharyngeal-tracheal leakage. In conclusion, the surgical procedure involving resection of the cricoid cartilage can be applied to some laryngotracheal diseases.

  9. [Proper procedure for adhesive reconstructions with an emphasis on maintaining aesthetics: treating people from 7 to 77 years].

    PubMed

    Bonnet, Eric

    2012-06-01

    Aesthetics is not an empty word: it is full of meaning, not only for patients but also for practitioners who regularly practice this «science». Maintenance of a high standard of quality has become so important that it requires the active, collaborative participation of several disciplines in the field of dentistry so that patients can be assured of getting the good results they justifiably expect. Orthodontics, composite stratification, bonding techniques, minimally invasive preparations, and all-ceramics, all represent what enables us to meet the growing demand of aesthetics. Even if young adults remain uninterested in these applications for many years, as life-expectancy increases, these adults will one day join the "aesthetic" community. A thorough knowledge of therapeutic indications, a deep respect for different treatment durations as well as different technical solutions will allow us to respond positively to their demands.

  10. Laparoscopic telescope with alpha port and aesop to view open surgical procedures.

    PubMed

    Russell, K M; Broderick, T J; Demaria, E J; Kothari, S N; Merrell, R C

    2001-08-01

    Laparoscopy has advanced surgery by allowing the surgeon to operate within a patient's abdominal and pelvic cavity with minimal trauma and scarring. The coupling of a video camera to the laparoscopic telescope has had the secondary effect of allowing others to view the surgical field either on color video monitors or by watching the video feed over the Internet at a remote location. These advancements have allowed better teaching and mentoring of operations. Open procedures can benefit from this technology as well but have suffered in the past from inadequate methods to depict the open surgical field. We used the Alpha Port and Aesop robot to position a sterile laparoscopic telescope near the surgical field to view open cholecystectomies performed on five pigs and to send the video feed over the Internet to remote physicians. Viewing the video on the monitor, the surgeons performed the operation in a comfortable ergonomic upright position. Both the surgeons and the remote physicians found the quality of the video to be excellent, and the remote physicians felt comfortable learning and mentoring surgical procedures using this technique.

  11. [The isolated perfused porcine kidney model for investigations concerning surgical therapy procedures].

    PubMed

    Peters, Kristina; Michel, Maurice Stephan; Matis, Ulrike; Häcker, Axel

    2006-01-01

    Experiments to develop innovative surgical therapy procedures are conventionally conducted on animals, as crucial aspects like tissue removal and bleeding disposition cannot be investigated in vitro. Extracorporeal organ models however reflect these aspects and could thus reduce the use of animals for this purpose fundamentally in the future. The aim of this work was to validate the isolated perfused porcine kidney model with regard to its use for surgical purposes on the basis of histological and radiological procedures. The results show that neither storage nor artificial perfusion led to any structural or functional damage which would affect the quality of the organ. The kidney model is highly suitable for simulating the main aspects of renal physiology and allows a constant calibration of perfusion pressure and tissue temperature. Thus, with only a moderate amount of work involved, the kidney model provides a cheap and readily available alternative to conventional animal experiments; it allows standardised experimental settings and provides valid results.

  12. Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS).

    PubMed

    Matsushima, T; Fujiwara, S; Nagata, S; Fujii, K; Fukui, M; Kitamura, K; Hasuo, K

    1989-01-01

    Surgical results of paediatric patients with Moyamoya disease who were treated by indirect revascularization procedures are reported. Encephalo-duro-arterio-synangiosis (EDAS), encephalomyo-arterio-synangiosis (EMAS), and/or encephalo-myo-synangiosis (EMS) were performed on 47 sides of 29 children with Moyamoya disease. The results of those non-anastomotic EC-IC bypass procedures were evaluated clinically, angiographically, and by computed tomography (CT). Postoperative external carotid angiograms showed a good collateral formation through EDAS, EMAS, or EMS in about 70-80 percent of all surgically treated sides. The symptoms such as TIA, RIND, and/or involuntary movements disappeared in the cases with a good collateral formation but not in those with insufficient development of the collateral circulation. The indirect EC-IC bypass surgery seems effective for most of the children with Moyamoya disease who present with ischaemic signs.

  13. Investigations into the efficacy of different procedures for surgical hand disinfection between consecutive operations.

    PubMed

    Rehork, B; Rüden, H

    1991-10-01

    In order to examine whether thorough surgical hand disinfection (handwashing plus hand disinfection) between consecutive operations is necessary, tests were carried out simulating normal clinical conditions. The tests were performed according to the guidelines for the evaluation of disinfection procedures of the German Society for Hygiene and Microbiology. Surgical hand disinfection was as follows: handwashing with soap without antimicrobial additives and subsequent 5-min disinfection with 60% n-propanol. This was followed by simulated operations of 30 or 120 min duration with a 30-min break between operations, during which half of the test group kept on the surgical gloves, while the other half removed them. The second surgical hand disinfection was done without prior handwashing by 50% of the test group. The disinfection time was reduced from 5 to 1 min by 50% of the test group. The results were evaluated by means of explorative data analysis and inductive statistical methods. Removing the surgical gloves during the interoperative break did not result in significantly higher numbers of colony forming units (cfu) compared with retaining the gloves. This was also the case after a subsequent handwashing. At the second surgical hand disinfection, after a simulated operation of 60 min duration (including break), there was no significant difference in the numbers of cfus between the test group who had washed their hands and those who had not. Reducing the disinfection time from 5 min to 1 min was not associated with a significant increase in the number of cfus. However, after a simulated operating time of 150 min (including the break), the second surgical hand disinfection with handwashing resulted in a significantly lower number of microorganisms than disinfection alone. In half the tests, the numbers of cfu were significantly lower when the test group disinfected their hands for 5 min rather than 1 min.

  14. The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance

    PubMed Central

    Paes, Juliana; de Oliveira, Leticia; Pereira, Mirtes Garcia; David, Isabel; Souza, Gabriela Guerra Leal; Sobral, Ana Paula; Machado-Pinheiro, Walter; Mocaiber, Izabela

    2016-01-01

    It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose “neutral” as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work. PMID:27518897

  15. The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance.

    PubMed

    Paes, Juliana; de Oliveira, Leticia; Pereira, Mirtes Garcia; David, Isabel; Souza, Gabriela Guerra Leal; Sobral, Ana Paula; Machado-Pinheiro, Walter; Mocaiber, Izabela

    2016-01-01

    It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose "neutral" as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work.

  16. Infrainguinal endovascular procedures should be reserved for patients who do not have good open surgical options.

    PubMed

    Rubin, Brian; Reddy, Daniel J; Kalman, Peter G

    2005-09-01

    This article is the result of a debate. The motion proposed was "Infrainguinal endovascular procedures should be reserved for patients who do not have good open surgical options.'' Arguments in favor of the motion were offered by Daniel J. Reddy of Henry Ford Hospital in Detroit, MI, and arguments against the motion were offered by Peter Kalman of Loyola University Medical Center in Maywood, IL.

  17. Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against national standards.

    PubMed

    Williams, Catherine; Johnson, Pat A; Guzzetta, Cathie E; Guzzetta, Philip C; Cohen, Ira Todd; Sill, Anne M; Vezina, Gilbert; Cain, Sherry; Harris, Christine; Murray, Jodi

    2014-01-01

    Prolonged preoperative fasting can be associated with adverse outcomes, particularly in children. Our aims were to assess the time pediatric patients fasted prior to surgical or radiologic procedures and evaluate whether fasting (NPO) orders complied with national guidelines. We measured NPO start time, time of last intake, and time test or surgery was scheduled, took place, or was cancelled in 219 pediatric patients. Findings demonstrate that pediatric patients experienced prolonged fasting before procedures and that the majority of NPO orders were non-compliant with national guidelines. We have developed strategies to reduce fasting times and ensure compliance with recommended national fasting standards.

  18. Identification of Cutaneous Mycobacterium massiliense Infections Associated with Repeated Surgical Procedures

    PubMed Central

    Cho, Ah Young; Kim, Yeon Sook; Kook, Yoon Hoh; Kim, Shin Ok; Back, Seung Ju; Seo, Young Joon; Lee, Jeung Hoon

    2010-01-01

    Mycobacterium massiliense, an emerging pathogen that is increasingly reported as a causative agent in infections occurring during medical procedures, is difficult to be identified using conventional methods. Here we report the case of a cutaneous M. massiliense infection that was associated with repeated surgical procedures and that was identified via a comparative sequence analysis of rpoB and hsp65. The patient showed a substantial response to treatment with a combination of antimicrobial therapies consisting of clarithromycin, amikacin, and cefoxitin for 6 months. PMID:20548899

  19. The bilateral bispectral and the composite variability indexes during anesthesia for unilateral surgical procedure

    PubMed Central

    Lopes-Pimentel, Pedro; Koo, Maylin; Bocos, Javier; Sabaté, Antoni

    2017-01-01

    Background: The composite variability index (CVI), derived from the bispectral analysis (BIS), has been designed to detect nociception; however, there is no evidence that bilateral BIS and CVI show intrapatient reproducibility or variability. Methods: We conducted an observational study in patients who underwent for total knee arthroplasty. A BIS Bilateral Sensor was applied and continuously recorded at different points of the anesthesia procedure. Bland–Altman limits of agreement and dispersion for BIS and for CVI were applied. Results: Forty-nine right-handed patients were studied. There were differences between the right and left BIS values after tracheal intubation (which was higher on the right side) and at surgical stimulus (higher on the left side). The maximum BIS and minimum, mean, and maximum CVI scores were higher on the left side for left-side procedures, but there were no differences in any indexes for the right-side procedures. Except for the baseline measurements, both CVI and BIS scores presented high interpatient variability. Although the right to left bias was < 3% for the BIS index, dispersion was large at different stages of the anesthesia. The right to left bias for the CVI was 3.8% at tracheal intubation and 5.7% during surgical stimulus. Conclusions: Our results indicate that the large interindividual variability of BIS and CVI limits their usefulness. We found differences between the left and right measurements in a right-handed series of patients during surgical stimuli though they were not clinically relevant. PMID:28217053

  20. [Postoperative evaluation of different surgical procedures in genuine stress urinary incontinence: a retrospective study].

    PubMed

    Rodríguez-Colorado, S; Pérez-Soriano, P; Alvarez-Mercado, R L; Herbert, A; Kunhardt-Rasch, J

    1996-06-01

    An evaluation of the surgical treatment for stress and mixed urinary incontinence and pelvic relaxation. One-year follow-up, was done. A retrospective study with 144 files from the surgeries performed between February 1993 and June 1994, at the Clínica de Urología Ginecológica del Instituto Nacional de Perinatología. We excluded 37 files because of incomplete information. The age, parity, hormonal stage, preoperative diagnosis by urodynamic studies, surgical treatments and one-year follow-up were analyzed. The mean age was 45.5 years. Pereyra procedure was performed in 53, Burch procedure in 47, anterior colporrhaphy in 5, and sling procedure in 2 patients. The incidence of complications was similar between the different groups. Resumption of spontaneous postsurgical voiding was delayed in the Pereyra group. The Burch urethropexy and Pereyra procedures were equally effective, with no statistical differences observed. Burch vaginal suspension was not more effective for the correction of urinary stress incontinence than Pereyra procedure.

  1. Surgically-induced astigmatism in combined ECCE with filtering procedures compared to ECCE alone.

    PubMed

    Choplin, N T; Monroe, J F

    1992-02-01

    Extracapsular cataract extraction with implantation of a posterior chamber lens combined with filtering surgery (glaucoma triple procedure) is frequently employed in the co-management of cataract and glaucoma. Nineteen triple procedures with a minimum of six months follow up were compared to 19 cases of extracapsular cataract extraction with lens implant matched for age, sex, and surgeon with regard to surgically induced astigmatism as determined by vector analysis. Follow up averaged 10 months for the triple group and 14 months for the controls. There was no statistically significant difference in preoperative astigmatism between the two groups nor in the mean number of sutures cut. Postoperatively, the keratometric cylinder averaged 2.55 +/- 1.54 diopters for the cases and 1.20 +/- 1.11 D for the controls; the difference of 1.36 D was statistically significant (P = .004). The postoperative refractive cylinder was 2.34 +/- 1.54 D for the cases and 1.29 +/- 1.07 D for the controls; the difference of 1.05 D was statistically significant (P = .017). With regard to surgically-induced astigmatism, vector analysis showed that the cases averaged 2.18 +/- 1.25 D and the controls 1.23 +/- 0.81 D; the difference of 0.95 D was statistically significant (P = .006). With regard to surgically-induced astigmatism, vector analysis showed that the cases averaged 2.18 +/- 1.25 D and the controls 1.23 +/- 0.81 D; the difference of 0.95 D was statistically significant (P = .006). When analyzed for change along the vertical meridian, the cases averaged 1.12 +/- 1.57 D surgically-induced against-the-rule astigmatism, as compared with 0.30 +/- 1.16 D for the controls (difference, 0.83 D; P = .062). The glaucoma triple procedures induced approximately 1.00 D more cylinder than the controls.

  2. Development of a surgical procedure for implantation of a prototype suprachoroidal retinal prosthesis

    PubMed Central

    Saunders, Alexia L; Williams, Chris E; Heriot, Wilson; Briggs, Robert; Yeoh, Jonthan; Nayagam, David AX; McCombe, Mark; Villalobos, Joel; Burns, Owen; Luu, Chi D; Ayton, Lauren N; McPhedran, Michelle; Opie, Nicholas L; McGowan, Ceara; Shepherd, Robert K; Guymer, Robyn; Allen, Penelope J

    2014-01-01

    Background Current surgical techniques for retinal prosthetic implantation require long and complicated surgery, which can increase the risk of complications and adverse outcomes. Method The suprachoroidal position is known to be an easier location to access surgically, and so this study aimed to develop a surgical procedure for implanting a prototype suprachoroidal retinal prosthesis. The array implantation procedure was developed in 14 enucleated eyes. A full-thickness scleral incision was made parallel to the intermuscular septum and superotemporal to the lateral rectus muscle. A pocket was created in the suprachoroidal space, and the moulded electrode array was inserted. The scleral incision was closed and scleral anchor point sutured. In 9 of the 14 eyes examined, the device insertion was obstructed by the posterior ciliary neurovascular bundle. Subsequently, the position of this neurovascular bundle in 10 eyes was characterized. Implantation and lead routing procedure was then developed in six human cadavers. The array was tunnelled forward from behind the pinna to the orbit. Next, a lateral canthotomy was made. Lead fixation was established by creating an orbitotomy drilled in the frontal process of the zygomatic bone. The lateral rectus muscle was detached, and implantation was carried out. Finally, pinna to lateral canthus measurements were taken on 61 patients in order to determine optimal lead length. Results These results identified potential anatomical obstructions and informed the anatomical fitting of the suprachoroidal retinal prosthesis. Conclusion As a result of this work, a straightforward surgical approach for accurate anatomical suprachoroidal array and lead placement was developed for clinical application. PMID:24330322

  3. Elbow denervation in dogs: development of an in vivo surgical procedure and pilot testing.

    PubMed

    Zamprogno, Helia; Hash, Jon; Hulse, Don A; Lascelles, B Duncan X

    2011-11-01

    The objective of this study was to develop a surgical technique for sensory denervation of the canine elbow joint and to assess the effects of denervation on limb function in normal dogs. Twenty cadavers (40 elbows) were used to characterize innervation and design the surgical protocol which was tested in 13 cadavers (26 normal elbows). The effect of denervation on limb function was assessed in vivo in four dogs with the elbow randomly selected for the procedure. Primary outcome measures were static bodyweight distribution and distal limb mechanical sensory thresholds; secondary outcome measures were subjectively scored lameness, neurological function and pain on manipulation. Histology was performed on all resected tissues to determine whether nerves had been resected. Denervation was achieved by separate medial and lateral surgical approaches. In testing the developed surgical protocol, 111/130 resected samples contained nerve tissue in the healthy cadaveric elbows and 18/20 in the in vivo study. Limb function and sensation were not altered by elbow joint denervation. The protocol developed for denervation of the canine elbow appears feasible and does not result in any sensory or motor deficits of the forelimb.

  4. Android application for determining surgical variables in brain-tumor resection procedures.

    PubMed

    Vijayan, Rohan C; Thompson, Reid C; Chambless, Lola B; Morone, Peter J; He, Le; Clements, Logan W; Griesenauer, Rebekah H; Kang, Hakmook; Miga, Michael I

    2017-01-01

    The fidelity of image-guided neurosurgical procedures is often compromised due to the mechanical deformations that occur during surgery. In recent work, a framework was developed to predict the extent of this brain shift in brain-tumor resection procedures. The approach uses preoperatively determined surgical variables to predict brain shift and then subsequently corrects the patient's preoperative image volume to more closely match the intraoperative state of the patient's brain. However, a clinical workflow difficulty with the execution of this framework is the preoperative acquisition of surgical variables. To simplify and expedite this process, an Android, Java-based application was developed for tablets to provide neurosurgeons with the ability to manipulate three-dimensional models of the patient's neuroanatomy and determine an expected head orientation, craniotomy size and location, and trajectory to be taken into the tumor. These variables can then be exported for use as inputs to the biomechanical model associated with the correction framework. A multisurgeon, multicase mock trial was conducted to compare the accuracy of the virtual plan to that of a mock physical surgery. It was concluded that the Android application was an accurate, efficient, and timely method for planning surgical variables.

  5. Complications after Surgical Procedures in Patients with Cardiac Implantable Electronic Devices: Results of a Prospective Registry

    PubMed Central

    da Silva, Katia Regina; Albertini, Caio Marcos de Moraes; Crevelari, Elizabeth Sartori; de Carvalho, Eduardo Infante Januzzi; Fiorelli, Alfredo Inácio; Martinelli Filho, Martino; Costa, Roberto

    2016-01-01

    Background: Complications after surgical procedures in patients with cardiac implantable electronic devices (CIED) are an emerging problem due to an increasing number of such procedures and aging of the population, which consequently increases the frequency of comorbidities. Objective: To identify the rates of postoperative complications, mortality, and hospital readmissions, and evaluate the risk factors for the occurrence of these events. Methods: Prospective and unicentric study that included all individuals undergoing CIED surgical procedures from February to August 2011. The patients were distributed by type of procedure into the following groups: initial implantations (cohort 1), generator exchange (cohort 2), and lead-related procedures (cohort 3). The outcomes were evaluated by an independent committee. Univariate and multivariate analyses assessed the risk factors, and the Kaplan-Meier method was used for survival analysis. Results: A total of 713 patients were included in the study and distributed as follows: 333 in cohort 1, 304 in cohort 2, and 76 in cohort 3. Postoperative complications were detected in 7.5%, 1.6%, and 11.8% of the patients in cohorts 1, 2, and 3, respectively (p = 0.014). During a 6-month follow-up, there were 58 (8.1%) deaths and 75 (10.5%) hospital readmissions. Predictors of hospital readmission included the use of implantable cardioverter-defibrillators (odds ratio [OR] = 4.2), functional class III­-IV (OR = 1.8), and warfarin administration (OR = 1.9). Predictors of mortality included age over 80 years (OR = 2.4), ventricular dysfunction (OR = 2.2), functional class III-IV (OR = 3.3), and warfarin administration (OR = 2.3). Conclusions: Postoperative complications, hospital readmissions, and deaths occurred frequently and were strongly related to the type of procedure performed, type of CIED, and severity of the patient's underlying heart disease. PMID:27579544

  6. Control of bleeding in surgical procedures: critical appraisal of HEMOPATCH (Sealing Hemostat)

    PubMed Central

    Lewis, Kevin Michael; Kuntze, Carl Erik; Gulle, Heinz

    2016-01-01

    The need for advanced hemostatic agents increases with the complexity of surgical procedures and use of anticoagulation and antiplatelet treatments. HEMOPATCH (Sealing Hemostat) is a novel, advanced hemostatic pad that is composed of a synthetic, protein-reactive monomer and a collagen backing. The active side is covered with a protein-reactive monomer: N-hydroxysuccinimide functionalized polyethylene glycol (NHS-PEG). NHS-PEG rapidly affixes the collagen pad to tissue to promote and maintain hemostasis. The combined action of the NHS-PEG and collagen is demonstrated to have benefit relative to other hemostatic agents in surgery and preclinical surgical models. This paper reviews the published investigations and case reports of the hemostatic efficacy of HEMOPATCH, wherein HEMOPATCH is demonstrated to be an effective, easy-to-use hemostatic agent in open and minimally invasive surgery of patients with thrombin- or platelet-induced coagulopathies. PMID:26730213

  7. Control of bleeding in surgical procedures: critical appraisal of HEMOPATCH (Sealing Hemostat).

    PubMed

    Lewis, Kevin Michael; Kuntze, Carl Erik; Gulle, Heinz

    2016-01-01

    The need for advanced hemostatic agents increases with the complexity of surgical procedures and use of anticoagulation and antiplatelet treatments. HEMOPATCH (Sealing Hemostat) is a novel, advanced hemostatic pad that is composed of a synthetic, protein-reactive monomer and a collagen backing. The active side is covered with a protein-reactive monomer: N-hydroxysuccinimide functionalized polyethylene glycol (NHS-PEG). NHS-PEG rapidly affixes the collagen pad to tissue to promote and maintain hemostasis. The combined action of the NHS-PEG and collagen is demonstrated to have benefit relative to other hemostatic agents in surgery and preclinical surgical models. This paper reviews the published investigations and case reports of the hemostatic efficacy of HEMOPATCH, wherein HEMOPATCH is demonstrated to be an effective, easy-to-use hemostatic agent in open and minimally invasive surgery of patients with thrombin- or platelet-induced coagulopathies.

  8. Lateral ankle instability: MR imaging of associated injuries and surgical treatment procedures.

    PubMed

    Alparslan, Leyla; Chiodo, Christopher P

    2008-12-01

    Chronic ankle instability has been defined as the development of recurrent ankle sprains and persistent symptoms after initial lateral ankle sprain. The diagnosis of ankle instability is usually established on the patient's history, physical examination, and radiographic assessment. Patients have signs of both functional and mechanical instability, and the repetitive, chronic nature of the injury may lead to intra-articular and periarticular pathologies. This article discusses the incidence, etiology, and magnetic resonance (MR) imaging of these pathologies, reviews the surgical treatment procedures for lateral ankle instability, and presents the postoperative MR imaging findings.

  9. Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

    PubMed

    Kuo, Benjamin J; Vissoci, Joao Ricardo N; Egger, Joseph R; Smith, Emily R; Grant, Gerald A; Haglund, Michael M; Rice, Henry E

    2017-03-01

    OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform. METHODS Data on 9996 pediatric neurosurgical patients were acquired from the 2012-2014 NSQIP-Peds participant user file. Neurosurgical cases were analyzed by the NSQIP-Peds targeted procedure categories, including craniotomy/craniectomy, defect repair, laminectomy, shunts, and implants. The primary outcome measure was 30-day mortality, with secondary outcomes including individual AEs, composite morbidity (all AEs excluding mortality and unplanned reoperation), surgical-site infection, and unplanned reoperation. Univariate analysis was performed between individual AEs and patient characteristics using Fischer's exact test. Associations between individual AEs and continuous variables (duration from admission to operation, work relative value unit, and operation time) were examined using the Student t-test. Patient characteristics and continuous variables associated with any AE by univariate analysis were used to develop category-specific multivariable models through backward stepwise logistic regression. RESULTS The authors analyzed 3383 craniotomy/craniectomy, 242 defect repair, 1811 laminectomy, and 4560 shunt and implant cases and found a composite overall morbidity of 30.2%, 38.8%, 10.2%, and 10.7%, respectively. Unplanned reoperation rates were highest for defect repair (29.8%). The mortality rate ranged from 0.1% to 1.2%. Preoperative ventilator dependence was a significant predictor of any AE for all procedure groups, whereas

  10. Lingual frenectomy: a comparison between the conventional surgical and laser procedure.

    PubMed

    De Santis, D; Gerosa, R; Graziani, P F; Zanotti, G; Rossini, N; Castellani, R; Bissolotti, G; Chiarini, L; Nocini, P F; Bertossi, D

    2013-08-01

    Aim: Ankyloglossia, commonly known as tongue-tie, is a congenital oral anomaly characterized by a short lingual frenulum that may contribute to feeding, speech and mechanical problems. The purpose of this study is to compare the advantages of laser vis-à-vis conventional frenectomy in both intra- and post-surgical phases. Methods: This study took into consideration two patients, who were respectively 9 and 10-year-old. The first one underwent a common surgical procedure. A Nd:Yap laser device with a micropulsed wavelength of 1340 nm and power of 8 watts was used for the second. The postsurgical discomfort and healing characteristics were evaluated. Results: The results indicated that the Nd:Yap laser has the following advantages when compared to the conventional frenectomy: 1) soft tissue cutting was efficient, with no bleeding, giving a clear operative field; 2) there was no need to use sutures; 3) the surgery was less time-consuming; 4) there was no postsurgical infection and no need for analgesics or antibiotics; 5) wound contraction and scarring were decreased or eliminated; 6) despite the initial slowness of the healing process, the complete and final recovery was faster. Conclusion: Considering the above elements, it is possible to assert that the laser frenectomy has a series of unquestionable advantages if compared to the conventional surgical technique.

  11. Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury

    PubMed Central

    Abdel-Aal, Ahmed Kamel; Ezzeldin, Islam B.; Moustafa, Amr Soliman; Ertel, Nathan; Oser, Rachel

    2015-01-01

    We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple’s pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure. PMID:27200175

  12. Surgical treatment of moyamoya disease in children: which is more effective procedure, EDAS or EMS?

    PubMed

    Fujita, K; Tamaki, N; Matsumoto, S

    1986-01-01

    At present, encephaloduroarteriosynangiosis (EDAS) and encephalomyosynangiosis (EMS) are the treatments of choice for moyamoya disease in children, but no attempts have been made to determine which is the more effective procedure, for the ischemic lesions in moyamoya disease. Ten patients (seven children and three adults) underwent EDAS and/or EMS: three patients EDAS on both sides; seven patients EDAS on one side and EMS on the other. These ten patients were followed up with a neurological examination and r-CBF and angiographic studies. Postoperative angiograms and r-CBF studies demonstrated more revascularization from the external carotid artery in sides treated with EDAS than with sides treated with EMS. From these results, it is concluded that the EDAS surgical procedure is superior to that of EMS for moyamoya disease.

  13. Leveraging Lexical Matching and Ontological Alignment to Map SNOMED CT Surgical Procedures to ICD-10-PCS

    PubMed Central

    Fung, Kin Wah; Xu, Julia; Ameye, Filip; Gutiérrez, Arturo Romero; D'Havé, Arabella

    2016-01-01

    In 2015 ICD-10-PCS replaced ICD-9-CM for coding medical procedures in the U.S. We explored two methods to automatically map SNOMED CT surgical procedures to ICD-10-PCS. First, we used MetaMap to lexically map ICD-10-PCS index terms to SNOMED CT. Second, we made use of the axial structure of ICD-10-PCS and aligned them to defining attributes in SNOMED CT. Lexical mapping produced 45% of correct maps and 44% of broader maps. Ontological mappings were 40% correct and 5% broader. Both correct and broader maps will be useful in assisting mappers to create the map. When the two mapping methods agreed, the accuracy increased to 93%. Reviewing the MetaMap generated body part mappings and using additional information in the SNOMED CT names and definitions can lead to better results for the ontological map. PMID:28269853

  14. Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures.

    PubMed

    Park, Jin Ha; Lee, Jong Seok; Lee, Jae Hoon; Shin, Seokyung; Min, Nar Hyun; Kim, Min-Soo

    2016-03-01

    Prolonged inspiratory to expiratory (I:E) ratio ventilation has been researched to reduce lung injury and improve oxygenation in surgical patients with one-lung ventilation (OLV) or carbon dioxide (CO2) pneumoperitoneum. We aimed to confirm the efficacy of the 1:1 equal ratio ventilation (ERV) compared with the 1:2 conventional ratio ventilation (CRV) during surgical procedures. Electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched.Prospective interventional trials that assessed the effects of prolonged I:E ratio of 1:1 during surgical procedures. Adult patients undergoing OLV or CO2 pneumoperitoneum as specific interventions depending on surgical procedures. The included studies were examined with the Cochrane Collaboration's tool. The data regarding intraoperative oxygenation and respiratory mechanics were extracted, and then pooled with standardized mean difference (SMD) using the method of Hedges. Seven trials (498 total patients, 274 with ERV) were included. From overall analysis, ERV did not improve oxygenation at 20 or 30 minutes after specific interventions (SMD 0.193, 95% confidence interval (CI): -0.094 to 0.481, P = 0.188). From subgroup analyses, ERV provided significantly improved oxygenation only with laparoscopy (SMD 0.425, 95% CI: 0.167-0.682, P = 0.001). At 60 minutes after the specific interventions, ERV improved oxygenation significantly in the overall analysis (SMD 0.447, 95% CI: 0.209-0.685, P < 0.001) as well as in the subgroup analyses with OLV (SMD 0.328, 95% CI: 0.011-0.644, P = 0.042) and laparoscopy (SMD 0.668, 95% CI: 0.052-1.285, P = 0.034). ERV provided lower peak airway pressure (Ppeak) and plateau airway pressure (Pplat) than CRV, regardless of the type of intervention. The relatively small number of the included articles and their heterogeneity could be the main limitations. ERV improved oxygenation at all of the

  15. Ridge augmentation with soft tissue procedures in aesthetic dentistry: first clinical results measured with a new kind of moire technique

    NASA Astrophysics Data System (ADS)

    Studer, Stephan P.; Bucher, Andreas; Mueller, Felix

    1993-09-01

    The oral health of the Swiss population was significantly improved by the successful prevention of dental caries and periodontitis. Along with the healthy dentition the demand for aesthetic dentistry is increasing. Removable partial dentures are becoming less accepted. Therefore, to substitute lost teeth by permanent fixed partial prosthesis (bridges), the often deformed alveolar ridge has to be operated, either to improve the aesthetic appearance or to make it possible to restore the missing teeth by a fixed cemented bridge. The aim of this paper is (1) to evaluate whether the moire technique is an appropriate and handy method, and (2) to validate the precision of the new method. The measuring system consisted of a moire projector with an integrated phase shift device and a moire viewer with a CCD video camera, connected to a frame grabber in a personal computer. a highly versatile software was allowed to control the system as well as to grab the moire images using the four-phase shift technique in order to compute the phase image of the actual object. The new technique was validated with one solid test object measured by a 3D coordination, high precision measuring machine.

  16. "Skin facts" to optimize aesthetic outcomes.

    PubMed

    Brennan, Connie

    2015-01-01

    Aesthetic providers need to be well versed in the anatomy and intricacies of the skin. This foundational skin knowledge is critical in assessing clients' aged skin during the aesthetic consultation. A sound understanding of the skin is also a prerequisite to any facial rejuvenation procedure. This article provides the aesthetic provider with the basics of skin anatomy and how the skin changes over time.

  17. Invisalign and aesthetic dentistry.

    PubMed

    Schwartz, Benjamin

    2012-01-01

    Invisalign has been an integral part of dental practices for many years. Besides improving crowding and spacing in teeth, it is an excellent adjunct for many different aesthetic procedures. One such case is illustrated in this article, where the combination of Invisalign and minimally invasive dentistry allowed for a stellar outcome, and one very happy dental patient.

  18. Interventional Radiological Procedures in Impaired Function of Surgically Implanted Catheter-Port Systems

    SciTech Connect

    Herrmann, Karin Anna; Waggershauser, Tobias; Heinemann, Volker; Reiser, Maximilian

    2001-01-15

    Purpose: System-related complications in surgically implanted catheter-port systems (CPS) for intraarterial (i.a.) chemotherapy are well known. In most cases of complications, the treatment must be interrupted and the catheter-port system must be repaired surgically. We describe microinvasive interventional radiological procedures to correct some dysfunctions of CPS.Methods: Five patients with repetitive dysfunction of CPS were treated with interventional techniques. Two patients presented with perfusion impairment, one patient had a pseudoaneurysm of the hepatic artery, and two patients presented with catheter displacement. Radiological interventions included mechanical recanalization with a guidewire, vascular stenting, and correction of catheter dislocation with a goose-neck snare.Results: In all cases, correct function of the CPS was restored. No intervention-related complications occurred and surgery was avoided. Chemotherapy could be continued for a period of 4-10 months.Conclusion: For some system-related complications, minimally invasive radiological interventions can be used to restore the function of CPS for i.a. chemotherapy.

  19. [Incidence of primary malignant lesions in clinically benign teratoma: on the problem of adequate surgical procedure].

    PubMed

    Kindermann, G; Jung, E M; Maassen, V; Bise, K

    1996-08-01

    The Problem of an Adequate Surgical Approach: Frequency of malignant teratomas is, according to the literature, 2%-10%. Examining 194 own cases (1983-1993) it was 1.5%. We found one squamous cell carcinoma (0.5%). Additionally we found 2 immature teratomas (1%). We point out the different biological behaviour of malignant mature teratomas and immature teratomas. We agree with the majority of authors that the method of choice is the intact removal of all teratomas without iatrogen rupture or contamination of the abdominal cavity by contents of the teratoma. This adequate surgical procedure can and should be performed by laparotomy or laparoscopy with endobag. The often practised method of cutting open the cyst during laparoscopy, sucking off the contents or cutting the teratoma into pieces, has been proven to lead to implantation and worsening the prognosis in case of a malignant teratoma. Even the rinsing of the abdominal cavity, usually carried out with this method, could not compensate always for the disadvantage of this "dirty" endoscopical method compared with usual oncological standards. This is pointed out by case reports in the literature and the first analysis of a German survey with early-follow-up of 192 laparoscopically managed ovarian malignancies [11a]. The principle of intact removal of every teratoma should again be kept in mind.

  20. The effect of aromatherapy on postoperative nausea in women undergoing surgical procedures.

    PubMed

    Ferruggiari, Luisa; Ragione, Barbara; Rich, Ellen R; Lock, Kathleen

    2012-08-01

    Postoperative nausea and vomiting (PONV) is a common source of patient discomfort and decreased satisfaction. Aromatherapy has been identified as a complementary modality for the prevention and management of PONV. The purpose of this study was to assess the effect of aromatherapy on the severity of postoperative nausea (PON) in women undergoing surgical procedures in the postanesthesia care unit. Women complaining of PON received traditional antiemetics, inhalation of peppermint oil, or saline vapor. A visual analog scale was used to rate nausea at the first complaint; at 5 minutes after intervention; and, if nausea persisted, at 10 minutes after intervention. At both 5 and 10 minutes, statistical analysis showed no significant differences between intervention and nausea rating. Obtaining eligible subjects was challenging. Although many women consented, most received intraoperative antiemetics and did not report nausea postoperatively.

  1. Hip transposition as a universal surgical procedure for periacetabular tumors of the pelvis.

    PubMed

    Gebert, Carsten; Gosheger, Georg; Winkelmann, Winfried

    2009-03-01

    Surgical treatment of pelvic tumors represents one of the most challenging problems in musculoskeletal oncology, especially in the periacetabular region. Because of the complex anatomy and demanding biomechanical situation, surgery leads to a considerable disability while all possible types of reconstruction are often associated with high complication rates. Nevertheless, it is known that wide resection of the tumor is one of the key points for long-term survival in sarcoma therapy. Therefore, hip transposition was established in our clinic as a universal tool for periacetabular tumors excelling in small foreign parts and resulting in acceptable complication rates with good functional outcome. The following article gives an overview of the technique and the indications of different types of hip transposition, which were developed from the first procedure, described and published by Winkelmann in 1988.

  2. A standard operating procedure for the surgical implantation of transmitters in juvenile salmonids

    USGS Publications Warehouse

    Liedtke, T.L.; Beeman, J.W.; Gee, L.P.

    2012-01-01

    Biotelemetry is a useful tool to monitor the movements of animals and is widely applied in fisheries research. Radio or acoustic technology can be used, depending on the study design and the environmental conditions in the study area. A broad definition of telemetry also includes the use of Passive Integrated Transponder (PIT) tags, either separately or with a radio or acoustic transmitter. To use telemetry, fish must be equipped with a transmitter. Although there are several attachment procedures available, surgical implantation of transmitters in the abdominal cavity is recognized as the best technique for long-term telemetry studies in general (Stasko and Pincock, 1977; Winter, 1996; Jepsen, 2003), and specifically for juvenile salmonids, Oncorhynchus spp. (Adams and others, 1998a, 1998b; Martinelli and others, 1998; Hall and others, 2009). Studies that use telemetry assume that the processes by which the animals are captured, handled, and tagged, as well as the act of carrying the transmitter, will have minimal effect on their behavior and performance. This assumption, commonly stated as a lack of transmitter effects, must be valid if telemetry studies are to describe accurately the movements and behavior of an entire population of interest, rather than the subset of that population that carries transmitters. This document describes a standard operating procedure (SOP) for surgical implantation of radio or acoustic transmitters in juvenile salmonids. The procedures were developed from a broad base of published information, laboratory experiments, and practical experience in tagging thousands of fish for numerous studies of juvenile salmon movements near Columbia River and Snake River hydroelectric dams. Staff from the Western Fisheries Research Center's Columbia River Research Laboratory (CRRL) frequently have used telemetry studies to evaluate new structures or operations at hydroelectric dams in the Columbia River Basin, and these evaluations typically

  3. Laser Hemorrhoidoplasty Procedure vs Open Surgical Hemorrhoidectomy: a Trial Comparing 2 Treatments for Hemorrhoids of Third and Fourth Degree

    PubMed Central

    Maloku, Halit; Gashi, Zaim; Lazovic, Ranko; Islami, Hilmi; Juniku-Shkololli, Argjira

    2014-01-01

    Objective: According to the ‘‘vascular’’ theory, arterial overflow in the superior hemorrhoidal arteries would lead to dilatation of the hemorrhoidal venous plexus. Hemorrhoid laser procedure (LHP) is a new laser procedure for outpatient treatment of hemorrhoids in which hemorrhoidal arterial flow feeding the hemorrhoidal plexus is stopped by laser coagulation. Aim: Our aim was to compare the hemorrhoid laser procedure with open surgical procedure for outpatient treatment of symptomatic hemorrhoids. Material and method: A comparison trial between hemorrhoid laser procedure or open surgical hemorrhoidectomy was made. This study was conducted at Aloka hospital in Kosovo. Patients with symptomatic grade III or grade IV hemorrhoids with minimal or complete mucosal prolapse were eligible for the study: 20 patients treated with the laser hemorrhoidoplasty, and 20 patients–with open surgery hemorrhoidectomy. Operative time and postoperative pain with visual analog scale, were evaluated. Results: A total number of 40 patients (23 men and 17 women, mean age, 46 years) entered the trial. Significant differences between laser hemorrhoidoplasty and open surgical procedure were observed in operative time and early postoperative pain. There was a statistically significant difference between the two groups regarding the early postoperative period: 1 week, 2 weeks, 3 weeks and 1 month after respective procedure (p<0.01). The procedure time for LHP was 15.94 min vs. 26.76 min for open surgery (p<0.01). Conclusion: The laser hemorrhoidoplasty procedure was more effective than open surgical hemorrhoidectomy. Postoperative pain and duration time are only two indicators for this difference between there procedures. PMID:25684841

  4. Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures

    NASA Astrophysics Data System (ADS)

    Zheng, Guoyan

    2007-03-01

    Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems, where a 3D volume or surface representation of the operated anatomy could be constructed from the preoperatively acquired tomographic data or through intraoperatively digitized anatomy landmarks, a photorealistic rendering of the surgical action has been identified to greatly improve usability of these navigation systems. However, this may not hold true when the virtual representation of surgical instruments and implants is superimposed onto 2D projection images in a fluoroscopy-based navigation system due to the so-called image occlusion problem. Image occlusion occurs when the field of view of the fluoroscopic image is occupied by the virtual representation of surgical implants or instruments. In these situations, the surgeon may miss part of the image details, even if transparency and/or wire-frame rendering is used. In this paper, we propose to use non-photorealistic rendering to overcome this difficulty. Laboratory testing results on foamed plastic bones during various computer-assisted fluoroscopybased surgical procedures including total hip arthroplasty and long bone fracture reduction and osteosynthesis are shown.

  5. Perspective: authentic patient perspectives in simulations for procedural and surgical skills.

    PubMed

    Nestel, Debra; Kneebone, Roger

    2010-05-01

    In this article, the authors consider the role of the patient in simulation-based training and assessment of clinical procedural skills. In recent years, there has been a progressive shift of emphasis from teacher-centered to student-centered education, resulting in a redefinition of approaches to medical education. Traditional models of transmission of information from an expert to a novice have been supplanted by a more student-centered approach. However, medical education is not a matter for teacher and student alone. At the center is always the patient, around whom everything must ultimately rotate. A further shift is occurring. The patient is becoming the focal point of medical teaching and learning. It is argued that this shift is necessary and that simulation in its widest sense can be used to support this process. However, sensitivity to what we are simulating is essential, especially when simulations purport to address patient perspectives. The essay first reviews the history of medical education "centeredness," then outlines ways in which real and simulated patients are currently involved in medical education. Patient-focused simulation (PFS) is described as a means of offering patients' perspectives during the acquisition of clinical procedural and surgical skills. The authors draw on their experiences of developing PFS and preliminary work to "authenticate" simulations from patient perspectives. The essay concludes with speculation on the value of a "complementarity" model that acknowledges the authentic and equal perspectives of patients, students, clinicians, and teachers.

  6. [Aesthetic surgery, medical discourse and health].

    PubMed

    Ferreira, Francisco Romão

    2011-05-01

    The increase in plastic surgery interventions in Brazil and the growth of the beauty industry, as well as care of the body and corporal enhancement, are part of a broader process of medical and aesthetic preoccupation with health. According to the Brazilian Plastic Surgery Association there has been a substantial increase in the number of plastic surgery procedures in Brazil. Every year, approximately 350,000 aesthetic surgical interventions are performed in the country. Our work investigated the construction of meaning and value, the use of aesthetic parameters in this construction and how those meanings are appropriated and treated by those representatives of the medical profession who work in the body transformation process, namely plastic surgeons. In this respect, an analysis of the pronouncements and discourse posted on the Brazilian Plastic Surgery Association website was conducted, as it is the regulatory body of the field and is responsible for training professionals and supervising the sector. Analysis of the official content of the website page posted on September 26, 2005 was the basis for this research.

  7. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    PubMed Central

    Lühmann, Dagmar; Burkhardt-Hammer, Tatjana; Borowski, Cathleen; Raspe, Heiner

    2005-01-01

    option between conservative and operative management of small lumbar disc herniations or protrusions causing sciatica. Two RCT comparing transforaminal endoscopic procedures with microdiscectomy in patients with sciatica and small non-sequestered disc herniations show comparable short and medium term overall success rates. Concerning speed of recovery and return to work a trend towards more favourable results for the endoscopic procedures is noted. It is doubtful though, whether these results from the eleven and five years old studies are still valid for the more advanced procedures used today. The only RCT comparing the results of automated percutaneous lumbar discectomy to those of microdiscectomy showed clearly superior results of microdiscectomy. Furthermore, success rates of automated percutaneous lumbar discectomy reported in the RCT (29%) differ extremely from success rates reported in case series (between 56% and 92%). The literature search retrieves no controlled trials to assess efficacy and/or effectiveness of laser-discectomy, percutaneous manual discectomy or endoscopic procedures using a posterior approach in comparison to the standard procedures. Results from recent case series permit no assessment of efficacy, especially not in comparison to standard procedures. Due to highly selected patients, modi-fications of operative procedures, highly specialised surgical units and poorly standardised outcome assessment results of case series are highly variable, their generalisability is low. The results of the five economical analyses are, due to conceptual and methodological problems, of no value for decision-making in the context of the German health care system. Discussion Aside from low methodological study quality three conceptual problems complicate the interpretation of results. Continuous further development of technologies leads to a diversity of procedures in use which prohibits generalisation of study results. However, diversity is noted not only for

  8. Corticotomies as a surgical procedure to accelerate tooth movement during orthodontic treatment: A systematic review

    PubMed Central

    Fernández-Ferrer, Laura; Montiel-Company, José-María; Candel-Martí, Eugenia; Almerich-Silla, José-Manuel; Peñarrocha-Diago, Miguel

    2016-01-01

    Background One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects. Material and Methods A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed. Results All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term. Conclusions The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure. Key words:Corticotomy, orthodontics, adults, accelerated tooth movement, osteotomy. PMID:27475698

  9. Risk factors and initial surgical failures of TMJ arthrotomy and arthroplasty: a four to nine year evaluation of 303 surgical procedures.

    PubMed

    Kirk, W S

    1998-07-01

    Studies exist which support the efficacy of TM joint arthrotomy, arthroplasty and arthroscopic surgery. Few, if any, studies have evaluated failures of arthroplasty and/or diskectomy and specific risk factors that might invite initial surgical failure. This paper is a retrospective review of 210 patients operated with arthrotomy/arthroplasty for painful and dysfunctional TM joint derangement. There were 303 surgical procedures evaluated over a follow-up period of 4-9 years. Patient ages ranged from 16-72 years. There was no age correlation seen with degree of joint derangement. All cases were operated by one surgeon. There were no cases of alloplastic materials in this group of patients. There were no cases of autograph such as auricular cartilage for dermal grafting or other disc substitution materials. Operations consisted of capsular arthroplasty in Wilkes' stage II, III, and IV. Diskectomy was performed in Wilkes' stages IV and V. Comparisons are made among staged groups and operation performed. Two hundred seventy-three of 303 operated joints met the criteria for surgical success for a technical success rate of 90.1%. Potential risk factors of missing molar teeth, preoperative joint collapse, and skeletal malocclusion were evaluated. The frequency of their presence in successful and non-successful surgical outcomes is noted. Patients with imaging confirmed osteoporosis were evaluated as group with potential systemic disease or a result of systemic disease that may influence long term surgical outcome. Predictable preoperative risk factors that may influence initial surgical outcome do appear to be significant in long term success. There were 30 cases of failure to evaluate. It is concluded that reconstructive arthroplasty is a stage specific operation with excellent results in Wilkes' stage II and good results in stage III derangement. Attempted arthroplasty failed significantly (50%) in a small number of attempts in stage IV cases. However, diskectomy was

  10. Preliminary Experience with a New Multidirectional Videoendoscope for Neuroendoscopic Surgical Procedures

    PubMed Central

    Cavallo, Luigi Maria; Di Somma, Alberto; Solari, Domenico; de Divitiis, Oreste; Bracale, Umberto Marcello; Cappabianca, Paolo

    2016-01-01

    Purpose We assessed the applicability of a new multidirectional videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) in various neuroendoscopic procedures. Methods A 4-mm-diameter rigid videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) with 1 sensor and an internal LED light source was tested. The device offers a resolution of 1920 x 1080 pixels and weighs ≈ 215 g. The prototype was tested on three cadaveric heads using three different approaches: a) endoscopic endonasal transsphenoidal; b) frontal transcortical intraventricular; c) supraorbital. Results We identified several major benefits of the integrated system as applied to endoscopic endonasal, transcortical intraventricular, and endoscopic supraorbital keyhole approaches. These included improved maneuverability of the scope on account of reduced bulk and integration of the camera and fiberoptic light components, a variable angle of view from 0–70 degrees, and a novel feature that can be activated to maintain orientation of the surgical horizon. Our preliminary report highlights the potential for handling the videoendoscope in one hand, as one would a microsurgical instrument. The videoendoscope harbors all its electronic and lighting data into a unique and thin cable, thus resembling a modern "all-in-one" computer technology. Because of its reduced weight and ergonomic shape, controlling its movements is very easy and comfortable, even in the microsurgical environment. Furthermore, the videoendoscope offers the unique feature of orienting the horizon of vision, thanks to the possibility of offering angled views while working; this helps the surgeons to stay oriented with direct visualization and improved control of the instruments over a specific area of interest. Conclusions The videoendoscope prototype represents an HD-image quality versatile tool in a neurosurgical environment, thanks to its reduced weight and dimensions; in these preliminary simulations, we have

  11. [Choice of surgical procedure in operations for chronic pancreatitis--personal experience].

    PubMed

    Sváb, J; Pesková, M; Fried, M; Gürlich, R; Krska, Z; Bortlík, M; Lukás, M; Horejs, J

    2002-01-01

    The First Surgical Clinic of the First Medical Faculty of Charles University and General Faculty Hospital in Prague made operations of the pancreas ever since 1971. In the work sooner or later all approaches to surgical treatment pancreatitis were reflected. The authors present a brief review of results and their own experience since 1994 when duodenum-sparing operations were introduced. Indications for surgical treatment were based on the diagnosis by US, CT and ERCP, in exceptional case MR, after evaluation by a pancreatologist, roentgenologist and surgeon. The group of patients with chronic pancreatitis was extended by 21 patients from a group operated because of preoperative suspicion of a malignant pancreatic tumour not confirmed during and after surgery. In those Whipple's operation was preformed. The same operation was performed in three patients with chronic pancreatitis with serious changes in the area of the head of the pancreas. In 123 patients a drainage and duodenum sparing operation was preformed, of these in 57 according to Beger, 19 according to Frey, 37 Partington-Rochelle's procedure. The authors record two sepsis postoperative complications after the classical Beger operation and the hospital stay was on average by five days shorter as compared with the classical method of Whipple. When evaluating postoperative complaints and problems (pain, malnutrition, physical constitution and social position) the authors recorded equally favourable results as after non-complicated duodenopancreatectomy. They varied, depending on the patients co-operation round 84-87% while authors consider Beger's operation logical because of the removal of the main tissue mass of the head of the pancreas, responsible for pain, complications caused by fibrosis in the area round the bile duct and duodenum, responsible for the deteriation of the compartment syndrome in the left half of the gland. Its result is destruction of the remainder of exocrine and endocrine tissue. Of

  12. Lymph node dissection for Siewert II esophagogastric junction adenocarcinoma: A retrospective study of 3 surgical procedures.

    PubMed

    Duan, Xiao-Feng; Yue, Jie; Tang, Peng; Shang, Xiao-Bin; Jiang, Hong-Jing; Yu, Zhen-Tao

    2017-02-01

    the perioperative mortality and complication rates in Siewert type II AEG, but obtained satisfactory length of the proximal surgical margin, and was better than the left transthoracic approach in thoracic and abdominal lymph node dissection. However, the advantages of Ivor-Lewis procedure requires further follow-up and validation through prospective randomized controlled trials.

  13. Factors Surgical Team Members Perceive Influence Choices of Wearing or Not Wearing Personal Protective Equipment during Operative/Invasive Procedures

    ERIC Educational Resources Information Center

    Cuming, Richard G.

    2009-01-01

    Exposure to certain bloodborne pathogens can prematurely end a person's life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail…

  14. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for facility services related to covered... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs § 413.118 Payment for facility services related to covered ASC surgical procedures performed in hospitals on...

  15. Aesthetic surgery of the male genitalia.

    PubMed

    Alter, Gary J; Salgado, Christopher J; Chim, Harvey

    2011-08-01

    Appearance of the male genitalia is linked with self-esteem and sexual identity. Aesthetic surgery of the male genitalia serves to correct perceived deficiencies as well as physical deformities, which may cause psychological distress. Attention to patient motivation for surgery and to surgical technique is key to achieving optimal results. In this review, the authors describe aesthetic surgical techniques for treatment of penile and scrotal deficiencies. They also discuss techniques for revision in patients with previous surgery.

  16. Internet Aesthetics

    NASA Astrophysics Data System (ADS)

    Cubitt, Sean

    This article addresses the ephemeral nature of digital media, especially of artworks designed for the world wide web and other network devices. It traces debates over the nature of digital aesthetics, including discussions of software authoring, interaction and conviviality. It looks at low and high tech paths, suggesting that the fundamental dialectic in digital media lies between democratisation and expertise. It concludes with the suggestion that digital aesthetics are subject to change, because they are embedded in the broader social, political and economic histories, as well as the technological and regulatory environments, in which they evolve.

  17. Evaluation of shoulder function in clavicular fracture patients after six surgical procedures based on a network meta-analysis.

    PubMed

    Huang, Shou-Guo; Chen, Bo; Lv, Dong; Zhang, Yong; Nie, Feng-Feng; Li, Wei; Lv, Yao; Zhao, Huan-Li; Liu, Hong-Mei

    2017-01-01

    Purpose Using a network meta-analysis approach, our study aims to develop a ranking of the six surgical procedures, that is, Plate, titanium elastic nail (TEN), tension band wire (TBW), hook plate (HP), reconstruction plate (RP) and Knowles pin, by comparing the post-surgery constant shoulder scores in patients with clavicular fracture (CF). Methods A comprehensive search of electronic scientific literature databases was performed to retrieve publications investigating surgical procedures in CF, with the stringent eligible criteria, and clinical experimental studies of high quality and relevance to our area of interest were selected for network meta-analysis. Statistical analyses were conducted using Stata 12.0. Results A total of 19 studies met our inclusion criteria were eventually enrolled into our network meta-analysis, representing 1164 patients who had undergone surgical procedures for CF (TEN group = 240; Plate group = 164; TBW group  =  180; RP group  =  168; HP group  =  245; Knowles pin group  =  167). The network meta-analysis results revealed that RP significantly improved constant shoulder score in patients with CF when compared with TEN, and the post-operative constant shoulder scores in patients with CF after Plate, TBW, HP, Knowles pin and TEN were similar with no statistically significant differences. The treatment relative ranking of predictive probabilities of constant shoulder scores in patients with CF after surgery revealed the surface under the cumulative ranking curves (SUCRA) value is the highest in RP. Conclusion The current network meta-analysis suggests that RP may be the optimum surgical treatment among six inventions for patients with CF, and it can improve the shoulder score of patients with CF. Implications for Rehabilitation RP improves shoulder joint function after surgical procedure. RP achieves stability with minimal complications after surgery. RP may be the optimum surgical treatment for

  18. Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures

    PubMed Central

    2009-01-01

    The goals of any treatment of cervical spine injuries are: return to maximum functional ability, minimum of residual pain, decrease of any neurological deficit, minimum of residual deformity and prevention of further disability. The advantages of surgical treatment are the ability to reach optimal reduction, immediate stability, direct decompression of the cord and the exiting roots, the need for only minimum external fixation, the possibility for early mobilisation and clearly decreased nursing problems. There are some reasons why those goals can be reached better by anterior surgery. Usually the bony compression of the cord and roots comes from the front therefore anterior decompression is usually the procedure of choice. Also, the anterior stabilisation with a plate is usually simpler than a posterior instrumentation. It needs to be stressed that closed reduction by traction can align the fractured spine and indirectly decompress the neural structures in about 70%. The necessary weight is 2.5 kg per level of injury. In the upper cervical spine, the odontoid fracture type 2 is an indication for anterior surgery by direct screw fixation. Joint C1/C2 dislocations or fractures or certain odontoid fractures can be treated with a fusion of the C1/C2 joint by anterior transarticular screw fixation. In the lower and middle cervical spine, anterior plating combined with iliac crest or fibular strut graft is the procedure of choice, however, a solid graft can also be replaced by filled solid or expandable vertebral cages. The complication of this surgery is low, when properly executed and anterior surgery may only be contra-indicated in case of a significant lesion or locked joints. PMID:19826842

  19. Bilateral symmetry in vision and influence of ocular surgical procedures on binocular vision: A topical review.

    PubMed

    Arba Mosquera, Samuel; Verma, Shwetabh

    2016-01-01

    We analyze the role of bilateral symmetry in enhancing binocular visual ability in human eyes, and further explore how efficiently bilateral symmetry is preserved in different ocular surgical procedures. The inclusion criterion for this review was strict relevance to the clinical questions under research. Enantiomorphism has been reported in lower order aberrations, higher order aberrations and cone directionality. When contrast differs in the two eyes, binocular acuity is better than monocular acuity of the eye that receives higher contrast. Anisometropia has an uncommon occurrence in large populations. Anisometropia seen in infancy and childhood is transitory and of little consequence for the visual acuity. Binocular summation of contrast signals declines with age, independent of inter-ocular differences. The symmetric associations between the right and left eye could be explained by the symmetry in pupil offset and visual axis which is always nasal in both eyes. Binocular summation mitigates poor visual performance under low luminance conditions and strong inter-ocular disparity detrimentally affects binocular summation. Considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK and LASIK, however the method to determine whether or not symmetry is maintained consist of comparing individual terms in a variety of ad hoc ways both before and after the refractive surgery, ignoring the fact that retinal image quality for any individual is based on the sum of all terms. The analysis of bilateral symmetry should be related to the patients' binocular vision status. The role of aberrations in monocular and binocular vision needs further investigation.

  20. Surgical site infection following cesarean delivery: patient, provider and procedure specific risk factors

    PubMed Central

    SHREE, Raj; Park, Seo Young; Beigi, Richard H.; Dunn, Shannon L.; Krans, Elizabeth E.

    2016-01-01

    Objective To identify risk factors for cesarean delivery (CD) surgical site infection (SSI). Study Design Retrospective analysis of 2739 CDs performed at the University of Pittsburgh in 2011. CD SSI’s were defined using National Healthcare Safety Network (NHSN) criteria. Chi-square and t tests were used for bivariate analyses and multivariate logistic regression was used to identify SSI risk factors. Results Of 2739 CDs, 178 (6.5%) were complicated by SSI. Patients with a SSI were more likely to have Medicaid, have resident physicians perform the CD, an ASA class of ≥3, chorioamnionitis, use tobacco and labor prior to CD. In multivariable analysis, labor (2.35;1.65–3.38), chorioamnionitis (2.24;1.25–3.83), resident teaching service (2.15;1.54–3.00), tobacco use (1.70; 1.04–2.70), ASA class ≥3 (1.61; 1.06–2.39) and CDs performed for non-reassuring fetal status (0.43; 0.26–0.67) were significantly associated with CD SSI. Conclusion Multiple patient, provider and procedure specific-risk factors contribute to CD SSI risk which may be targeted in infection control efforts. PMID:26344010

  1. Long Term Results of Innovative Procedure in Surgical Management of Chronic Lymphedema

    PubMed Central

    Mousavi, Seyed R.

    2016-01-01

    Background: Lymphedema is the result of impaired lymphatic drainage by the affected organ. This abnormality can be primary or secondary. Different operative approaches have been introduced to treat chronic lymphedema. Materials and Methods: This retrospective study included 816 patients who were diagnosed with chronic lower extremity lymphedema and did not respond to non-operative management for at least six months. Data was collected over 25 years, between March 1987 and March 2013. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm patency. The patients underwent surgery and their progress was followed for at least one year postoperatively. Results: All patients were operated by the suggested technique and long term fallow-up which is a modified form of the Homan’s technique. The outcome was excellent, and 89.2% of patients were free of complication and 2% had poor results. The most common complication was wound seroma and wound infection. Conclusion: The long term results and considering the difficulties associated with the treatment of chronic lymphedema and the variety of surgical options, our method achieved excellent results, and may be proposed for the standard operative procedure for treating intractable forms of this disease. PMID:27990192

  2. African Aesthetics

    ERIC Educational Resources Information Center

    Abiodun, Rowland

    2001-01-01

    No single traditional discipline can adequately supply answers to the many unresolved questions in African art history. Because of the aesthetic, cultural, historical, and, not infrequently, political biases, already built into the conception and development of Western art history, the discipline of art history as defined and practiced in the West…

  3. Transconjunctival dacryocystorhinostomy: An aesthetic approach

    PubMed Central

    Ganguly, Anasua; Ramarao, Kesarpu; Mohapatra, Samir; Rath, Suryasnata

    2016-01-01

    Purpose: To report the anatomical and cosmetic outcome of transconjunctival dacryocystorhinostomy (TDCR) in an Asian Indian population. Methods: TDCR was initially performed in cadaver eyes followed by patients with primary acquired nasolacrimal duct obstruction (NLDO). This was a prospective noncomparative case series of all consecutive TDCRs performed between April 2013 and June 2015. Outcome measures were anatomical patency, epiphora, presence of diplopia, aesthetic outcome, and health status. Results: A total of 17 (18 eyes) patients with a mean age 43.9 ± 11.8 years (range, 32–75) were included in the study. Eight were males, and one patient underwent TDCR in both eyes. TDCR was successfully performed in 15/18 (82%) eyes under local anesthesia. Procedure converted to transcutaneous external DCR in two and dacryocystectomy in one patient each. Mean duration of surgery was 52.6 (range, 29–110) min. Anatomical patency and relief from epiphora was achieved in all (15/15) eyes after TDCR at a median follow-up of 15.5 months. At final follow-up, objective assessment of the cosmetic outcome graded the surgical scar at the lateral canthus as invisible in all except one and conjunctival fornix as visible only after eyelid eversion in all patients. Disturbance of the medial fat pad was not seen in any patient. A questionnaire-based health status evaluation showed marked improvement in anxiety/depression before and after TDCR with an overall well-being score of 88 on a scale of 0–100 (worst–best) after TDCR. Conclusions: TDCR offers a promising aesthetic approach in patients with primary acquired NLDO and gives excellent functional and cosmetic outcome. PMID:28112129

  4. Haemostasis in head and neck surgical procedures: Valsalva manoeuvre versus Trendelenburg tilt

    PubMed Central

    Moumoulidis, I; Del Pero, Martinez M; Brennan, L; Jani, P

    2010-01-01

    INTRODUCTION The aim of the study was to identify whether Trendelenburg position helps detect any further bleeding points following Valsalva manoeuvre in order to achieve adequate haemostasis in head and neck surgery. PATIENTS AND METHODS Fifty consecutive patients undergoing major head and neck surgical procedures were included. The protocol consisted in performing Valsalva manoeuvre to check haemostasis and treated any bleeding points identified. The operating table was tilted 30° and haemostasis was checked again and treated accordingly. The number of vessels identified and the treatment was recorded. RESULTS Twelve male and 38 female patients were included. The median age was 53 years and 74% had an ASA of 1. Twelve patients had complicating features such as retrosternal extensions or raised T4 levels pre-operatively. Thyroid resections were the most common operations performed. The total number of bleeding vessels identified in Trendelenburg tilt was significantly greater than when using Valsalva manoeuvre (P < 0.0001). All bleeding points found on Valsalva manoeuvre were minor (< 2 mm) and dealt with using diathermy. In Trendelenburg position, 11% of bleeding vessels required ties or stitching. The time taken during Valsalva manoeuvre was 60 s on average and 360 s in Trendelenburg position. CONCLUSIONS The results show that the Trendelenburg position is vastly superior to the Valsalva manoeuvre in identifying bleeding vessels at haemostasis. It has become our practice to put patients in Trendelenburg tilt routinely (we have discontinued the Valsalva manoeuvre), to check its adequacy before closing the wound. We have not noticed any intracranial complications using a tilt angle of 30°. PMID:20501015

  5. Aesthetic Surgery in Patients with Lung Cancer: A Paradigm Shift

    PubMed Central

    Baranski, Jan; Sinno, Sammy

    2016-01-01

    Background: Lung cancer is the most common cancer worldwide and the leading cause of cancer death. With the development of targeted therapy against causative driver mutations, some patients have experienced dramatic responses that have converted their disease into a chronic, stable form. Shifting concerns away from survival and back to quality-of-life issues has led some of these patients to seek aesthetic surgery. Methods: Three patient examples are presented to illustrate current lung cancer treatment modalities, disease responses, and subsequent experiences with aesthetic surgical procedures. Two patients presented for blepharoplasty and the third for revisional breast augmentation surgery. Results: Two patients were treated for lung cancer with targeted therapy and a third with more traditional chemotherapy before undergoing aesthetic surgery. All 3 patients experienced a normal recovery from surgery without any untoward results. Two remain free of disease and one has chronic stable disease. All have returned to normal, active lives. Conclusions: Recent developments in lung cancer treatment are transforming this entity into a less formidable diagnosis for some patients, much like breast cancer and prostate cancer. Plastic surgeons should be aware of this paradigm shift. Successfully treated patients should be considered as reasonable candidates for aesthetic surgery, particularly when they have the full support of their oncologist. Beyond the typical psychological benefits that plastic surgery can produce, it also provides affirmation in this patient population of a return to normalcy, thereby imparting hope and optimism for the future. PMID:27826480

  6. Different Aspects of Informed Consent in Aesthetic Surgeries

    PubMed Central

    Nejadsarvari, Nasrin; Ebrahimi, Ali

    2014-01-01

    Providing an informed consent has an important role in promotion of medical treatments and reduction of judiciary litigations in this process. Today with cultural changes and wide propagation that is usually charming, the request for aesthetic surgery has an increasing trend. These problems with complexity of cosmetic surgeries lead to deeper differences of information between plastic surgeons and patients, so the discussion on giving information to a patient is of great importance. Regarding the elective choice of aesthetic surgeries, there is a need on providing a standard informed consent form. There are some problems on advertisements of aesthetic surgeries by non-plastic surgeons, taking insufficient or incorrect information to the patients affecting the patients’ autonomy. In fact, correct operative information should be share with the patients. Probable complications and alternative procedures should be presented to the patient to choose an operative option freely and without any charming. Obtaining a written informed consent can protect researchers and their sponsor institutions from any litigation. Patients with psychiatric problems can not benefit from aesthetic surgery and also they have no competency for giving any informed consent. So psychiatric problems can even worsen the surgical interventions. In this article, fundamentals of plastic surgery to provide an informed consent were reviewed and the legal and ethical considerations were evaluated. PMID:25489529

  7. [Importance of displacement ventilation for operations and small surgical procedures from the infection preventive point of view].

    PubMed

    Kramer, A; Külpmann, R; Wille, F; Christiansen, B; Exner, M; Kohlmann, T; Heidecke, C D; Lippert, H; Oldhafer, K; Schilling, M; Below, H; Harnoss, J C; Assadian, O

    2010-02-01

    Surgical teams need to breathe air that is conducive to their health. An adequate exchange of air ensures oxygen supply, the ventilation of humidity, smells, toxic substances, especially narcotic gases and surgical smoke, pathogens and particles. With regard to the infection risk, DIN 1946 / 4 -differentiates between operation theaters with the highest demand for clean air (operation room class I a), operation theatres with a high demand (operation room class I b) and rooms within the operation theatres without special requirements, meaning that the microbial load in the air is close to or equal to that of normal in-room air quality (room class II). For an operation room class I a, ventilation that displaces the used air is necessary, while a regular ventilation is sufficient for operation room class I b. Because of ambiguous -results in previous studies, the necessity to define a -class I a for operation rooms is being questioned. Therefore, this review focuses on the analysis of the existing publications with respect to this -question. The result of this analysis indicates that so far there is only one surgical procedure, the -implantation of hip endoprosthetics, for which a preventive effect on SSI of a class I a ventilation (displacement of the used air) is documented. One recent study, reviewed critically here, -showed opposite results, but lacks methodological clarity. Thus, it is concluded that evidence for the requirement of operation room classes can only be derived from risk assessment (infection risk by surgical intervention, extent of possible damages), but not from epidemiological studies. Risk assessment must be based on the following criteria: size and depth of the operation field, -duration of the procedure, vascular perfusion of the wound, implantation of alloplastic material and general risk of the patient for an infection. From an infection preventive point of view, no class I a "displacement ventilation" is necessary for small surgical

  8. Smart surgical needle actuated by shape memory alloys for percutaneous procedures

    NASA Astrophysics Data System (ADS)

    Konh, Bardia

    Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility

  9. Creating an animation-enhanced video library of hepato-pancreato-biliary and transplantation surgical procedures.

    PubMed

    Fung, Albert; Kelly, Paul; Tait, Gordon; Greig, Paul D; McGilvray, Ian D

    2016-01-01

    The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery ( http://tvasurg.ca ). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes.

  10. [Choice of surgical procedure and management of postoperative incision for anal fistula].

    PubMed

    Chen, Chaowen; Peng, Bo

    2015-12-01

    Anal fistula is a common disease in general surgery. It is difficult to heal without intervention and surgical treatment is the major treatment. Method of surgical treatment and management of postoperative incision are based on features and classifications of anal fistula. Choosing the appropriate approach in accordance with specific conditions of patients can obtain effective healing and proper protection against anal sphincter, along with the improvement of life quality. Comprehensive evaluation on methods of surgical treatment and managements of postoperative incision for anal fistula is presented in this paper.

  11. [Evaluation of efficacy of selected antiseptics for hands disinfection before surgical procedures].

    PubMed

    Leksowski, K; Jasiński, A; Marszałek, A

    2001-08-01

    The most important in surgical hands washing and disinfections is long-term and effective reduction of bacteria number. The aim of this study was to compare the efficiency of some antiseptic fluids used for surgical hands disinfection's (AHD 2000, Biotensid, Manopronto and Medi-Scrub PVP Iodine). 62 doctors and surgical nurses were examined. The material for the bacteriological examination was collected before and after hands disinfection's. The bacterial flora reduction have been presented as a percent and a logarithmic reduction ratio. All estimated antiseptic fluids were very potent and provided prolonged efficiency when the operation team complied with orders of hands washing.

  12. A MATERIAL COST-MINIMIZATION ANALYSIS FOR HERNIA REPAIRS AND MINOR PROCEDURES DURING A SURGICAL MISSION IN THE DOMINICAN REPUBLIC

    PubMed Central

    Cavallo, Jaime A.; Ousley, Jenny; Barrett, Christopher D.; Baalman, Sara; Ward, Kyle; Borchardt, Malgorzata; Thomas, J. Ross; Perotti, Gary; Frisella, Margaret M.; Matthews, Brent D.

    2013-01-01

    INTRODUCTION Expenditures on material supplies and medications constitute the greatest per capita costs for surgical missions. We hypothesized that supply acquisition at nonprofit organization (NPO) costs would lead to significant cost-savings compared to supply acquisition at US academic institution costs from the provider perspective for hernia repairs and minor procedures during a surgical mission in the Dominican Republic (DR). METHODS Items acquired for a surgical mission were uniquely QR-coded for accurate consumption accounting. Both NPO and US academic institution unit costs were associated with each item in an electronic inventory system. Medication doses were recorded and QR-codes for consumed items were scanned into a record for each sampled procedure. Mean material costs and cost savings ± SDs were calculated in US dollars for each procedure type. Cost-minimization analyses between the NPO and the US academic institution platforms for each procedure type ensued using a two-tailed Wilcoxon matched-pairs test with α=0.05. Item utilization analyses generated lists of most frequently used materials by procedure type. RESULTS The mean cost savings of supply acquisition at NPO costs for each procedure type were as follows: $482.86 ± $683.79 for unilateral inguinal hernia repair (IHR, n=13); $332.46 ± $184.09 for bilateral inguinal hernia repair (BIHR, n=3); $127.26 ± $13.18 for hydrocelectomy (HC, n=9); $232.92 ± $56.49 for femoral hernia repair (FHR, n=3); $120.90 ± $30.51 for umbilical hernia repair (UHR, n=8); $36.59 ± $17.76 for minor procedures (MP, n=26); and $120.66 ± $14.61 for pediatric inguinal hernia repair (PIHR, n=7). CONCLUSION Supply acquisition at NPO costs leads to significant cost-savings compared to supply acquisition at US academic institution costs from the provider perspective for IHR, HC, UHR, MP, and PIHR during a surgical mission to DR. Item utilization analysis can generate minimum-necessary material lists for each procedure

  13. A Multiphysics Modeling Approach to Develop Right Ventricle Pulmonary Valve Replacement Surgical Procedures with a Contracting Band to Improve Ventricle Ejection Fraction

    PubMed Central

    Tang, Dalin; Yang, Chun; Geva, Tal; Rathod, Rahul; Yamauchi, Haruo; Gooty, Vasu; Tang, Alexander; Kural, Mehmet H.; Billiar, Kristen L.; Gaudette, Glenn; del Nido, Pedro J.

    2012-01-01

    Patients with repaired tetralogy of Fallot account for the majority of cases with late onset right ventricle (RV) failure. A new surgical procedure placing an elastic band in the right ventricle is proposed to improve RV function measured by ejection fraction. A multiphysics modeling approach is developed to combine cardiac magnetic resonance imaging, modeling, tissue engineering and mechanical testing to demonstrate feasibility of the new surgical procedure. Our modeling results indicated that the new surgical procedure has the potential to improve right ventricle ejection fraction by 2–7% which compared favorably with recently published drug trials to treat LV heart failure. PMID:23667272

  14. 40 CFR 240.207 - Aesthetics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Aesthetics. 240.207 Section 240.207 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.207 Aesthetics....

  15. Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation.

    PubMed

    Stokbro, K; Aagaard, E; Torkov, P; Bell, R B; Thygesen, T

    2016-01-01

    This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy and transverse expansion. Furthermore, only a few have evaluated the precision and accuracy of genioplasty in placement of the chin segment. The virtual surgical plan was compared with the postsurgical outcome by using three linear and three rotational measurements. The influence of maxillary segmentation was analyzed in both superior and inferior maxillary repositioning. In addition, transverse surgical expansion was compared with the postsurgical expansion obtained. An overall, high degree of linear accuracy between planned and postsurgical outcomes was found, but with a large standard deviation. Rotational difference showed an increase in pitch, mainly affecting the maxilla. Segmentation had no significant influence on maxillary placement. However, a posterior movement was observed in inferior maxillary repositioning. A lack of transverse expansion was observed in the segmented maxilla independent of the degree of expansion.

  16. Minimally invasive myotomy for the treatment of esophageal achalasia: evolution of the surgical procedure and the therapeutic algorithm.

    PubMed

    Bresadola, Vittorio; Feo, Carlo V

    2012-04-01

    Achalasia is a rare disease of the esophagus, characterized by the absence of peristalsis in the esophageal body and incomplete relaxation of the lower esophageal sphincter, which may be hypertensive. The cause of this disease is unknown; therefore, the aim of the therapy is to improve esophageal emptying by eliminating the outflow resistance caused by the lower esophageal sphincter. This goal can be accomplished either by pneumatic dilatation or surgical myotomy, which are the only long-term effective therapies for achalasia. Historically, pneumatic dilatation was preferred over surgical myotomy because of the morbidity associated with a thoracotomy or a laparotomy. However, with the development of minimally invasive techniques, the surgical approach has gained widespread acceptance among patients and gastroenterologists and, consequently, the role of surgery has changed. The aim of this study was to review the changes occurred in the surgical treatment of achalasia over the last 2 decades; specifically, the development of minimally invasive techniques with the evolution from a thoracoscopic approach without an antireflux procedure to a laparoscopic myotomy with a partial fundoplication, the changes in the length of the myotomy, and the modification of the therapeutic algorithm.

  17. Surgical and Technical Modalities for Hearing Restoration in Ear Malformations.

    PubMed

    Dazert, Stefan; Thomas, Jan Peter; Volkenstein, Stefan

    2015-12-01

    Malformations of the external and middle ear often go along with an aesthetic and functional handicap. Independent of additional aesthetic procedures, a successful functional hearing restoration leads to a tremendous gain in quality of life for affected patients. The introduction of implantable hearing systems (bone conduction and middle ear devices) offers new therapeutic options in this field. We focus on functional rehabilitation of patients with malformations, either by surgical reconstruction or the use of different implantable hearing devices, depending on the disease itself and the severity of malformation as well as hearing impairment. Patients with an open ear canal and minor malformations are good candidates for surgical hearing restoration of middle ear structures with passive titanium or autologous implants. In cases with complete fibrous or bony atresia of the ear canal, the most promising functional outcome and gain in quality of life can be expected with an active middle ear implant or a bone conduction device combined with a surgical aesthetic rehabilitation in a single or multi-step procedure. Although the surgical procedure for bone conduction devices is straightforward and safe, more sophisticated operations for active middle ear implants (e.g., Vibrant Soundbridge, MED-EL, Innsbruck, Austria) provide an improved speech discrimination in noise and the ability of sound localization compared with bone conduction devices where the stimulation reaches both cochleae.

  18. Pesamosca osteoplasty: surgical procedure for the spatial correction of cubitus varus or valgus post malunited supracondylar fractures of the humerus

    PubMed Central

    Burnei, G; Gavriliu, Ş; Nepaliuc, I; Vlad, C; Drăgoescu, M; Georgescu, I; Ghita, RA; Muntean, L; Pârvan, AA; Dughilă, C; Ţiripa, I; Hamei, Ş; Klinaku, I

    2014-01-01

    Introduction. Supracondylar fractures of the humerus represent a current concern in the child’s and adolescent’s osteo-articular pathology. Even though orthopedic reductions are made correctly, fractures can become displaced when managed only by cast immobilization and complications may arise. The most frequent complications encountered in “Prof. Dr. Alexandru Pesamosca” Clinique, Bucharest, Romania, due to supracondylar humeral fractures, are valgus or varus deviations with angles that can sometimes exceed 40 degrees as a result of malunion. Varus or valgus deformations were rarely encountered after surgical treatment. The goal of this study is to present an alternative surgical technique to correct varus and valgus deformations as well as malrotation. Material and method. The study is a retrospective analysis of a 96 children study group surgically managed during 1985 and 2013. In the first period, various surgical techniques have been performed: cuneiform resections, step-cut osteotomies, open wedge osteotomies with external fixation, epiphysiodesis, hemichondrodiatasis and Pesamosca metaphyseal diaphyseal osteoplasty. Starting with 2005, all the cases that presented such complications – 28 out of 96 (29.1%) – were managed with the Pesamosca procedure. Due to the malunion of supracondylar humeral fractures only varus or valgus deformities were admitted in the study. The malunion due to the pathologic fractures encountered in osteogenesis imperfecta or fibrous dysplasia was precluded. The experience accumulated with the other surgical techniques used in 68 out of 96 patients (70.9%) determined us to exclusively use the Pesamosca osteoplasty following the year 2005, seeing the simplicity and the efficiency of this procedure. Results. The outcome was very good. In 5 cases out of the 28 (17%) an apparent residual elbow was encountered and one case of relapse (3%) was noted due to inadequate term of cast immobilization. The elbow’s mobility was

  19. What's new in aesthetic surgery.

    PubMed

    Baker, T M; Stuzin, J M; Baker, T J; Gordon, H L

    1996-01-01

    This article describes new trends, techniques, and instrumentation in aesthetic surgery. Advances in our understanding of anatomy and the changes that come about with intrinsic and extrinsic factors are discussed. Specifically, anatomic approaches to rhytidectomy, the preservation of lid shape in blepharoplasty, and CO2 facial resurfacing are highlighted. Body contouring surgical techniques, including minimal scar breast reductions, endoscopic-assisted augmentation mammoplasty, and superficial liposuction, are reviewed.

  20. Assessment of Intraoperative Blood Loss during Oral and Maxillofacial Surgical Procedures in a Nigerian Tertiary Health Care Center

    PubMed Central

    Akinbami, Babatunde O.

    2014-01-01

    Background. Reports on estimated amount of blood loss in maxillofacial surgical procedures will guide clinicians through units of blood required for each procedure. The aim of the study was to assess the amount of blood loss and duration of surgery. Methods. All cases of maxillofacial surgical procedures done under GA in the MFU theatre, from January 2007 to December 2013, were included in the study. Pre- and postoperative haematocrit values, number of units of whole blood requested and used, amount of blood loss, and duration of surgery were recorded. Results. 139 patients were analyzed, of which 75 (54.0%) were males and 64 (46.0%) were females. Fifty-six (40.3%) cases involved soft tissues. Eighty-three cases involved hard tissues. Age range was 2 months to 78 years; mean ± (SD) was 21.3 ± (18.5) years. Isolated unilateral cleft lip had the lowest mean value of estimated blood loss of 10.4 ± 10.8 mLs and also the lowest duration of surgery of 58 (76) minutes. There was no significant relationship between both parameters for cleft lip. Fractures of the mandible had mean blood loss of 352 mLs and duration was 175 min. Conclusion. In this study, there was significant relationship between estimated blood loss and duration of surgery for mandibular and zygomatic complex fractures. PMID:25258698

  1. Robotic-assisted transperitoneal nephron-sparing surgery for small renal masses with associated surgical procedures: surgical technique and preliminary experience.

    PubMed

    Ceccarelli, Graziano; Codacci-Pisanelli, Massimo; Patriti, Alberto; Ceribelli, Cecilia; Biancafarina, Alessia; Casciola, Luciano

    2013-09-01

    Small renal masses (T1a) are commonly diagnosed incidentally and can be treated with nephron-sparing surgery, preserving renal function and obtaining the same oncological results as radical surgery. Bigger lesions (T1b) may be treated in particular situations with a conservative approach too. We present our surgical technique based on robotic assistance for nephron-sparing surgery. We retrospectively analysed our series of 32 consecutive patients (two with 2 tumours and one with 4 bilateral tumours), for a total of 37 robotic nephron-sparing surgery (RNSS) performed between June 2008 and July 2012 by a single surgeon (G.C.). The technique differs depending on tumour site and size. The mean tumour size was 3.6 cm; according to the R.E.N.A.L. Nephrometry Score 9 procedures were considered of low, 14 of moderate and 9 of hight complexity with no conversion in open surgery. Vascular clamping was performed in 22 cases with a mean warm ischemia time of 21.5 min and the mean total procedure time was 149.2 min. Mean estimated blood loss was 187.1 ml. Mean hospital stay was 4.4 days. Histopathological evaluation confirmed 19 cases of clear cell carcinoma (all the multiple tumours were of this nature), 3 chromophobe tumours, 1 collecting duct carcinoma, 5 oncocytomas, 1 leiomyoma, 1 cavernous haemangioma and 2 benign cysts. Associated surgical procedures were performed in 10 cases (4 cholecystectomies, 3 important lyses of peritoneal adhesions, 1 adnexectomy, 1 right hemicolectomy, 1 hepatic resection). The mean follow-up time was 28.1 months ± 12.3 (range 6-54). Intraoperative complications were 3 cases of important bleeding not requiring conversion to open or transfusions. Regarding post-operative complications, there were a bowel occlusion, 1 pleural effusion, 2 pararenal hematoma, 3 asymptomatic DVT (deep vein thrombosis) and 1 transient increase in creatinine level. There was no evidence of tumour recurrence in the follow-up. RNSS is a safe and feasible technique

  2. The meniscus tear: state of the art of rehabilitation protocols related to surgical procedures

    PubMed Central

    Frizziero, Antonio; Ferrari, Raffaello; Giannotti, Erika; Ferroni, Costanza; Poli, Patrizia; Masiero, Stefano

    2012-01-01

    Summary Meniscal injuries represent one of the most frequent lesions in sport practicing and in particular in soccer players and skiers. Pain, functional limitation and swelling are typical symptoms associated with meniscal tears. Epidemiological studies showed that all meniscal lesions, in different sports athletes, involves 24% of medial meniscus, while 8% of lateral meniscus and about 20–30% of meniscal lesions are associated with other ligament injuries. Meniscal tears can be treated conservatively or surgically. Surgery leads in many cases to complete resolution of symptoms and allows the return to sport activity. However many studies show that this treatment can induce more frequently the development of degenerative conditions if not correctly associated to a specific rehabilitation protocol. The aim of this article is to compare different timing in specific rehabilitation programs related to the most actual surgical options. PMID:23738313

  3. Elective procedures and anesthesia in children: pediatric surgeons enter the dialogue on neurotoxicity questions, surgical options, and parental concerns.

    PubMed

    Byrne, Mary W; Ascherman, Jeffrey A; Casale, Pasquale; Cowles, Robert A; Gallin, Pamela F; Maxwell, Lynne G

    2012-10-01

    The Pediatric Anesthesia NeuroDevelopment Assessment research group at Columbia University Medical Center Department of Anesthesiology has conducted biannual national Symposia since 2008 to evaluate study data and invigorate continued thinking about unresolved issues of pediatric anesthesia neurotoxicities. The third Symposium extended the dialogue between pediatric anesthesiologists and surgeons in panel presentations and discussions by four surgical specialists. This paper reports the prevailing opinions expressed by a pediatric general surgeon, urologist, plastic surgeon and ophthalmologist and explores factors related to delayed operative intervention, need for multiple procedures, and parental concerns.

  4. Radiofrequency-Assisted Partial Splenectomy Plus Splenopexy--A Modified Surgical Procedure for Wandering Spleen: A Case Report.

    PubMed

    Hao, Fulong; Wang, Wenping; Yang, Xiaoli

    2015-09-01

    Wandering spleen is an extremely rare clinical condition characterized by abnormal anatomical position of the spleen. Up to now, its etiology remains unknown, and the best surgical procedure is still an area to explore in the future. In this article, we present the case of a 24-year-old woman with wandering spleen combined with congenital heart disease and pigeon chest. Based on the clinical features and our experiences of radiofrequency ablation for preservation of the spleen in traumatic spleen rupture, we successfully performed a modified splenectomy and splenopexy method. Since the operation, the organ has remained in place with good perfusion and function.

  5. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    PubMed

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P < 0.05). In conclusion, this study represents the first effort to create a mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool.

  6. Teaching Surgical Procedures with Movies: Tips for High-quality Video Clips

    PubMed Central

    Jacquemart, Mathieu; Bouletreau, Pierre; Breton, Pierre; Mojallal, Ali

    2016-01-01

    Summary: Video must now be considered as a precious tool for learning surgery. However, the medium does present production challenges, and currently, quality movies are not always accessible. We developed a series of 7 surgical videos and made them available on a publicly accessible internet website. Our videos have been viewed by thousands of people worldwide. High-quality educational movies must respect strategic and technical points to be reliable. PMID:27757342

  7. Surgical access through the stoma for laparoscopic reversal of Hartmann procedures.

    PubMed

    Parkin, Edward; Khurshid, Mujahid; Ravi, Srinivasan; Linn, Thu

    2013-02-01

    The rate of stoma reversal after Hartmann procedure is low, principally because of the technically demanding nature of the reversal procedure and preexisting comorbid disease frequently present in this patient group. Laparoscopic reversal of Hartmann procedure is an attractive alternative that can reduce perioperative morbidity but the feasibility of completing the procedure laparoscopically is often limited by extensive adhesion formation present after the initial open operation. We describe a technique for laparoscopic reversal of Hartmann procedure where the stoma is mobilized externally and a pneumoperitoneum established through this preexisting defect. Results for the first 7 cases show a median operative duration of 132 minutes and length of hospital stay of 6 days with no conversions. Insertion of the operating ports under direct vision and a more limited dissection to facilitate the anastomosis represents an alternative operative strategy that can be performed successfully, even in patients with comorbid disease.

  8. Critical Aesthetic Realism

    ERIC Educational Resources Information Center

    McMahon, Jennifer A.

    2011-01-01

    A clear-cut concept of the aesthetic is elusive. Kant's "Critique of Judgment" presents one of the more comprehensive aesthetic theories from which one can extract a set of features, some of which pertain to aesthetic experience and others to the logical structure of aesthetic judgment. When considered together, however, these features present a…

  9. Educational Aesthetics and Policy

    ERIC Educational Resources Information Center

    Smith, Ralph A.

    2008-01-01

    In this article, the author conceptualizes educational aesthetics in terms of two domains: educational aesthetics as arts education and educational aesthetics as a range of nonarts educational activities understood from artistic and aesthetic points of view. A lead is taken from Harry S. Broudy's midcentury essay "Some Duties of an Educational…

  10. Utilization of surgical procedures for pelvic organ prolapse: a population-based study in Olmsted County, Minnesota, 1965-2002.

    PubMed

    Babalola, Ebenezer O; Bharucha, Adil E; Melton, L Joseph; Schleck, Cathy D; Zinsmeister, Alan R; Klingele, Christopher J; Gebhart, John B

    2008-09-01

    To describe trends in the utilization of surgical procedures for pelvic organ prolapse among women in Olmsted County, MN, we retrospectively identified all county residents undergoing pelvic organ prolapse repair from January 1, 1965 through December 31, 2002. From 1965 to 2002, 3,813 women had pelvic organ prolapse surgeries: 3,126 had hysterectomy combined with pelvic floor repair (PFR) procedures and 687 had PFR alone. The age-adjusted utilization of hysterectomy plus PFR and of PFR alone decreased by 62% (P < 0.001) and 32% (P = 0.02), respectively. In both groups, utilization decreased in all age groups over time except in women aged 80 years and older undergoing hysterectomy plus PFR and women aged 70 years and older undergoing PFR only. The most common indication for PFR was uterovaginal prolapse. Among women in the community, the rate of utilization and age distribution of pelvic organ prolapse surgery changed substantially between 1965 and 2002.

  11. Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers.

    PubMed

    Dexter, Franklin; Ledolter, Johannes; Hindman, Bradley J

    2016-01-01

    In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications. The applications include strategic analyses (e.g., hospital marketing) and human resource analytics (e.g., comparisons among providers). Measures of diversity of procedures and activities (e.g., Herfindahl and Gini-Simpson index) are used for quantification of each facility (hospital) or anesthesia provider, one at a time. Diversity can be thought of as a summary measure. Thus, if the diversity of procedures for 48 hospitals is studied, the diversity (and its SE) is being calculated for each hospital. Likewise, the effective numbers of common procedures at each hospital can be calculated (e.g., by using the exponential of the Shannon index). Measures of similarity are pairwise assessments. Thus, if quantifying the similarity of procedures among cases with a break or handoff versus cases without a break or handoff, a similarity index represents a correlation coefficient. There are several different measures of similarity, and we compare their features and applicability for perioperative data. We rely extensively on sensitivity analyses to interpret observed values of the similarity index.

  12. Surgical treatment of infective endocarditis in active intravenous drug users: a justified procedure?

    PubMed Central

    2014-01-01

    Background Infective endocarditis is a life threatening complication of intravenous drug abuse, which continues to be a major burden with inadequately characterised long-term outcomes. We reviewed our institutional experience of surgical treatment of infective endocarditis in active intravenous drug abusers with the aim of identifying the determinants long-term outcome of this distinct subgroup of infective endocarditis patients. Methods A total of 451 patients underwent surgery for infective endocarditis between January 1993 and July 2013 at the University Hospital of Heidelberg. Of these patients, 20 (7 female, mean age 35 ± 7.7 years) underwent surgery for infective endocarditis with a history of active intravenous drug abuse. Mean follow-up was 2504 ± 1842 days. Results Staphylococcus aureus was the most common pathogen detected in preoperative blood cultures. Two patients (10%) died before postoperative day 30. Survival at 1, 5 and 10 years was 90%, 85% and 85%, respectively. Freedom from reoperation was 100%. Higher NYHA functional class, higher EuroSCORE II, HIV infection, longer operating time, postoperative fever and higher requirement for red blood cell transfusion were associated with 90-day mortality. Conclusions In active intravenous drug abusers, surgical treatment for infective endocarditis should be performed as extensively as possible and be followed by an aggressive postoperative antibiotic therapy to avoid high mortality. Early surgical intervention is advisable in patients with precipitous cardiac deterioration and under conditions of staphylococcal endocarditis. However, larger studies are necessary to confirm our preliminary results. PMID:24661344

  13. A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures

    PubMed Central

    Epstein, Nancy E.

    2014-01-01

    Background: The impact of early mobilization on perioperative comorbidities and length of stay (LOS) has shown benefits in other medical/surgical subspecialties. However, few spinal series have specifically focused on the “pros” of early mobilization for spinal surgery, other than in acute spinal cord injury. Here we reviewed how early mobilization and other adjunctive measures reduced morbidity and LOS in both medical and/or surgical series, and focused on how their treatment strategies could be applied to spinal patients. Methods: We reviewed studies citing protocols for early mobilization of hospitalized patients (day of surgery, first postoperative day/other) in various subspecialties, and correlated these with patients’ perioperative morbidity and LOS. As anticipated, multiple comorbid factors (e.g. hypertension, high cholesterol, diabetes, hypothyroidism, obesity/elevated body mass index hypothyroidism, osteoporosis, chronic obstructive pulmonary disease, coronary artery disease and other factors) contribute to the risks and complications of immobilization for any medical/surgical patient, including those undergoing spinal procedures. Some studies additionally offered useful suggestions specific for spinal patients, including prehabilitation (e.g. rehabilitation that starts prior to surgery), preoperative and postoperative high protein supplements/drinks, better preoperative pain control, and early tracheostomy, while others cited more generalized recommendations. Results: In many studies, early mobilization protocols reduced the rate of complications/morbidity (e.g. respiratory decompensation/pneumonias, deep venous thrombosis/pulmonary embolism, urinary tract infections, sepsis or infection), along with the average LOS. Conclusions: A review of multiple medical/surgical protocols promoting early mobilization of hospitalized patients including those undergoing spinal surgery reduced morbidity and LOS. PMID:24843814

  14. Outcomes in Patients With Hemophilia and von Willebrand Disease Undergoing Invasive or Surgical Procedures.

    PubMed

    Chapin, John; Bamme, Jaqueline; Hsu, Fraustina; Christos, Paul; DeSancho, Maria

    2017-03-01

    Adults with hemophilia A (HA), hemophilia B (HB), and von Willebrand disease (VWD) frequently require surgery and invasive procedures. However, there is variability in perioperative management guidelines. We describe our periprocedural outcomes in this setting. A retrospective chart review from January 2006 to December 2012 of patients with HA, HB, and VWD undergoing surgery or invasive procedures was conducted. Type of procedures, management including the use of continuous factor infusion, and administration of antifibrinolytics were reviewed. Adverse outcomes were defined as acute bleeding (<48 hours), delayed bleeding (≥48 hours), transfusion, inhibitor development, and thrombosis. We identified 59 patients with HA and HB. In all, 24 patients had severe hemophilia and 12 had mild/moderate hemophilia. Twelve patients had inhibitors. There were also 5 female carriers of HA and 6 patients with VWD. There were 34 major surgeries (26 orthopedic, 8 nonorthopedic) and 129 minor surgeries. Continuous infusion was used in 55.9% of major surgeries versus 8.5% of minor surgeries. Antifibrinolytics were administered in 14.7% of major surgeries versus 23.2% of minor surgeries. In all, 4 patients developed acute bleeding and 10 patients developed delayed bleeding. Delayed bleeding occurred in 28.6% of genitourinary procedures and in 16.1% of dental procedures. Five patients acquired an inhibitor and 2 had thrombosis. In conclusion, patients with HA, HB, or VWD had similar rates of adverse outcomes when undergoing minor surgeries or major surgeries. This finding underscores the importance of an interdisciplinary management and procedure-specific guidelines for patients with hemophilia and VWD prior to even minor invasive procedures.

  15. Evaluation of propofol as a general anesthetic agent for minor oral surgical procedure.

    PubMed

    Jaggi, Nitin; Kalra, Amit; Baghla, Gunpreet Kaur; Medsinge, Sonali V; Purohit, Nikhil

    2013-07-01

    Nausea and vomiting following anesthesia is a distressing problem for the patient as it increases the recovery time, intensity of nursing care and delays discharge. The aim of randomized controlled single blind study is to evaluate the efficacy and safety of subhypnotic doses of propofol for the prevention of postoperative nausea and vomiting (PONV) in day care management of cases in oral and maxillofacial surgeries. Twenty-five patient of ASA-1 with age ranging from 12 to 40 years were scheduled for various maxillofacial surgical cases like fracture, cyst enucleation, surgical removal of 3rd molar, etc. were given propofol at the dose of 2 to 2.5 mg/kg as induction dose and sedation was maintained with the dose 5 to 10 mg/min. There was no significant effect on heart rate, systolic and diastolic blood pressure, respiratory rate and oxygen saturation intraoperatively. In conclusion, a subhypnotic dose of propofol is fast acting, safe and easily controllable, short acting general anesthetic agent with rapid recovery. The study found that the PONV was significantly reduced in the patient with propofol, no hemodynamic derangements were noted in the postoperative period.

  16. Surgical sterilization: an underutilized procedure for evaluating the merits of induced sterility

    USGS Publications Warehouse

    Kennelly, James J.; Converse, Kathryn A.

    1993-01-01

    Despite more than 4 decades of effort, development of effective wildlife damage control programs based on sterilization of target species has met with limited success. This is partly due to the fact that investigators have assumed, rather than empirically tested, whether the reproductive strategies of the target populations were vulnerable to the planned treatment. Equally important, methods selected to include sterility usually involve a chemical agent that can affect sociosexual behaviors of the nuisance population. In this report, we illustrate how surgically induced sterility circumvents both problems--how the concept without the potentially confounding secondary effects of a chemical. We assessed the merits of initiating research to develop a male chemosterilant for Norway rats, red-winged blackbirds, beaver, and Canada geese by inducing sterility surgically. The infidelity of many red-winged females to their polygynous territorial male was surprising and argued against searching for a male sterilant. On the other hand, beaver and Canada goose studies confirmed previous reports that both form par-bonds and are monogamous. Both should be vulnerable to a male chemosterilant approach, and research toward this goal is justified.

  17. Optimizing cerebrovascular surgical and endovascular procedures in children via personalized 3D printing.

    PubMed

    Weinstock, Peter; Prabhu, Sanjay P; Flynn, Katie; Orbach, Darren B; Smith, Edward

    2015-07-31

    OBJECT Despite the availability of multiplanar imaging, understanding relational 3D anatomy for complex cerebrovascular lesions can be difficult. A 3D printed model allows for instantaneous visualization of lesional anatomy from all perspectives, with the added ability to simulate operative approaches with tactile feedback. The authors report their experience with customized 3D printed models of pediatric cerebrovascular lesions as an educational and clinical tool for patients, trainees, and physicians. METHODS Via an "in-house" 3D print service, magnetic resonance imaging (MRI) and computerized tomography (CT) studies of pediatric patients with arteriovenous malformations (AVMs) were processed with specialized software, and regions of interest were selected by the surgical/endovascular team. Multiple models for each patient were then printed on a 3D printer, with each construct designed to illustrate different aspects of the specific lesion. Intraoperative validation of model fidelity was performed using perioperative imaging, surgical filming, and post hoc analysis of models with intraoperative photography. RESULTS Four cases involving pediatric patients (ages 0-16 years) were studied for initial proof of principle. Three of the patients had AVMs and one had a vein of Galen malformation (VOGM). The VOGM was embolized successfully and the AVMs were resected without complication. In the AVM cases, intraprocedural imaging and photography were performed and verified millimeter-level fidelity of the models (n = 5, 98% concordance, range 94%-100% with average of < 2 mm variation in the largest AVM [6-cm diameter]). The use of 3D models was associated with a 30-minute reduction in operative time (12%) in 2 cases when they were compared with matched controls as a feasibility study. CONCLUSIONS Patient-specific 3D printed models of pediatric cerebrovascular conditions can be constructed with high fidelity. This proof-of-principle series demonstrates, for the first time

  18. Laparoscopic Gastric Plication: An Emerging Bariatric Procedure with High Surgical Revision Rate

    PubMed Central

    Albanese, Alice; Prevedello, Luca; Verdi, Daunia; Nitti, Donato; Vettor, Roberto

    2015-01-01

    Introduction: Laparoscopic gastric plication (LGCP) reduces gastric volume without resecting or implanting a foreign body. Although still considered investigational, it could be appropriate for young patients with a low body mass index (BMI) and for those unwilling to undergo sleeve gastrectomy, gastric banding, or bypass. Objectives: The aim of this study was to assess the mid-term results (2 years) of LGCP in terms of safety and efficacy. Methods: A total of 56 obese patients (47 female; mean age=30.5±11.7 years; mean BMI=40.31±4.7 kg/m2) were candidates for LGCP from January 2011 to October 2013. Early and late complications, BMI, and excess BMI loss (EBL) were prospectively recorded at 3, 6, 9, 12, 18, and 24 months follow-up. Results: Mean operative time was 72.4±15.6 minutes. No conversion was required. Mean hospital stay was 3 days. Mean %EBL was 34.3±18.40%, 40.1±24.5%, 47.4±30.2%, 46.5±34.6%, 47.8±43.2%, and 55.3±53.6% at 3, 6, 9, 12, 18, and 24 months, respectively. The overall complication rate was 32.14%. Perioperative mortality was zero. Surgical revision was needed in 30 patients: 12 for unsatisfactory weight loss and 18 for gastric prolapse (one acute within 30 days), respectively. Conclusion: LGCP showed high complication rates requiring surgical revision. PMID:26421246

  19. [The clinical estimation of ketoprofen lysine salt effect on the intensitivity of acute pain syndrome in the oral cavity during surgical procedures and postoperative period].

    PubMed

    Durnovo, E A; Shashurina, S V; Bespalova, N A; Khomutinnikova, N E; Gliavina, I A; Marochkina, M S; Iartseva, A V

    2013-01-01

    Is studying and control of the clinical efficacy and safety of ketoprofen lysine salt (КLS) (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in the form of sachets and solutions for application in postoperative period after dental surgeries procedures. The comparison of the analgetic effect of systemic and local forms of the "Oki" drug, depending on the type and extent of surgery procedures. Was carried out surgical treatment and patients examination in the postoperative period. Surgical procedures included: vestibulolasty, vestibulolasty with apically-displaced flap, vestibulolasty with apically-displaced flap and a free palatal mucogingival graft, removal impacted and dystopic teeth, periodontal surgery. The research was conducted in the Surgical stomatology and Maxillofacial surgery Department (stomatological policlinic of the Nizhny Novgorod State Medical Academy). Was noted rapid advanced of anesthesia when using sachets and solutions of the ketoprofen lysine salt (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in postoperative period after dental surgical procedures. Was noted a more advanced of analgetic effect in the application therapy by DCI solution when open surgical wound presented. Analgetic effect was observed after 20-30 min and was maintained in the postoperative period to an average of 8 hours. Local application sachets and solution of the ketoprofen lysine salt (KLS ), in our opinion, is the most appropriate and is highly effective when open surgical wound presented. Ketoprofen lysine salt (KLS) has a neutral pH and does not irritate the gastrointestinal tract, that determines the safety of its used.

  20. Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series.

    PubMed

    de Ruiter, Godard C W; Nogarede, Claudine O; Wolfs, Jasper F C; Arts, Mark P

    2017-01-01

    OBJECTIVE The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL. METHODS The authors prospectively followed a cohort of 113 patients with spinal metastases who were referred to their clinic for surgical evaluation between July 2012 and July 2014. Quality of life was assessed using the EQ-5D at intake and at 3, 6, 9, and 12 months after treatment. RESULTS Nineteen patients were treated conservatively, 41 underwent decompressive surgery with or without stabilization, 47 underwent a piecemeal corpectomy procedure with stabilization and expandable cage reconstruction, and 6 had a stabilization procedure without decompression. Among all surgical patients, the mean EQ-5D score was significantly increased from 0.44 pretreatment to 0.59 at 3 months after treatment (p < 0.001). Mean EQ-5D scores at 1 year after surgery further increased to 0.84 following decompression with stabilization, 0.74 after corpectomy with stabilization, and 0.94 after stabilization without decompression. Frankel scores also improved after surgery. There were no significant differences in improvements in EQ-5D scores and Frankel grades among the different surgical procedures. In addition, mortality and complication rates were similar. CONCLUSIONS Quality of life can improve significantly after various extensive and less extensive surgical procedures in patients with spinal metastases. The relatively invasive corpectomy procedure, as compared with alternative less invasive techniques, does not negatively

  1. Emergency Major Abdominal Surgical Procedures in Older Adults: A Systematic Review of Mortality and Functional Outcomes

    PubMed Central

    Cooper, Zara; Scott, John W.; Rosenthal, Ronnie A.; Mitchell, Susan L.

    2016-01-01

    OBJECTIVES To systematically review the current literature on mortality and functional outcomes after emergency major abdominal surgery in older adults. DESIGN Systematic literature search and standardized data collection of primary research publications from January 1994 through December 2013 on mortality or functional outcome in adults aged 65 and older after emergency major abdominal surgery using PubMed, EMBASE, Web of Science, Cochrane, and CINAHL. Bibliographies of relevant reports were also hand-searched to identify all potentially eligible studies. SETTING Systematic review of retrospective and cohort studies using Preferred Reporting Items for Systematic reviews and Meta-Analyses, Meta-analysis Of Observational Studies in Epidemiology, Strengthening the Reporting of Observational Studies in Epidemiology, and A Measurement Tool to Assess Systematic Reviews guidelines. PARTICIPANTS Older adults. MEASUREMENTS Articles were assessed using a standardized quality scoring system based on study design, measurement of exposures, measurement of outcomes, and control for confounding. RESULTS Of 1,459 articles screened, 93 underwent full-text review, and 20 were systematically reviewed. In-hospital and 30-day mortality of all older adults exceeded 15% in 14 of 16 studies, where reported. Older adults undergoing emergency major abdominal surgery consistently had higher mortality across study settings and procedure types than younger individuals undergoing emergency procedures and older adults undergoing elective procedures. In studies that stratified older adults, odds of death increased with age. None of these studies examined postoperative functional status, which precluded including functional outcomes in this review. Differences in exposures, outcomes, and data presented in the studies did not allow for quantification of association using metaanalysis. CONCLUSION Age independently predicts mortality after emergency major abdominal surgery. Data on changes in

  2. Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet.

    PubMed

    Khanfour, Ashraf A

    2013-05-01

    When choosing the Ilizarov technique for the treatment of recurrent or neglected clubfeet deformity, there was a consensus on the treatment of 3-8-year-old children by the soft-tissue distraction 'bloodless method' either alone or with an adjunctive-limited soft tissue release; whereas, in older children, adjunctive osteotomies were required. Major foot osteotomies such as V, U, Y, or supramalleolar types were established for patients after puberty when the foot bones become fully ossified. So, children falling in the age group between 8 and 13 years (preadolescents) represents a transitional growing stage that has its identity that makes carrying out major foot osteotomies unsuitable. Twenty-five feet in 21 patients with a mean age at the time of operation of 10.9 years (range, 9-13 years) with recurrent or neglected clubfeet deformity who presented to the orthopedic department at Alexandria (Egypt) between February 2004 and December 2008 were treated with the Ilizarov technique combined with adjunctive limited bony and/or soft-tissue procedures as will be discussed. After a mean follow-up period of 3.6 years (range, 2-7 years), 21 children showed good results, four children showed fair results, and no poor results were recorded. No major complications were reported. The Ilizarov technique with limited bony and/or soft-tissue procedures can be considered as a suitable, convenient, efficient, and successful salvage procedure for preadolescent recurrent or neglected clubfeet.

  3. [Alternative surgical method in malalignment of healed distal radius fracture: Kapandji-Sauvé procedure].

    PubMed

    Pechlaner, S

    1998-11-01

    Malunion after distal radius fracture with subluxation of the distal radioulnar joint can considerably limit the function of the hand. If the malunion cannot be eliminated by the corrective osteotomy of the radius, care must be taken not to additionally impair the stability of the wrist joint and the carpus, in the event of any necessary salvage procedure. In the Kapandji-Sauvé procedure, an arthrodesis is carried out after repositioning of the distal radioulnar joint. By segment resection of the ulnar shaft, a new joint is made to permit forearm rotation. Between 1984 and 1995, a total of 96 patients were treated with this procedure in our hospital. It was possible to re-examine 87 of those patients after an average period of 4 1/2 (1 to 11) years. The average age of the patients was 59 (14 to 72) years. In 25 cases the results were very good and in 52 cases good. In nine cases the results were poor. In one case the result was unsatisfactory.

  4. Intraoperative antibiotic wound lavage: an attempt to eliminate postoperative infection in arterial and clean general surgical procedures.

    PubMed

    Lord, J W; Rossi, G; Daliana, M

    1977-06-01

    Intraoperative antibiotic wound lavage has been used in all arterial reconstructive procedures for the past 7 years and reduced the incidence of early and late postoperative infections from 1.5% in 400 operations prior to 1969 to 0.23% (one post-hospital) in 434 patients operated since that date. In 226 consecutive clean major general surgical procedures since June 1971 there has been no early or late wound infections following intraoperative antibiotic wound lavage in contrast to an infection rate of 1.5% in 185 operations prior to that date. A double blind study of 200 patients undergoing operations for varicose veins was carried out as follows: The wounds of alternate patients were irrigated either with normal saline or with antibiotic solution. There were no gross (grade II) postoperative wound infections. Minor skin changes were noted in 93 of 632 incisions in the saline group and only 49 of 608 incisions irrigated with antibiotic solution (P less than 0.001). In clean operations without antibiotic wound lavage there was a 0.73% rate of in-hospital wound infections in 685 patients in contrast to a zero rate in 760 patients wherein intraoperative wound lavage was carried out throughout the operative procedure.

  5. Early reoperation performed for the management of complications in patients undergoing general thoracic surgical procedures

    PubMed Central

    Foroulis, Christophoros N.; Kleontas, Athanasios; Karatzopoulos, Avgerinos; Nana, Chryssoula; Tagarakis, George; Tossios, Paschalis; Anastasiadis, Kyriakos

    2014-01-01

    Objective To detect the rate and predisposing factors for the development of postoperative complications requiring re-operation for their control in the immediate postoperative period. Methods During the time period 2009-2012, 719 patients (male: 71.62%, mean age: 54±19 years) who underwent a wide range of general thoracic surgery procedures, were retrospectively collected. Data of patients who underwent early re-operation for the management of postoperative complications were assessed for identification of the responsible causative factors. Results Overall, 33/719 patients (4.6%) underwent early re-operation to control postoperative complications. Early re-operation was obviated by the need to control bleeding or to drain clotted hemothoraces in nine cases (27.3%), to manage a prolonged air leak in six cases (18.2%), to drain a post-thoracotomy empyema in five cases (15.2%), to revise the thoracotomy incision or an ischemic musculocutaneous flap in five cases (15.2%), to manage a bronchopleural fistula in four cases (12.1%), to manage persistent atelectasis of the remaining lung in two cases (6.1%), to cease a chyle leak in one case (3%) and to plicate the right hemidiaphragm in another one case (3%). The factors responsible for the development of complications requiring reopening of the chest for their management were technical in 17 cases (51.5%), initial surgery for lung or pleural infections in 9 (27.3%), the recent antiplatelet drug administration in 4 (12.1%) and advanced lung emphysema in 3 (9.1%). Mortality of re-operations was 6.1% (2/33) and it was associated with the need to proceed with completion pneumonectomy in the two cases with persistent atelectasis of the remaining lung and permanent parenchymal damage. The majority of complications requiring reoperation were observed after lung parenchyma resection (17 out of the 228 procedures/7.4%) or pleurectomy (7 out of the 106 procedures/6.5%). Reoperations after video-assisted thoracic surgery (VATS

  6. Short-term survival and effects of transmitter implantation into western grebes using a modified surgical procedure

    USGS Publications Warehouse

    Gaydos, Joseph K.; Massey, J. Gregory; Mulcahy, Daniel M.; Gaskins, Lori A.; Nysewander, David; Evenson, Joseph; Siegel, Paul B.; Ziccardi, Michael H.

    2011-01-01

    Two pilot trials and one study in a closely related grebe species suggest that Western grebes (Aechmophorus occidentalis) will not tolerate intracoelomic transmitter implantation with percutaneous antennae and often die within days of surgery. Wild Western grebes (n = 21) were captured to evaluate a modified surgical technique. Seven birds were surgically implanted with intracoelomic transmitters with percutaneous antennae by using the modified technique (transmitter group), 7 received the same surgery without transmitter implantation (celiotomy group), and 7 served as controls (only undergoing anesthesia). Modifications included laterally offsetting the body wall incision from the skin incision, application of absorbable cyanoacrylate tissue glue to the subcutaneous space between the body wall and skin incisions, application of a waterproof sealant to the skin incision after suture closure, and application of a piece of porcine small intestine submucosa to the antenna egress. Survival did not differ among the 3 groups with 7 of 7 control, 6 of 7 celiotomy, and 6 of 7 transmitter birds surviving the 9-day study. Experimental birds were euthanized at the end of the study, and postmortem findings indicated normal healing. Significant differences in plasma chemistry or immune function were not detected among the 3 groups, and only minor differences were detected in red blood cell indices and plasma proteins. After surgery, the birds in the transmitter group spent more time preening tail feathers than those in the control and celiotomy groups. These results demonstrate that, in a captive situation, celiotomy and intracoelomic transmitter implantation caused minimal detectable homeostatic disturbance in this species and that Western grebes can survive implantation of intracoelomic transmitters with percutaneous antennae. It remains to be determined what potential this modified surgical procedure has to improve postoperative survival of Western grebes that are

  7. Perspectives on procedure-based assessments: a thematic analysis of semistructured interviews with 10 UK surgical trainees

    PubMed Central

    Shalhoub, Joseph; Ippolito, Kate

    2017-01-01

    Objectives The introduction of competency-based training has necessitated development and implementation of accompanying mechanisms for assessment. Procedure-based assessments (PBAs) are an example of workplace-based assessments that are used to examine focal competencies in the workplace. The primary objective was to understand surgical trainees' perspective on the value of PBA. Design Semistructured interviews with 10 surgical trainees individually interviewed to explore their views. Interviews were audio-recorded and transcribed; following this, they were open and axial coded. Thematic analysis was then performed. Results Semistructured interviews yielded several topical and recurring themes. In trainees' experience, the use of PBAs as a summative tool limits their educational value. Trainees reported a lack of support from seniors and variation in the usefulness of the tool based on stage of training. Concerns related to the validity of PBAs for evaluating trainees' performance with reports of ‘gaming’ the system and trainees completing their own assessments. Trainees did identify the significant value of PBAs when used correctly. Benefits included the identification of additional learning opportunities, standardisation of assessment and their role in providing a measure of progress. Conclusions The UK surgical trainees interviewed identified both limitations and benefits to PBAs; however, we would argue based on their responses and our experience that their use as a summative tool limits their formative use as an educational opportunity. PBAs should either be used exclusively to support learning or solely as a summative tool; if so, further work is needed to audit, validate and standardise them for this purpose. PMID:28341687

  8. A rapid and non-surgical procedure for jugular catheterization of pigs.

    PubMed

    Matte, J J

    1999-07-01

    A rapid and non-surgical method for jugular catheterization in pigs was set up in 30 piglets of 6.2 kg, 23 pigs of 46 kg and 84 kg and two lactating multiparous sows. The animal was restrained on a V-shaped table (piglets) or with a rope around the mandible (slaughter pigs and sows). The vein was located with the Vacutainer system and a wire guide was inserted into the Vacutainer needle up to the vein lumen. When the needle was removed, the catheter was inserted over the wire guide and advanced until it penetrated the skin and thereafter, the vein wall. The catheter was fixed outside by a large tape and coiled inside a patch just behind the ears. The technique utilizes readily available material and is no more risky for the animal than a single blood sampling. Moreover, it can be performed within 15 to 20 min (including animal restraint) within pens. This new approach might have important implications not only for research purposes by facilitating repeated blood samplings but also for projects which require a rapid and easy method for testing of any kind of pharmaceutical or other type of products under husbandry conditions.

  9. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    PubMed Central

    2011-01-01

    Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

  10. Non pigmented melanocytic nevus of the oral cavity: a case report with emphasis on the surgical excision procedures.

    PubMed

    Porrini, R; Valente, G; Colombo, E; Cannas, M; Sabbatini, M

    2013-01-01

    We report a case of a 37-year-old caucasian woman presenting a 1 cm pinkish nodular asymptomatic lesion of the hard palate, slowly growing in the last years. The lesion underwent to biopsy. Histological analysis showed the nevus tissue layered under a continuous squamous epithelium. The stroma contained nests of medium-sized round cells, with regular monomorphous nuclei. The nevus cells were immunohistochemically positive for S-100 protein, while melanin, visualized by Masson-Fontana silver staining, was absent. Therefore a diagnosis of non pigmented melanocytic nevus was formulated. Because of its rarity and to avoid any risk of malignant transformation, a surgical treatment with wide excision was chosen; the surgical wound was previously covered with a membrane of fibrin and autologous platelets, and subsequently sutured, resulting in a total heal. This procedure seems to be the most reliable to approach melanocytic lesions of the oral cavity. Clinical diagnosis of non-pigmented nevi, either flat or protruding, is difficult, because the nevus shows a pinkish colour that is indistinguishable from that of the surrounding mucosa. Moreover, attention is required when similar clinical evidence occurs, because the localization inside the oral cavity may offer several problems of differential diagnosis.

  11. Surgical correction of 639 pectus excavatum cases via the Nuss procedure

    PubMed Central

    Zhang, Dong-Kun; Tang, Ji-Ming; Ben, Xiao-Song; Xie, Liang; Zhou, Hai-Yu; Ye, Xiong; Zhou, Zi-Hao; Shi, Rui-Qing; Xiao, Pu

    2015-01-01

    Background To review the clinical experience and short- to middle-term effects of the Nuss procedure for correction of pectus excavatum (PE). Methods From September 2006 to August 2014, 639 patients with PE were treated using the Nuss procedure. Of these, 546 were male and 93 were female. The mean age was 15.3±5.8 years (2.5-49 years). Preoperative chest CT scans Haller index (HI) was 4.3±1.7 (2.9-17.4), with 75 cases of mild PE (HI <3.2), 114 cases of moderate PE (HI 3.2-3.5), 393 cases of severe PE (HI 3.6-6.0), and 57 cases of extremely severe PE (HI >6.0). Results A total of 638 patients successfully completed the surgery, an 11-year-old male patient who died after the surgery had undergone ventricular septal defect closure surgery through a sternal incision 7 years ago. The mean operative time was 64.3±41.7 min (40-310 min). Excluding the patient who died, the average blood loss was 24.5±17.8 mL (10-160 mL). The average length of postoperative hospital stay was 5.2±2.9 days (4-36 days). A total of 484 cases (75.7%) required 1 steel bar insertion, 153 cases (24.0%) required 2 steel bars, and 2 cases (0.3%) required 3 bars. Postoperative evaluation of the surgery outcomes revealed the following: excellent in 504 cases, good in 105, fair in 28 and poor in 2, good quality rate was 95.3%. Conclusions Correction of PE via the Nuss procedure is minimally invasive and simple to perform with good short and mid-term effects, while long-term efficacy remains to be determined. PMID:26543607

  12. Estimation of the stapes-bone thickness in the stapedotomy surgical procedure using a machine-learning technique.

    PubMed

    Kaburlasos, V G; Petridis, V; Brett, P N; Baker, D A

    1999-12-01

    Stapedotomy is a surgical procedure aimed at the treatment of hearing impairment due to otosclerosis. The treatment consists of drilling a hole through the stapes bone in the inner ear in order to insert a prosthesis. Safety precautions require knowledge of the nonmeasurable stapes thickness. The technical goal herein has been the design of high-level controls for an intelligent mechatronics drilling tool in order to enable the estimation of stapes thickness from measurable drilling data. The goal has been met by learning a map between drilling features, hence no model of the physical system has been necessary. Learning has been achieved as explained in this paper by a scheme, namely the d-sigma Fuzzy Lattice Neurocomputing (d sigma-FLN) scheme for classification, within the framework of fuzzy lattices. The successful application of the d sigma-FLN scheme is demonstrated in estimating the thickness of a stapes bone "on-line" using drilling data obtained experimentally in the laboratory.

  13. Surgical Resection for Hepatocellular Carcinoma with Cardiac Cirrhosis after the Fontan Procedure

    PubMed Central

    Takuma, Yoshitaka; Fukada, Yuji; Iwadou, Shota; Miyatake, Hirokazu; Uematsu, Shuji; Okamoto, Ryoichi; Sato, Daisuke; Matsukawa, Hiroyoshi; Shiozaki, Shigehiro; Kamada, Masahiro; Morito, Toshiaki; Araki, Yasuyuki

    2016-01-01

    A 29-year-old woman who underwent the Fontan procedure at 10 years of age had an incidental finding of liver masses on abdominal ultrasonography. Subsequent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid magnetic resonance imaging showed a 15 mm hypervascular mass with washout in the hepatobiliary phase in liver segment 4 (S4), and an 18 mm hypervascular mass without washout in the hepatobiliary phase in liver segment 2 (S2). The S2 liver mass was pathologically diagnosed to be a regenerative nodule by an ultrasound-guided needle biopsy, and the S4 liver mass was pathologically diagnosed as a poorly differentiated hepatocellular carcinoma after partial hepatectomy. PMID:27853067

  14. A Bayesian network meta-analysis of three different surgical procedures for the treatment of humeral shaft fractures

    PubMed Central

    Qiu, Hao; Wei, Zhihui; Liu, Yuting; Dong, Jing; Zhou, Xin; Yin, Liangjun; Zhang, Minhua; Lu, Minpeng

    2016-01-01

    Abstract Background: The optimal surgical procedure for humeral shaft fractures remains a matter of debate. We aimed to establish the optimum procedure by performing a Bayesian network meta-analysis. Methods: PubMed, EMBASE, the Cochrane Library, and Medline were searched for both randomized controlled trials and prospective studies of surgical treatment for humeral shaft fractures. The quality of the included studies was assessed according to the Cochrane Collaboration's “Risk of bias”. Results: Seventeen RCTs or prospective studies were included in the meta-analysis. The pooled results showed that the occurrence rate of radial nerve injury was lowest for minimally invasive plate osteosynthesis (MIPO; SUCRA probability, 95.1%), followed by open reduction and plate osteosynthesis (ORPO; SUCRA probability, 29.5%), and was highest for intramedullary nailing (IMN; SUCRA probability, 25.4%). The aggregated results of pairwise meta-analysis showed no significant difference in radial nerve injury rate when comparing ORPO versus IMN (OR, 1.92; 95% CI, 0.96 to 3.86), ORPO versus MIPO (OR, 3.38; 95% CI, 0.80 to 14.31), or IMN versus MIPO (OR, 3.19; 95% CI, 0.48 to 21.28). Regarding the nonunion, SUCRA probabilities were 90.5%, 40.2%, and 19.3% for MIPO, ORPO, and IMN, respectively. The aggregated results of a pairwise meta-analysis also showed no significant difference for ORPO versus IMN (OR, 0.83; 95% CI, 0.41 to 1.69), ORPO versus MIPO (OR, 2.42; 95% CI, 0.45 to 12.95), or IMN versus MIPO (OR, 2.49; 95% CI, 0.35 to 17.64). Conclusion: The current evidence indicates that MIPO is the optimum choice in the treatment of humeral shaft fractures and that ORPO is superior to IMN. PMID:28002327

  15. Human fallopian tube: a new source of multipotent adult mesenchymal stem cells discarded in surgical procedures

    PubMed Central

    Jazedje, Tatiana; Perin, Paulo M; Czeresnia, Carlos E; Maluf, Mariangela; Halpern, Silvio; Secco, Mariane; Bueno, Daniela F; Vieira, Natassia M; Zucconi, Eder; Zatz, Mayana

    2009-01-01

    Background The possibility of using stem cells for regenerative medicine has opened a new field of investigation. The search for sources to obtain multipotent stem cells from discarded tissues or through non-invasive procedures is of great interest. It has been shown that mesenchymal stem cells (MSCs) obtained from umbilical cords, dental pulp and adipose tissue, which are all biological discards, are able to differentiate into muscle, fat, bone and cartilage cell lineages. The aim of this study was to isolate, expand, characterize and assess the differentiation potential of MSCs from human fallopian tubes (hFTs). Methods Lineages of hFTs were expanded, had their karyotype analyzed, were characterized by flow cytometry and underwent in vitro adipogenic, chondrogenic, osteogenic, and myogenic differentiation. Results Here we show for the first time that hFTs, which are discarded after some gynecological procedures, are a rich additional source of MSCs, which we designated as human tube MSCs (htMSCs). Conclusion Human tube MSCs can be easily isolated, expanded in vitro, present a mesenchymal profile and are able to differentiate into muscle, fat, cartilage and bone in vitro. PMID:19538712

  16. Reflections on Aesthetic Teaching

    ERIC Educational Resources Information Center

    Sotiropoulou-Zormpala, Marina

    2012-01-01

    This article examines how it is possible to use the aesthetic process to enrich teaching practices in preschool and elementary school education. What is under scrutiny is the aesthetic dimension of a core curricular subject, the ultimate goal being to achieve an understanding of curricular content through aesthetic learning processes. For this…

  17. TOT 8/4: A Way to Standardize the Surgical Procedure of a Transobturator Tape

    PubMed Central

    Ludwig, Sebastian; Stumm, Martin; Mallmann, Peter; Jager, Wolfram

    2016-01-01

    Suburethral tapes are placed “tension-free” below the urethra. Several studies reported considerable differences of the distance between urethra and tape. These distances ranged from 1 to 10 mm amongst different patients. This either caused urethral obstruction or had no effect on urinary incontinence. Therefore, we decided to standardize the procedure by placing a Hegar dilator of 8-millimeter diameter in the urethra and another Hegar dilator of 4-millimeter diameter between the urethra and the tape during transobturator tape placement. Using that simple technique, which we named “TOT 8/4,” we observed that 83% of the tapes were placed in the desired distance between 3 and 5 millimeters below the urethra. PMID:26981532

  18. A technique for administering xenon gas anesthesia during surgical procedures in mice.

    PubMed

    Ruder, Arne Mathias; Schmidt, Michaela; Ludiro, Alessia; Riva, Marco A; Gass, Peter

    2014-11-01

    Carrying out invasive procedures in animals requires the administration of anesthesia. Xenon gas offers advantages as an anesthetic agent compared with other agents, such as its protection of the brain and heart from hypoxia-induced damage. The high cost of xenon gas has limited its use as an anesthetic in animal experiments, however. The authors designed and constructed simple boxes for the induction and maintenance of xenon gas and isoflurane anesthesia in small rodents in order to minimize the amount of xenon gas that is wasted. While using their anesthesia delivery system to anesthetize pregnant mice undergoing caesarean sections, they measured the respiratory rates of the anesthetized mice, the survival of the pups and the percentages of oxygen and carbon dioxide within the system to confirm the system's safety.

  19. TOT 8/4: A Way to Standardize the Surgical Procedure of a Transobturator Tape.

    PubMed

    Ludwig, Sebastian; Stumm, Martin; Mallmann, Peter; Jager, Wolfram

    2016-01-01

    Suburethral tapes are placed "tension-free" below the urethra. Several studies reported considerable differences of the distance between urethra and tape. These distances ranged from 1 to 10 mm amongst different patients. This either caused urethral obstruction or had no effect on urinary incontinence. Therefore, we decided to standardize the procedure by placing a Hegar dilator of 8-millimeter diameter in the urethra and another Hegar dilator of 4-millimeter diameter between the urethra and the tape during transobturator tape placement. Using that simple technique, which we named "TOT 8/4," we observed that 83% of the tapes were placed in the desired distance between 3 and 5 millimeters below the urethra.

  20. High condylectomy procedure: a valuable resource for surgical management of the mandibular condylar hyperplasia.

    PubMed

    Pereira-Santos, Darklilson; De Melo, Willian Morais; Souza, Francisley Avila; de Moura, Walter Leal; Cravinhos, Julio César de Paulo

    2013-07-01

    Condylar hyperplasia is an overdevelopment of the condyle, which may manifest unilaterally or bilaterally. This pathological condition can lead to facial asymmetry, malocclusion, and dysfunction of the temporomandibular joint. The etiology and pathogenesis of condylar hyperplasia remain uncertain, but it has been suggested that its etiology may be associated with hormonal factors, trauma, and hereditary hypervascularity, affecting both genders. The diagnosis is made by clinical examination, and radiological imaging, and additionally, bone scintigraphy, is a fundamental resource for determining whether the affected condyle shows active growth. Patients with active condylar hyperplasia management have better results when they are subjected to the high condylectomy procedure. The authors report a case in a 20-year-old female subject with unilateral active condylar hyperplasia who was treated by high condylectomy. The patient has been followed up for 4 years without signs of recurrence and with good functional stability of the occlusion.

  1. A Fluidic Cell Embedded Electromagnetic Wave Sensor for Online Indication of Neurological Impairment during Surgical Procedures

    NASA Astrophysics Data System (ADS)

    Blakey, R. T.; Mason, A.; Al-Shamma'a, A. I.

    2013-06-01

    Lactate is known to be an indicator of neurological impairment during aortic aneurysm surgery. It is suggested that cerebrospinal fluid removed during such surgery could provide useful information in this regard. Medical professionals find the prospect of online detection of such analytes exciting, as current practice is time consuming and leads to multiple invasive procedures. Advancing from the current laboratory based analysis techniques to online methods could provide the basis for improved treatment regimes, better quality of care, and enhanced resource efficiency within hospitals. Accordingly, this article considers the use of a low power fluidic system with embedded electromagnetic wave sensor to detect varying lactate concentrations. Results are promising over the physiological range of 0 - 20 mmol/L with a calibration curve demonstrating an R2 value > 0.98.

  2. Occupational Radiation Exposure from C Arm Fluoroscopy During Common Orthopaedic Surgical Procedures and its Prevention

    PubMed Central

    Samuel, Sumant; Saran, Atul K; Mahajan, M K; Mam, M K

    2015-01-01

    Background: Image intensifiers have become popular due to the concept of minimally invasive surgeries leading to decreasing invasiveness, decreased operative time, and less morbidity. The drawback, however, is an increased risk of radiation exposure to surgeon, patient and theatre staff. These exposures have been of concern due to their potential ability to produce biological effects. The present study was embarked upon to analyse the amount of radiation received by orthopedic surgeons in India using standard precautionary measures and also to bring awareness about the use of image intensifier safety in everyday practice. Materials and Methods: Twelve right-handed male orthopedic surgeons (4 senior consultants, 5 junior consultants and 3 residents) were included in a three month prospective study for radiation exposure measurement with adequate protection measures in all procedures requiring C Arm fluoroscopy. Each surgeon was provided with 5 Thermo Luminescent Dosimeter (TLD) badges which were tagged at the level of neck, chest, gonads and both wrists. Operative time and exposure time of each procedure was recorded. Exposure dose of each badge at the end of the study was obtained and the results were analysed. Results: Mean radiation exposure to all the parts were well within permissible limits. There was a significantly positive correlation between the exposure time and the exposure dose for the left wrist (r=0.735, p<0.01) and right wrist (r=0.58, p<0.05). The dominant hand had the maximum exposure overall. Conclusion: Orthopaedic surgeons are not classified radiation workers. The mean exposure doses to all parts of the body were well within permissible limits. Nothing conclusive, however, can be said about the stochastic effects (chance effects like cancers). Any amount of radiation taken is bound to pose an additional occupational hazard. It is thus desirable that radiation safety precautions should be taken and exposures regularly monitored with at least one

  3. Adding aesthetics to the OB-GYN practice.

    PubMed

    Kulkin, Jay M; Flash, Shayna

    2010-12-01

    Laser aesthetic procedures have substantially increased in popularity for both women and men over the past several years. As public awareness grows, so does the demand for the safe and effective delivery of these services. Gynecologists and other primary care providers are offering laser aesthetic procedures to meet their own patient demand.

  4. Surgical exposures of the hand.

    PubMed

    Watt, Andrew J; Chung, Kevin C

    2014-11-01

    Surgical approaches to the hand are commonly executed in the treatment of fractures, ligament injuries, and less commonly in the resection of bony tumors. Careful design and execution of these surgical approaches translates into superior functional and aesthetic outcomes. We have provided a thorough review of commonly used approaches to the hand by evaluating each of these approaches in the context of core principles including safety, versatility, preservation of stability, and aesthetic outcomes.

  5. Total autogenous mandibular reconstruction using virtual surgical planning.

    PubMed

    Winters, Ryan; Saad, Adam; Beahm, Donald David; Wise, Matthew Whitten; St Hilaire, Hugo

    2012-09-01

    Free fibula transfer has become the workhorse in mandibular reconstruction. Total mandibular reconstruction is an uncommon procedure with added complexity. Numerous techniques have been described for such reconstruction, many requiring a temporomandibular joint prosthesis. We present a novel method where simultaneous bilateral free fibula transfer utilizing preoperative virtual surgical planning was used to produce a total autogenous reconstruction. The virtual surgical planning allows to effectively quantify the bone stock required preoperatively and facilitates intraoperative modeling of the fibula. Therefore, a more anatomically correct reconstruction is obtained resulting in improved functional and aesthetic outcomes.

  6. A Novel Surgical Procedure for Er:YAG Laser-Assisted Periodontal Regenerative Therapy: Case Series.

    PubMed

    Taniguchi, Yoichi; Aoki, Akira; Sakai, Kazuto; Mizutani, Koji; Meinzer, Walter; Izumi, Yuichi

    2016-01-01

    The objective of this study was to evaluate an Er:YAG laser (ErL) application for periodontal regenerative surgery in angular bone defects at nine sites in six patients. Debridement was thoroughly performed using a combination of curettage with a Gracey-type curette and ErL irradiation at a panel setting of 70 mJ/pulse and 20 Hz with sterile saline spray. After applying an enamel matrix derivative and autogenous bone grafting, ErL was used to form a blood clot coagulation on the grafted bone surface at 50 mJ/pulse and 20 Hz without water spray for approximately 30 seconds. Twelve months after surgery the mean probing depth had improved from 6.2 mm to 2.0 mm, the mean clinical attachment level had reduced from 7.5 mm to 3.4 mm, and bleeding on probing had improved from (+) to (-). Mean intrabony defect depth decreased from 6.0 mm before surgery to 1.0 mm 12 months after surgery. A novel procedure for periodontal regenerative surgery applying ErL irradiation for thorough decontamination during debridement as well as blood coagulation following autogenous bone grafting seems to have achieved favorable and stable healing of periodontal pockets with significant clinical improvement and desirable regeneration of angular bone defects, including one-wall defects.

  7. [Introduction to nursing aesthetics].

    PubMed

    Chen, Chen-Jung; Tsai, Chuan-Hsiu; Chen, Yi-Chang

    2011-04-01

    Empirical, aesthetic, ethical, and personal knowing are the four fundamental patterns of knowledge inquiry. Of these, the aesthetic knowing pattern is least discussed in nursing literature. This article discusses the definition of nursing aesthetics; its utilization in practice; and correlations between aesthetics and clinical practice. One of the advantages inherent to nursing is its ability to deliver skillful care directly to patients. Skillful performance is essential to reduce discrepancies between goals and patterns. Aesthetic nursing addresses more than the form of nursing. It further addresses the crucial elements of nursing knowledge. The science of nursing is influential in its ability to attain harmony among abundant empiric content, power of beneficence, and pleasure of aesthetic experience. In clinical practice, nurses can employ aesthetic nursing through various channels to create meaning and promote the professional image of nurses. Concepts listed in this article may be utilized in clinical supervision, practice and education.

  8. Dynamics of aesthetic appreciation

    NASA Astrophysics Data System (ADS)

    Carbon, Claus-Christian

    2012-03-01

    Aesthetic appreciation is a complex cognitive processing with inherent aspects of cold as well as hot cognition. Research from the last decades of empirical has shown that evaluations of aesthetic appreciation are highly reliable. Most frequently, facial attractiveness was used as the corner case for investigating aesthetic appreciation. Evaluating facial attractiveness shows indeed high internal consistencies and impressively high inter-rater reliabilities, even across cultures. Although this indicates general and stable mechanisms underlying aesthetic appreciation, it is also obvious that our taste for specific objects changes dynamically. Aesthetic appreciation on artificial object categories, such as fashion, design or art is inherently very dynamic. Gaining insights into the cognitive mechanisms that trigger and enable corresponding changes of aesthetic appreciation is of particular interest for research as this will provide possibilities to modeling aesthetic appreciation for longer durations and from a dynamic perspective. The present paper refers to a recent two-step model ("the dynamical two-step-model of aesthetic appreciation"), dynamically adapting itself, which accounts for typical dynamics of aesthetic appreciation found in different research areas such as art history, philosophy and psychology. The first step assumes singular creative sources creating and establishing innovative material towards which, in a second step, people adapt by integrating it into their visual habits. This inherently leads to dynamic changes of the beholders' aesthetic appreciation.

  9. Computed tomographic-based morphometric study of thoracic spine and its relevance to anaesthetic and spinal surgical procedures

    PubMed Central

    Kaur, Kiranpreet; Singh, Roop; Prasath, Vishnu; Magu, Sarita; Tanwar, Milind

    2016-01-01

    Background To collect a baseline computer software aided normative morphometric data of thoracic spine in the Indian population and analyze it to give pre-procedural guidelines to clinicians for safe surgical and anaesthetic procedures in the thoracic spine. Methods CT scans of thoracic spine of patients free from spinal disorders were reviewed in a total of 600 vertebrae in 50 patients. Parameters recorded with the help of computer software were pedicle width, length and height, transverse pedicle angles, chord length, canal dimensions, body width and height, spinous process angle and transverse process length. Results Pedicle width decreased from T1 (9.27 ± 1.01) to T4 (4.5 ± 0.93) and increased to T12 (8.31 ± 1.83). At T4 76% and at T5 62% of the pedicles were smaller than 5 mm and would not accept 4 mm screw with 1.0-mm clearance. However, at T1 2%, at T11 7% and at T12 8% would not accept a 4 mm screw. Chord length gradually increased in upper thoracic vertebrae and was relatively constant in middle and decreased in lower thoracic vertebrae. Shortest estimated chord length was at T1 (30.30 ± 2.11). On an average, from T1 to T6 and at T11 and T12, a screw length of 25–30 mm could be accommodated and from T7 to T10, 30–35 mm screw length could be accommodated. Transverse pedicle angle decreased from T1 (35.4 ± 2.21) to T12 (−9.8 ± 2.39). Canal dimensions were narrowest at T4/T5 (20.02 ± 1.23) in anteroposterior and 21.12 ± 1.23 in interpedicular diameters. Spinous process angle increased from T1 (30.11 ± 6.74) to T6 (57.89 ± 9.31) and decreased to 16.21 ± 7.38 at T12. Transverse process length increased from T1 to T7 (23.54 + 2.12 to 31.21 + 1.91) and then decreased to 12.11 + 2.3 at T12. Vertebral body dimensions showed increasing trends from T1 to T12. Conclusions A thorough knowledge of anatomical and radiological characteristics of the spine and their variations is essential for the clinicians. Data collected

  10. Aesthetic, urological, orthopaedic and functional outcomes in complex bladder exstrophy-epispadias's management

    PubMed Central

    Kouame, Bertin Dibi; Kouame, Guy Serge Yapo; Sounkere, Moufidath; Koffi, Maxime; Yaokreh, Jean Baptiste; Odehouri-Koudou, Thierry; Tembely, Samba; Dieth, Gaudens Atafi; Ouattara, Ossenou; Dick, Rufin

    2015-01-01

    Background: Postoperative complications are related to the surgical procedures, of failures of initial bladder closure and influence the urological, aesthetical and orthopaedic outcomes. Materials and Methods: We reviewed four patients who underwent complex bladder exstrophy-epispadias repair over a period of 14 years. The outcomes of treatment were assessed using, aesthetic, urological and orthopaedic examination data. Orthopaedic complications were explored by a radiography of the pelvis. Results: Out of four patients who underwent bladder exstrophy surgical management, aesthetic, functional outcomes and complications in the short and long follow-up were achieved in three patients. The first patient is a male and had a good penis aspect. He has a normal erection during micturition with a good jet miction. He has a moderate urinary incontinence, which requires diaper. In the erection, his penis-measures 4 cm long and 3 cm as circumference. The second patient was a female. She had an unsightly appearance of the female external genitalia with bipartite clitoris. Urinary continence could not be assessed; she did not have the age of cleanness yet. The third patient had a significant urinary leakage due to the failure of the epispadias repair. He has a limp, a pelvic obliquity, varus and internal rotation of the femoral head. He has an inequality of limbs length. Pelvis radiograph shows the right osteotomy through the ilium bone, the left osteotomy through the hip joint at the acetabular roof. Conclusion: When, the epispadias repair is performed contemporary to initial bladder closure, its success is decisive for urinary continence. In the female, surgical revision is required after the initial bladder closure for an aesthetic appearance to the external genitalia. Innominate osteotomy must be performed with brilliancy amplifier to avoid osteotomy through to the hip joint to prevent inequality in leg length. PMID:25659552

  11. Review of three-dimensional (3D) surface imaging for oncoplastic, reconstructive and aesthetic breast surgery.

    PubMed

    O'Connell, Rachel L; Stevens, Roger J G; Harris, Paul A; Rusby, Jennifer E

    2015-08-01

    Three-dimensional surface imaging (3D-SI) is being marketed as a tool in aesthetic breast surgery. It has recently also been studied in the objective evaluation of cosmetic outcome of oncological procedures. The aim of this review is to summarise the use of 3D-SI in oncoplastic, reconstructive and aesthetic breast surgery. An extensive literature review was undertaken to identify published studies. Two reviewers independently screened all abstracts and selected relevant articles using specific inclusion criteria. Seventy two articles relating to 3D-SI for breast surgery were identified. These covered endpoints such as image acquisition, calculations and data obtainable, comparison of 3D and 2D imaging and clinical research applications of 3D-SI. The literature provides a favourable view of 3D-SI. However, evidence of its superiority over current methods of clinical decision making, surgical planning, communication and evaluation of outcome is required before it can be accepted into mainstream practice.

  12. Clinician-led surgical site infection surveillance of orthopaedic procedures: a UK multi-centre pilot study.

    PubMed

    Morgan, M; Black, J; Bone, F; Fry, C; Harris, S; Hogg, S; Holmes, A; Hughes, S; Looker, N; McIlvenny, G; Nixon, J; Nolan, J; Noone, A; Reilly, J; Richards, J; Smyth, E; Howard, A

    2005-07-01

    The UK Department of Health established the Healthcare-associated Infection (HAI) Surveillance Steering Group in 2000 to develop a strategy for implementing a national programme for HAI surveillance in National Health Service trusts. A subgroup of this committee examined the surveillance of surgical site infections following orthopaedic surgery. This group oversaw a pilot scheme that was set up in 12 hospitals around the UK to explore the feasibility of implementing a system of surveillance that engaged clinical staff in its operation, provided a process for continuous data collection and could be maintained as part of routine hospital operation over time. A minimum data set was established by the subgroup, and Centers for Disease Control and Prevention (CDC) definitions of infection were used. By March 2003, the surveillance had been undertaken continuously in 11 sites for one to two years, depending on the date of implementation. Only one hospital had ceased data collection. The information was collected mainly by clinical staff, with support and co-ordination usually provided by infection control teams. Data on more than 5400 procedures were available for analysis for four core procedures: arthroplasty of the hip and knee; hemi-arthroplasty of the hip; and internal fixation of trochanteric fractures of the femur. The data set permitted the calculation of risk-adjusted rates, allowing comparisons between hospitals and within a hospital over time. The methodology enhanced clinical ownership of the surveillance process, re-inforced infection control as the responsibility of all staff, and provided timely feedback and local data analysis. The use of CDC definitions permitted international comparisons of the data.

  13. Comparison of conventional surgical resection, radioactive implantation, and bypass procedures for exocrine carcinoma of the pancreas 1975-1980

    SciTech Connect

    Morrow, M.; Hilaris, B.; Brennan, M.F.

    1984-01-01

    To examine the efficacy of a variety of procedures for treatment of biopsy proven exocrine adenocarcinoma of the pancreas, a retrospective review of 231 patients surgically treated at a single institution from January 1975 through December 1980 was performed. Thirty-nine patients underwent resection for cure, of which 19 were conventional resection, 33 I125 implantation, 76 biliary or GI bypass, and 83 biopsy alone, a resectability rate of 16.9%. There was one pancreatic fistula in the implant group. Median survival following implant was 8 months (0%, 30-day mortality) and, for conventional resection (n . 19), 17 months with an inhospital mortality of 16%. Median survival excluding inhospital mortality was 17 months for the conventional resection group. For bypass, median survival was 4 months with an inhospital mortality of 14%. Of patients discharged from hospital, 5 of 16 (31%) survived 2 years in the conventional resection group, while 4 of 132 (3%) survived 2 years in the nonresected groups. Only one patient (5% of resected) has survived 4 years in the conventional resection group, although eight others are alive and at risk in this group. Resectability rate for patients referred with adenocarcinoma of the pancreas remains low. The only long-term survivors are in those patients undergoing resection. Local implantation with I125 requires prospective evaluation because of an apparent influence on palliation without significant morbidity.

  14. Positional changes of the masseter and medial pterygoid muscles after surgical mandibular advancement procedures: an MRI study.

    PubMed

    Dicker, G J; Koolstra, J H; Castelijns, J A; Van Schijndel, R A; Tuinzing, D B

    2012-08-01

    This study evaluated whether surgical mandibular advancement procedures induced a change in the direction and the moment arms of the masseter (MAS) and medial pterygoid (MPM) muscles. Sixteen adults participated in this study. The sample was divided in two groups: Group I (n=8) with a mandibular plane angle (mpa) <39° and Group II (n=8) with an mpa >39°. Group I patients were treated with a bilateral sagittal split osteotomy (BSSO). Those in Group II were treated with a BSSO combined with a Le Fort I osteotomy. Pre- and postoperative direction and moment arms of MAS and MPM were compared in these groups. Postsurgically, MAS and MPM in Group II showed a significantly more vertical direction in the sagittal plane. Changes of direction in the frontal plane and changes of moment arms were insignificant in both groups. This study demonstrated that bimaxillary surgery in patients with an mpa >39° leads to a significant change of direction of MAS and MPM in the sagittal plane.

  15. Mastectomy -- The Surgical Procedure

    MedlinePlus

    ... and Staging Stages Molecular Subtypes Molecular Subtypes Triple Negative Breast Cancer Emerging Areas in Diagnosis Inflammatory Breast ... Accessing Sources of Support Accessing Sources of Support Social Support Local Support Support Groups Hospice Donate Now Fundraise ...

  16. IC Treatment: Surgical Procedures

    MedlinePlus

    ... Body-based Practices Energy Medicine Bringing Treatments to Market IC Healthcare Provider Toolkit Join the Provider Registry ... Body-based Practices Energy Medicine Bringing Treatments to Market IC Healthcare Provider Toolkit Join the Provider Registry ...

  17. Surface Aesthetics and Analysis.

    PubMed

    Çakır, Barış; Öreroğlu, Ali Rıza; Daniel, Rollin K

    2016-01-01

    Surface aesthetics of an attractive nose result from certain lines, shadows, and highlights with specific proportions and breakpoints. Analysis emphasizes geometric polygons as aesthetic subunits. Evaluation of the complete nasal surface aesthetics is achieved using geometric polygons to define the existing deformity and aesthetic goals. The relationship between the dome triangles, interdomal triangle, facet polygons, and infralobular polygon are integrated to form the "diamond shape" light reflection on the nasal tip. The principles of geometric polygons allow the surgeon to analyze the deformities of the nose, define an operative plan to achieve specific goals, and select the appropriate operative technique.

  18. Aesthetic Response and Cosmic Aesthetic Distance

    NASA Astrophysics Data System (ADS)

    Madacsi, D.

    2013-04-01

    For Homo sapiens, the experience of a primal aesthetic response to nature was perhaps a necessary precursor to the arousal of an artistic impulse. Among the likely visual candidates for primal initiators of aesthetic response, arguments can be made in favor of the flower, the human face and form, and the sky and light itself as primordial aesthetic stimulants. Although visual perception of the sensory world of flowers and human faces and forms is mediated by light, it was most certainly in the sky that humans first could respond to the beauty of light per se. It is clear that as a species we do not yet identify and comprehend as nature, or part of nature, the entire universe beyond our terrestrial environs, the universe from which we remain inexorably separated by space and time. However, we now enjoy a technologically-enabled opportunity to probe the ultimate limits of visual aesthetic distance and the origins of human aesthetic response as we remotely explore deep space via the Hubble Space Telescope and its successors.

  19. Comparison of GlideScope video laryngoscope with Macintosh laryngoscope in adult patients undergoing elective surgical procedures

    PubMed Central

    Parasa, Mrunalini; Yallapragada, Srivishnu Vardhan; Vemuri, Nagendra Nath; Shaik, Mastan Saheb

    2016-01-01

    Background: GlideScope (GS) is a video laryngoscope that allows a real-time view of the glottis and endotracheal intubation. It provides a better view of the larynx without the need for alignment of the airway axes. Aim: This prospective randomized comparative study is designed to compare the intubation time, hemodynamic response, and complications associated with intubation using a GS or Macintosh laryngoscope (ML) in adult subjects undergoing elective surgical procedures. Materials and Methods: Sixty American Society of Anesthesiologists physical status 1–2 patients were included in this prospective randomized comparative study. Patients were randomized to be intubated using either a GS or an ML. The primary outcome measure was the intubation time. The secondary outcome measures were the hemodynamic response to intubation and the incidence of mucosal injury. Statistical Analysis: Mean and standard deviation were calculated for different parameters under the study. The observed results were analyzed using Student's t-test for quantitative data and Z-test of proportions. P<0.05 was considered statistically significant. Results: Intubation time was longer in GS group (45.7033 ± 11.649 s) as compared to ML (27.773 ± 5.122 s) P< 0.0001 with 95% confidence interval (95% CI) −13.2794 to −22.5806. GS provided better Cormack and Lehane laryngoscopic view (P = 0.0016 for grade 1 view) with 95% CI −0.1389 to −0.5951. GS group exhibited more laryngoscopic response than ML group with more increase in blood pressure and heart rate, but the difference was not statistically significant. More cases of mucosal trauma were documented in GS group. Conclusion: Use of GS to facilitate intubation led to better glottic view but took a longer time to achieve endotracheal intubation. GS was associated with more hemodynamic response to intubation and mucosal injury in comparison with an ML. PMID:27212755

  20. Time-dependent RNA degradation affecting cDNA array quality in spontaneous canine tumours sampled using standard surgical procedures.

    PubMed

    Von Euler, Henrik; Khoshnoud, Reza; He, Qimin; Khoshnoud, Aida; Fornander, Tommy; Rutqvist, Lars-Erik; Skog, Sven

    2005-12-01

    Heterogeneous gene expression in tumours and the degradation of RNA when sampling under non-RNAse-free conditions may limit the potential benefit of cDNA array studies. This study examines changes in the integrity of RNA by means of RNA gel electrophoresis at various post-operative intervals on canine mammary tumours (n=10) and malignant lymphoma (n=1). The tumours were cut into pieces (3-5 mm diameter, approximately 50 mg) and kept in tubes without RNAse-free buffer at room temperature. No special precautions were taken to avoid the influences of Rnase; rather, normal surgical procedures were used. We found that total RNA of the mammary tumours started to degrade within 30 min of the operation, and the rate of degradation increased up to 4 h, which was the last time point included in this study. RNA in the lymphoma tumours degraded more rapidly, and was completely degraded at 30 min post-operation. The degradation of mRNA in the mammary tumours, as studied by human cDNA arrays, was heterogeneous, i.e. some mRNA degraded completely, some only partially. This indicates that the mRNA degradation rate varied depending on the type of mRNA. However, since we found that gene expression differs depending on the part of the mammary tumour examined, one cannot exclude that the variation in the mRNA degradation rate may simply reflect heterogeneous gene expression within the tumour. We conclude that RNA integrity is unaffected immediately after sampling under non-RNAse-free conditions; however, the tumour sample should be preserved under RNAse-free conditions within 15 min to avoid RNA degradation. This is a much shorter time interval than previously reported in other similar studies; however, these studies generally treated normal tissue, under which 3-5 h non-RNAse-free conditions have been found not to affect RNA quality.

  1. I-gel versus laryngeal mask airway-Proseal: Comparison of two supraglottic airway devices in short surgical procedures

    PubMed Central

    Jadhav, Poonam A; Dalvi, Naina P; Tendolkar, Bharati A

    2015-01-01

    Background and Aims: Supraglottic airway devices have been established in clinical anesthesia practice and have been previously shown to be safe and efficient. The objective of this prospective, randomized trial was to compare I-Gel with LMA-Proseal in anesthetized spontaneously breathing patients. Material and Methods: Sixty patients undergoing short surgical procedures were randomly assigned to I-gel (Group I) or LMA- Proseal (Group P). Anesthesia was induced with standard doses of propofol and the supraglottic airway device was inserted. We compared the ease and time required for insertion, airway sealing pressure and adverse events. Results: There were no significant differences in demographic and hemodynamic data. I-gel was significantly easier to insert than LMA-Proseal (P < 0.05) (Chi-square test). The mean time for insertion was more with Group P (41 + 09.41 secs) than with Group I (29.53 + 08.23 secs) (P < 0.05). Although the airway sealing pressure was significantly higher with Group P (25.73 + 02.21 cm of H2O), the airway sealing pressure of Group I (20.07 + 02.94 cm of H2O) was very well within normal limit (Student's t test). The success rate of first attempt insertion was more with Group I (P < 0.05). There was no evidence of airway trauma, regurgitation and aspiration. Sore throat was significantly more evident in Group P. Conclusion: I-Gel is a innovative supraglottic device with acceptable airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence I-Gel can be a good alternative to LMA-Proseal. PMID:25948905

  2. Aesthetics and Dance.

    ERIC Educational Resources Information Center

    Thomas, Carolyn E.

    The nine articles in this monograph deal with aesthetics from a broad-based approach appealing to an eclectic dance audience. The papers were written by dancers, dance philosophers, and physical educators. Two papers examine the role of the body as the dancers' aesthetic medium, including the use of yoga to increase body awareness. Other papers…

  3. Components of aesthetic experience: aesthetic fascination, aesthetic appraisal, and aesthetic emotion

    PubMed Central

    Marković, Slobodan

    2012-01-01

    In this paper aesthetic experience is defined as an experience qualitatively different from everyday experience and similar to other exceptional states of mind. Three crucial characteristics of aesthetic experience are discussed: fascination with an aesthetic object (high arousal and attention), appraisal of the symbolic reality of an object (high cognitive engagement), and a strong feeling of unity with the object of aesthetic fascination and aesthetic appraisal. In a proposed model, two parallel levels of aesthetic information processing are proposed. On the first level two sub-levels of narrative are processed, story (theme) and symbolism (deeper meanings). The second level includes two sub-levels, perceptual associations (implicit meanings of object's physical features) and detection of compositional regularities. Two sub-levels are defined as crucial for aesthetic experience, appraisal of symbolism and compositional regularities. These sub-levels require some specific cognitive and personality dispositions, such as expertise, creative thinking, and openness to experience. Finally, feedback of emotional processing is included in our model: appraisals of everyday emotions are specified as a matter of narrative content (eg, empathy with characters), whereas the aesthetic emotion is defined as an affective evaluation in the process of symbolism appraisal or the detection of compositional regularities. PMID:23145263

  4. Toward Aesthetic Response.

    ERIC Educational Resources Information Center

    DeFurio, Anthony G.

    1979-01-01

    The view of aesthetic responding presented herein has grown out of a theory of contextual aesthetics as explicated by John Dewey and Stephen Pepper and a phenomenological inquiry into art by John Anderson. The method for entry into the responsive domain has evolved from a direction elaborated by Kenneth Beittel. (Author)

  5. Queering the Homeboy Aesthetic

    ERIC Educational Resources Information Center

    Rodriguez, Richard T.

    2006-01-01

    The homeboy aesthetic is identifiable as an assemblage of key signifiers: clothing (baggy pants and undershirts are perhaps the most significant), hair (or, in the current moment of the aesthetic, lack of hair), bold stance, and distinct language (think "calo" mixed with hip-hop parlance), all combining to form a distinguishable cultural…

  6. Aesthetics and Education

    ERIC Educational Resources Information Center

    Reid, L. Arnaud

    2008-01-01

    In this essay, the author talks about the aesthetic aspects of education with some special reference to movement in different senses. First, he discusses the aesthetic and its relation to education in a general way. He then explains the concepts of expression and embodiment in the appreciation of the arts. Lastly, the author talks about the…

  7. Lasers in aesthetic dentistry.

    PubMed

    Adams, Timothy C; Pang, Peter K

    2004-10-01

    This article focuses on lasers and aesthetic dentistry and their unique parallel in history from their early development to their present day usage and application. The demand for aesthetic dentistry has had a major impact not only on treatment planning but also on the choice of materials, techniques, and equipment. It is this demand that has married the use of lasers with aesthetic dentistry. A short literature review on the five basic laser types precedes the basic premise of smile design and its critical importance in attaining the desirable aesthetic end result. A short review on biologic width and biologic zone reinforces their importance when manipulating gingival tissue. Four case reports highlight the use of diode, erbium, and carbon dioxide lasers. The end results show the power of proper treatment planning and the use of a smile design guide when using these instruments and confirm a conservative, aesthetic treatment without compromising the health and function of the patients.

  8. Ridge augmentation with soft tissue procedures in aesthetic dentistry: pre- and postoperative volume measurements with a new kind of moire technique

    NASA Astrophysics Data System (ADS)

    Studer, Stephan P.; Mueller, Ernst; Bucher, Alfred

    1993-09-01

    The aim of this paper was to measure the volume differences of operated alveolar ridge defects before and until 3 months post-surgically. Ten patients with ten localized alveolar ridge defects were operated on. Five alveolar ridge defects were corrected by using the full thickness onlay graft technique and the other five defects were operated by the subepithelial connective tissue graft technique. A strict standardized operation protocol was followed and all alveolar ridge defects were operated on by the same dental surgeon. Before as well as 1, 2, and 3 months after surgery the corrected defect was photographed and an impression was made by using an A-silicon material to produce a gypsum-cast model. The form of all these cast models was then measured using the moire technique. The three months result of ten cases shows that the form of the operated alveolar ridge defects, which were corrected by the subepithelial connective tissue graft technique are more stable compared to those which were operated on by the full thickness onlay graft technique. Localized alveolar ridge defects using the latter method does not show a form stability after 3 months post-surgically.

  9. Ancillary role of vitamin C in pink aesthetics.

    PubMed

    Sheel, Vaibhav; Purwar, Parth; Dixit, Jaya; Rai, Priya

    2015-06-08

    A smile expresses feelings of joy, affection and self-confidence in an individual. Melanin hyperpigmentation of the gingiva jeopardises the aesthetics of an individual significantly. In the present case, gingival depigmentation was performed with a surgical scalpel along with local applications of ascorbic acid, yielding satisfactory aesthetic results with low subjective pain levels, and no recurrence has been observed after 9 months of follow-up.

  10. Review of Corneal Endothelial Specular Microscopy for FDA Clinical Trials of Refractive Procedures, Surgical Devices and New Intraocular Drugs and Solutions

    PubMed Central

    McCarey, Bernard E.; Edelhauser, Henry F.; Lynn, Michael J.

    2010-01-01

    Specular microscopy can provide a non-invasive morphological analysis of the corneal endothelial cell layer from subjects enrolled in clinical trials. The analysis provides a measure of the endothelial cell physiological reserve from aging, ocular surgical procedures, pharmaceutical exposure, and general health of the corneal endothelium. The purpose of this review is to discuss normal and stressed endothelial cell morphology, the techniques for determining the morphology parameters, and clinical trial applications. PMID:18245960

  11. Trials based on specific fracture configuration and surgical procedures likely to be more relevant for decision making in the management of fractures of the proximal humerus

    PubMed Central

    Patel, N. K.; Griffiths, D.; Athanasiou, T.; Gupte, C. M.; Reilly, P.

    2016-01-01

    . Griffiths, T. Athanasiou, C. M. Gupte, P. Reilly. Trials based on specific fracture configuration and surgical procedures likely to be more relevant for decision making in the management of fractures of the proximal humerus: Findings of a meta-analysisBone Joint Res 2016;5:470–480. DOI: 10.1302/2046-3758.510.2000638. PMID:27756738

  12. How Might Aesthetic Knowing Relate to Leadership? A Review of the Literature

    ERIC Educational Resources Information Center

    Katz-Buonincontro, Jennifer

    2011-01-01

    Aesthetic knowing may be valuable to educational leadership practice because it links feeling and intuition to procedural information to inform decision-making. Within the large and diverse field of aesthetics, some models apply aesthetic knowing to leadership practice. Scholarly interest in this area emerged in the late 1980's, and various…

  13. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

    Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

  14. Study on Surgical Management of Post Burn Hand Deformities

    PubMed Central

    Ahmed, Firdos; Jash, Prabir Kumar; Gupta, Madhumita; Suba, Santanu

    2015-01-01

    Context Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. Aim The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome. Settings and Design It’s a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department. Materials and Methods Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months. Results Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties and 23% with flap coverage. Split thickness skin grafts (STSG) and full thickness graft (FTSG) reconstructed cases had good recovery of joint mobility in 43% and 75% of cases respectively. Reconstructive procedures were aesthetically acceptable to the patients in 63%, 75% and 94% of STSG, FTSG and Z plasty cases respectively. Recurrence was seen in 17% of STSG done cases. Conclusion Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases. PMID:26435994

  15. Dimensions of Aesthetic Perception.

    ERIC Educational Resources Information Center

    Biaggio, Mary Kay; Supplee, Katherine A.

    1983-01-01

    Examines the validity of three dimensions of aesthetic perception: hedonic value, arousal, and uncertainty. Hedonic interest and arousal factors were found to differ from factors previously reported, while the uncertainty factor paralleled that previously reported. (Author/RH)

  16. The aesthetics of chemical biology.

    PubMed

    Parsons, Glenn

    2012-12-01

    Scientists and philosophers have long reflected on the place of aesthetics in science. In this essay, I review these discussions, identifying work of relevance to chemistry and, in particular, to the field of chemical biology. Topics discussed include the role of aesthetics in scientific theory choice, the aesthetics of molecular images, the beauty-making features of molecules, and the relation between the aesthetics of chemical biology and the aesthetics of industrial design.

  17. Abortion - surgical - aftercare

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  18. Personalized visual aesthetics

    NASA Astrophysics Data System (ADS)

    Vessel, Edward A.; Stahl, Jonathan; Maurer, Natalia; Denker, Alexander; Starr, G. G.

    2014-02-01

    How is visual information linked to aesthetic experience, and what factors determine whether an individual finds a particular visual experience pleasing? We have previously shown that individuals' aesthetic responses are not determined by objective image features but are instead a function of internal, subjective factors that are shaped by a viewers' personal experience. Yet for many classes of stimuli, culturally shared semantic associations give rise to similar aesthetic taste across people. In this paper, we investigated factors that govern whether a set of observers will agree in which images are preferred, or will instead exhibit more "personalized" aesthetic preferences. In a series of experiments, observers were asked to make aesthetic judgments for different categories of visual stimuli that are commonly evaluated in an aesthetic manner (faces, natural landscapes, architecture or artwork). By measuring agreement across observers, this method was able to reveal instances of highly individualistic preferences. We found that observers showed high agreement on their preferences for images of faces and landscapes, but much lower agreement for images of artwork and architecture. In addition, we found higher agreement for heterosexual males making judgments of beautiful female faces than of beautiful male faces. These results suggest that preferences for stimulus categories that carry evolutionary significance (landscapes and faces) come to rely on similar information across individuals, whereas preferences for artifacts of human culture such as architecture and artwork, which have fewer basic-level category distinctions and reduced behavioral relevance, rely on a more personalized set of attributes.

  19. A 1-minute hand wash does not impair the efficacy of a propanol-based hand rub in two consecutive surgical hand disinfection procedures.

    PubMed

    Kampf, G; Ostermeyer, C

    2009-11-01

    We studied the effect of a 1-min hand wash on the bacterial hand flora in two consecutive surgical hand disinfection procedures. A propanol-based hand rub (PBHR; Sterillium) and n-propanol (60%, v/v) were tested in a Latin-square design according to EN 12791 in four variations. The reference alcohol was always applied for 3 min after a 1-min hand wash (variation 1). The PBHR was applied for 1.5 min (first application) or 0.5 min (second application). Variation 2 included a 1-min hand wash before both applications, variation 3 included the hand wash before application 1, in variation 4 hands were not washed at all before application. Pre- and post-values were obtained according to EN 12791. The reference disinfection reduced bacteria by 2.99 log(10) (immediate efficacy) and 2.22 log(10) after 3 h. The second reference disinfection reduced bacteria by 0.95 log(10) (immediate efficacy) and 0.68 log(10) after 3 h. The PBHR always yielded an equivalent reduction with and without a preceding hand wash (p > 0.05; Friedman test). A 1-min hand wash before application of the PBHR did not significantly change its efficacy for surgical hand disinfection in two consecutive surgical procedures of 3 h.

  20. The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

    PubMed

    Cillo, Joseph E; Theodotou, Nicholas; Samuels, Marc; Krajekian, Joseph

    2010-06-01

    This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible.

  1. Micro-surgical endodontics.

    PubMed

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  2. Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

    PubMed Central

    Sivasubramaniam, Vinothan; Patel, Hitesh C; Ozdemir, Baris A; Papadopoulos, Marios C

    2015-01-01

    Objectives Low back pain (LBP), from degenerative lumbar spine disease, represents a significant burden on healthcare resources. Studies worldwide report trends attributable to their country's specific demographics and healthcare system. Considering England's specific medico-socioeconomic conditions, we investigate recent trends in hospital admissions and procedures for LBP, and discuss the implications for the allocation of healthcare resources. Design Retrospective cohort study using Hospital Episode Statistics data relating to degenerative lumbar spine disease in England, between 1999 and 2013. Regression models were used to analyse trends. Outcome measures Trends in the number of admissions and procedures for LBP, mean patient age, gender and length of stay. Results Hospital admissions and procedures have increased significantly over the study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100 000, respectively, (p<0.001). The increase was most marked in the oldest age groups with a 1.9 and 2.33-fold increase in admissions for patients aged 60–74 and ≥75 years, respectively, and a 2.8-fold increase in procedures for those aged ≥60 years. Trends in hospital admissions were characterised by a widening gender gap, increasing mean patient age, and decreasing mean hospital stay (p<0.001). Trends in procedures were characterised by a narrowing gender gap, increasing mean patient age (p=0.014) and decreasing mean hospital stay (p<0.001). Linear regression models estimate that each hospital admission translates to 0.27 procedures, per 100 000 (95% CI 0.25 to 0.30, r 0.99, p<0.001; r, Pearson's correlation coefficient). Hospital admissions are increasing at 3.5 times the rate of surgical procedures (regression gradient 7.63 vs 2.18 per 100 000/year). Conclusions LBP represents a significant and increasing workload for hospitals in England. These trends demonstrate an increasing demand for specialists involved in the surgical and non-surgical

  3. Perioperative normothermia depends on intraoperative warming procedure, extent of the surgical intervention and age of the experimental animal.

    PubMed

    Felies, Melanie; Poppendieck, Sonja; Nave, Heike

    2005-11-04

    The maintenance of a physiological body temperature during and early after surgical interventions in experimental animals such as rodents is often neglected. Therefore the positive influence of an adequate use of warming blankets (WB) on the rectal body temperature in rats was investigated during two different surgical interventions, with a special focus on possible differences between young adult (2.5+/-0.14 months) and adult animals (9.3+/-0.13 months). Anesthesia was induced with isoflurane short inhalation and maintained with ketamine and domitor intramuscularly. Animals were divided into ten groups according to (a) the age of the animals, (b) the temperature of the WB and (c) the kind of surgical intervention (either an intravenous [i.v.] cannulation of the right external jugular vein or an intra-aortal implantation of a telemetric transmitter or both). Results clearly show that the surface temperature of the WB has a major impact on the perioperative thermoregulation. The rectal body temperature of animals operated on a cooler WB dramatically decreased depending on the age of the rat and also on the extent of the surgical intervention. The opening of the abdominal cavity in older rats resulted in a severe hypothermia: they lost 5.6 degrees C compared to 3.2 degrees C in the young adult rats. The implantation of the i.v. catheter had no serious effect on the thermoregulation. In conclusion, the results clearly show that an adequate perioperative warming system positively influences the postoperative outcome in young adult and most notably in adult rats and thus enables early postoperative experiments without effects on measured parameters.

  4. Using surgical microscope for sclera buckling and transscleral cryopexy: an alternative procedure of treatment for rhegmatogenous retinal detachment.

    PubMed

    Zhong, Liu-xue-ying; Du, Yi; Liu, Wen; Huang, Su-Ying; Zhang, Shao-chong

    2014-01-01

    Purpose. To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment. Methods. This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ≤ C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens. Results. After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%). Conclusion. Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness.

  5. Using Surgical Microscope for Sclera Buckling and Transscleral Cryopexy: An Alternative Procedure of Treatment for Rhegmatogenous Retinal Detachment

    PubMed Central

    Zhong, Liu-xue-ying; Liu, Wen; Huang, Su-Ying; Zhang, Shao-chong

    2014-01-01

    Purpose. To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment. Methods. This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ≤ C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens. Results. After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%). Conclusion. Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness. PMID:24790997

  6. Hepburn's Natural Aesthetic and Its Implications for Aesthetic Education

    ERIC Educational Resources Information Center

    Yang, Chung-Ping

    2013-01-01

    The world is rich in natural beauty, and learning how to appreciate the beauty of nature is an important part of aesthetic education. Unfortunately, the teaching of aesthetics is usually restricted to art education, especially in Taiwan. Students' perceptual awareness of and sensitivity to the aesthetics of nature should be cultivated so that…

  7. Surgical Reconstruction of Radiation Injuries

    PubMed Central

    Fujioka, Masaki

    2014-01-01

    Significance: Patients with cancer receive benefits from radiation therapy; however, it may have adverse effects on normal tissue such as causing radiation-induced ulcer and osteoradionecrosis. The most reliable method to treat a radiation ulcer is wide excision of the affected tissue, followed by coverage with well-vascularized tissue. As usual, radiation-induced skin ulcers are due to therapeutic irradiation for residual cancer or lymph nodes; the locations of radiation ulcers are relatively limited, including the head, neck, chest wall, lumbar, groin, and sacral areas. Thus, suitable reconstructive methods vary according to functional and aesthetic conditions. I reviewed the practices and surgical results for radiation ulcers over the past 30 years, and present the recommended surgical methods for these hard-to-heal ulcers. Recent Advances: At a minimum, flaps are required to treat radiation ulcers. Surgeons can recommend earlier debridement, followed by immediate coverage with axial-pattern musculocutaneous and fasciocutaneous flaps. Free flaps are also a useful soft tissue coverage option. The choice of flap varies with the location and size of the wounds. Critical Issues: The most crucial procedure is the complete resection of the radiation-affected area, followed by coverage with well-vascularized tissue. Future Directions: Recent developments in perforator flap techniques, which are defined as flaps with a blood supply from isolated perforating vessels of a stem artery, have allowed the surgeons to successfully resurface these difficult wounds with reduced morbidity. PMID:24761342

  8. Ideal female brow aesthetics.

    PubMed

    Griffin, Garrett R; Kim, Jennifer C

    2013-01-01

    The concept of the ideal female eyebrow has changed over time. Modern studies examining youthful brow aesthetics are reviewed. An analysis of ideal female brow characteristics as depicted in the Western print media between 1945 and 2011 was performed. This analysis provided objective evidence that the ideal youthful brow peak has migrated laterally over time to lie at the lateral canthus. There has been a nonstatistically significant trend toward lower and flatter brows. These findings are discussed in relation to current concepts of female brow aging, with repercussions regarding endoscopic brow lift and aesthetic forehead surgery.

  9. Assessing the performance characteristics and clinical forces in simulated shape memory bone staple surgical procedure: The significance of SMA material model.

    PubMed

    Saleeb, A F; Dhakal, B; Owusu-Danquah, J S

    2015-07-01

    This work is focused on the detailed computer simulation of the key stages involved in a shape memory alloy (SMA) osteosynthesis bone stapling procedure. To this end, a recently developed three-dimensional constitutive SMA material model was characterized from test data of three simple uniaxial-isothermal-tension experiments for powder metallurgically processed nickel-rich NiTi (PM/NiTi-P) material. The calibrated model was subsequently used under the complex, thermomechanical loading conditions involved in the surgical procedure using the body-temperature-activated PM/NiTi-P bone staple. Our aim here is to assess the immediate and post-surgical performance characteristics of the stapling operation using the material model. From this study: (1) it was found that adequate compressive forces were developed by the PM/NiTi-P bone staple, with the tendency of this force to even increase under sustained thermal loading due to the intrinsic "inverse relaxation phenomena" in the SMA material, (2) the simulation results correlated well with those from experimental measurements, (3) the body-temperature-activated PM/NiTi-P staple was proved to be clinically viable, providing a stable clamping force needed for speedy coaptation of the fractured bones, and (4) these realistic assessments crucially depend on the use of suitable and comprehensive SMA material models.

  10. The Childhood Adenotonsillectomy Trial (CHAT): Rationale, Design, and Challenges of a Randomized Controlled Trial Evaluating a Standard Surgical Procedure in a Pediatric Population

    PubMed Central

    Redline, Susan; Amin, Raouf; Beebe, Dean; Chervin, Ronald D.; Garetz, Susan L.; Giordani, Bruno; Marcus, Carole L.; Moore, Renee H.; Rosen, Carol L.; Arens, Raanan; Gozal, David; Katz, Eliot S.; Mitchell, Ronald B.; Muzumdar, Hiren; Taylor, H.G.; Thomas, Nina; Ellenberg, Susan

    2011-01-01

    Each year, over 500,000 adenotonsillectomies (AT), mostly for the treatment of pediatric obstructive sleep apnea (OSA) are performed in the US in children under 15 years of age. No definitive study, however, has been yet conducted that has rigorously evaluated the effectiveness of AT for not only improving sleep disordered breathing, but also for improving clinically relevant outcomes, such as neurocognitive function, behavior, and quality of life. The Childhood Adenotonsillectomy Trial (CHAT) was designed to assess neuropsychological and health outcomes in children randomized to receive early AT (eAT) as compared to Watchful Waiting with Supportive Care (WWSC). Important secondary goals of the study are to evaluate outcomes in subgroups defined by obesity and race. This paper addresses key elements in the design and implementation of a controlled trial for a widely used “standard practice” surgical intervention in a pediatric population, that include establishment of standardized data collection procedures across sites for a wide variety of data types, establishment of equipoise, and approaches for minimizing unblinding of selected key personnel. The study framework that was established should provide a useful template for other pediatric controlled studies or other studies that evaluate surgical interventions. Citation: Redline S; Amin R; Beebe D; Chervin RD; Garetz SL; Giordani B; Marcus CL; Moore RH; Rosen CL; Arens R; Gozal D; Katz ES; Mitchell RB; Muzumdar H; Taylor HG; Thomas N; Ellenberg S. The Childhood Adenotonsillectomy Trial (CHAT): rationale, design, and challenges of a randomized controlled trial evaluating a standard surgical procedure in a pediatric population. SLEEP 2011;34(11):1509-1517. PMID:22043122

  11. What's Wrong with "Aesthetic Education"?

    ERIC Educational Resources Information Center

    Luca-Marshall, Judith B.

    1980-01-01

    The author considers definitions of "aesthetic," especially that offered by Woodrow Wilson in his essay on Adam Smith. Her major contention is that too much of aesthetic and other education is not very aesthetic, for it does not excite both senses and intellect nor develop the ability to generalize. (Author/SJL)

  12. Aesthetic Principles for Instructional Design

    ERIC Educational Resources Information Center

    Parrish, Patrick E.

    2009-01-01

    This article offers principles that contribute to developing the aesthetics of instructional design. Rather than describing merely the surface qualities of things and events, the concept of aesthetics as applied here pertains to heightened, integral experience. Aesthetic experiences are those that are immersive, infused with meaning, and felt as…

  13. Scientific aesthetics: three steps forward.

    PubMed

    Chatterjee, Anjan

    2014-11-01

    Leder and Nadal (2014, this issue) examine the current state of scientific aesthetics through the lens of a prescient psychological model proposed 10 years ago. These retrospective points to several future directions of which I touch on three: the nature of aesthetic emotions, the time course of emotions in aesthetic episodes, and the relationship of art and evolution.

  14. A Road to Aesthetic Stylistics

    ERIC Educational Resources Information Center

    Al-Sheikh, Samir

    2016-01-01

    Being a linguistic phenomenon, poetry is marked by the defamilarization of language in a poetic discourse there is an "aesthetic distortion" of the normal codes, in which the aesthetic value is the most prominent function of the poetic texture . This study is a new adventure in correlating linguistics to aesthetics by and through the…

  15. The Aesthetic Heart of Education.

    ERIC Educational Resources Information Center

    Smith, Tim

    1984-01-01

    Through aesthetic education, students become sensitized to reason, beauty, and excellence as they relate to human feeling. Aesthetic education can be justified for everyone as a paradigm of education itself. The study of music is the most effective method of teaching aesthetic perception. (RM)

  16. Interpretation and the Aesthetic Dimension

    ERIC Educational Resources Information Center

    Mortensen, Charles O.

    1976-01-01

    The author, utilizing a synthesis of philosophic comments on aesthetics, provides a discourse on the aesthetic dimension and offers examples of how interpreters can nurture the innate sense of beauty in man. Poetic forms, such as haiku, are used to relate the aesthetic relationship between man and the environment. (BT)

  17. VAC therapy for wound management in patients with contraindications to surgical treatment.

    PubMed

    Negosanti, Luca; Sgarzani, Rossella; Nejad, Parissa; Pinto, Valentina; Tavaniello, Beatrice; Palo, Stefano; Oranges, Carlo Maria; Fabbri, Erich; Michelina, Veronica Vietti; Zannetti, Guido; Morselli, Paolo Giovanni; Cipriani, Riccardo

    2012-01-01

    The treatment of complex wounds often requires multiple surgical debridement and eventually reconstruction with skin grafts or flaps, under local or general anesthesia. When the patient's general conditions contraindicate surgical procedures, topical negative pressure with vacuum assisted closure (VAC)) device can achieve wound healing with reduction of healing time and simpler management. We treated with VAC device four patients with complex wounds and important contraindications to surgery. In all the patients, we used VAC device with common protocol of topical negative pressure. The healing was obtained in a period variable between 18 and 40 days; the results were satisfactory in three cases, one patient developed an aesthetically unpleasant scar. We present our experience to propose VAC when surgical procedures are contraindicated.

  18. Aesthetic evolution of anterior maxillary crowns: a literature review.

    PubMed

    Paul, S J; Pietrobon, N

    1998-01-01

    The aesthetics of anterior maxillary restorations and health of the surrounding tissues are primary determinants of the successful outcome of a clinical procedure. Various restorative materials and application techniques have been developed to achieve optimal aesthetics. While early porcelain-fused-to-metal restorations exhibited metal margins, the development of shoulder porcelain margins in the 1980s resulted in a significant aesthetic improvement. Only in the 1990s, however, did all-porcelain restorations finally achieve the strength and complete range of optical characteristics exhibited by the natural dentition.

  19. Engaging Nature Aesthetically

    ERIC Educational Resources Information Center

    Kupfer, Joseph H.

    2003-01-01

    For the most part, most people appreciate nature as spectators. Some portion of a natural scene is viewed as if it were a painting or photograph. However, thinking of nature solely or chiefly as an aesthetic scene to be observed is unnecessarily limiting. Regarding natural phenomena as material for detached, pictorial observation overlooks the…

  20. Against Moderate Aesthetic Formalism

    ERIC Educational Resources Information Center

    Parsons, Glenn

    2004-01-01

    Formalists believe that the aesthetic appreciation of an artwork generally involves an attentive awareness of its sensory or perceptual qualities and does not require knowledge about its nonperceptual properties. Criticisms of classical formalist views, such as that of Clive Bell, are well known. However, a number of philosophers have recently…

  1. Laparoendoscopic single-site (LESS) adrenalectomy and partial nephrectomy: current Italian experience with two challenging surgical procedures.

    PubMed

    Cindolo, Luca; Scoffone, Cesare; Salzano, Luigi; Autorino, Riccardo; Mirone, Vincenzo; Schips, Luigi

    2010-10-01

    Since its initial clinical use in urology, there has been an increasing enthusiasm and a growing interest for laparoendoscopic single-site surgery (LESS). Several clinical series have been reported with an estimated cumulative clinical experience of more than four hundred so far. Nowadays, virtually all extirpative and reconstructive urological procedures have been described and shown to be feasible and safe, including advanced reconstructive procedures and major extirpative ones. Among them, adrenalectomy and partial nephrectomy represent highly complex procedures. Initial clinical data have been recently reported to test the safety and efficacy of these interventions in selected patients. Herein, we describe our initial cases of unclamp LESS partial nephrectomy and adrenalectomy. In our opinion, LESS is an established technique within the field of minimally invasive surgery. Even if further studies are needed to demonstrate its actual benefits, early clinical outcomes are encouraging and LESS might represent the way to go in minimally invasive urological surgery.

  2. The Australian experiment: the use of evidence based medicine for the reimbursement of surgical and diagnostic procedures (1998–2004)

    PubMed Central

    O'Malley, Sue P

    2006-01-01

    Background In 1998 a formal process using the criteria of safety, effectiveness and cost-effectiveness (evidence based medicine) on the introduction and use of new medical procedures was implemented in Australia. As part of this process an expert panel, the Medical Services Advisory Committee (MSAC) was set up. This paper examines the effectiveness of this process based on the original criteria, that is, evidence based medicine. Method The data for this analysis was sourced primarily from that made available in the public domain. The MSAC web site provided Minutes from MSAC meetings; Annual Reports; Assessment and Review reports; Progress status; and Archived material. Results The total number of applications submitted to the MSAC has been relatively low averaging approximately only fourteen per year. Additionally, the source of applications has quickly shifted to the medical devices, equipment and diagnostic industry as being the major source of applications. An overall average time for the processing of an application is eighteen months. Negative recommendations were in most cases based on insufficient clinical evidence rather than clinical evidence that clearly demonstrated a lack of clinical effectiveness. It was rare for a recommendation, either positive or negative, to be based on cost-effectiveness. Conclusion New medical procedures are often the result of a process of experimentation rather than formally conducted research. Affordability and the question of who should pay for the generation, collection and analysis of the clinical evidence is perhaps the most difficult to answer. This is especially the case where the new procedure is the result of a process of experimentation with an old procedure. A cost-effective way needs to be found to collect acceptable levels of evidence proving the clinical effectiveness of these new procedures, otherwise the formal processes of evaluation such as that used by the Australian MSAC since 1998 will continue to run the

  3. Essential Requirements to Setting up an Aesthetic Practice

    PubMed Central

    Sachdev, Mukta; Britto, Gillian R

    2014-01-01

    Aesthetic dermatology is becoming a vital and popular branch of medicine. This article aims to guide dermatologists to set up a professional and ethical aesthetic practice. Dermatologists should have an integrated practice of clinical dermatology, dermatosurgery and cosmetic dermatology. Ethical practice is the gold standard for any medical field, especially with dermatologists, who should avoid doing unnecessary procedures. Proper patient counselling and addressing the patients’ concerns is imperative. PMID:25538440

  4. Surgical ethics and the challenge of surgical innovation.

    PubMed

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  5. Results of surgical techniques for re-innervation of the triceps as additional procedures for patients with upper root injuries.

    PubMed

    Flores, L Pretto

    2013-03-01

    Patients with injuries restricted to the upper and middle trunks of the brachial plexus may obtain recovery of elbow extension via the lower trunk, which makes it difficult to assess the real effect of interventions to restore the triceps function in such cases. This study aimed to determine the impact of surgical strategies for re-innervation of the triceps in individuals with partial injuries of the brachial plexus. Patients were divided into two groups. Group 1 consisted of 21 participants in whom the surgery included one technique for re-innervation of elbow extension. In this group, six different extra- or intra-plexal donors were targeted to one of the motor branches of the triceps muscle. Group 2 was composed of 24 controls in which the reconstruction did not include any intervention for recovering triceps function. The individuals who underwent intervention for re-innervation of the triceps obtained significantly better outcomes for elbow extension than the controls.

  6. Incidence of intraoperative seizures during motor evoked potential monitoring in a large cohort of patients undergoing different surgical procedures.

    PubMed

    Ulkatan, Sedat; Jaramillo, Ana Maria; Téllez, Maria J; Kim, Jinu; Deletis, Vedran; Seidel, Kathleen

    2017-04-01

    OBJECTIVE The purpose of this study was to investigate the incidence of seizures during the intraoperative monitoring of motor evoked potentials (MEPs) elicited by electrical brain stimulation in a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. METHODS The authors retrospectively analyzed data from 4179 consecutive patients who underwent surgery or an interventional radiology procedure with MEP monitoring. RESULTS Of 4179 patients, only 32 (0.8%) had 1 or more intraoperative seizures. The incidence of seizures in cranial procedures, including craniotomies and interventional neuroradiology, was 1.8%. In craniotomies in which transcranial electrical stimulation (TES) was applied to elicit MEPs, the incidence of seizures was 0.7% (6/850). When direct cortical stimulation was additionally applied, the incidence of seizures increased to 5.4% (23/422). Patients undergoing craniotomies for the excision of extraaxial brain tumors, particularly meningiomas (15 patients), exhibited the highest risk of developing an intraoperative seizure (16 patients). The incidence of seizures in orthopedic spine surgeries was 0.2% (3/1664). None of the patients who underwent surgery for conditions of the spinal cord, neck, or peripheral nerves or who underwent cranial or noncranial interventional radiology procedures had intraoperative seizures elicited by TES during MEP monitoring. CONCLUSIONS In this largest such study to date, the authors report the incidence of intraoperative seizures in patients who underwent MEP monitoring during a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. The low incidence of seizures induced by electrical brain stimulation

  7. Ten years of a model of aesthetic appreciation and aesthetic judgments : The aesthetic episode - Developments and challenges in empirical aesthetics.

    PubMed

    Leder, Helmut; Nadal, Marcos

    2014-11-01

    About a decade ago, psychology of the arts started to gain momentum owing to a number of drives: technological progress improved the conditions under which art could be studied in the laboratory, neuroscience discovered the arts as an area of interest, and new theories offered a more comprehensive look at aesthetic experiences. Ten years ago, Leder, Belke, Oeberst, and Augustin (2004) proposed a descriptive information-processing model of the components that integrate an aesthetic episode. This theory offered explanations for modern art's large number of individualized styles, innovativeness, and for the diverse aesthetic experiences it can stimulate. In addition, it described how information is processed over the time course of an aesthetic episode, within and over perceptual, cognitive and emotional components. Here, we review the current state of the model, and its relation to the major topics in empirical aesthetics today, including the nature of aesthetic emotions, the role of context, and the neural and evolutionary foundations of art and aesthetics.

  8. The Body Image Dissatisfaction and Psychological Symptoms among Invasive and Minimally Invasive Aesthetic Surgery Patients

    PubMed Central

    Y. Yazdandoost, Rokhsareh; Hayatbini, Niki; Asgharnejad Farid, Ali Asghar; Gharaee, Banafsheh; Latifi, Noor Ahmad

    2016-01-01

    BACKGROUND Elective aesthetic surgeries are increasing in the Iranian population with reasons linked to body image dissatisfaction and psychological symptoms. This study compared the body image dissatisfaction and psychological symptoms among invasive and minimally invasive aesthetic surgery patients and a control group. METHODS Data from 90 participants (invasive aesthetic surgery=30 Ss, minimally invasive aesthetic surgery=30 Ss, and control group=30 Ss) were included. Subjects were assessed on body image dissatisfaction and psychological symptoms to provide an evidence for a continuum of body image dissatisfaction, anxiety, depression and interpersonal sensitivity in invasive and minimally invasive aesthetic surgery clients. RESULTS Between the three groups of invasive, minimally invasive aesthetic surgeries and control on body image dissatisfaction and psychological symptoms (anxiety, depression and interpersonal sensitivity), there was a significant difference. CONCLUSION These findings have implications for pre-surgical assessment as well as psychological interventions rather than invasive medical interventions at first step. PMID:27579270

  9. [Correction of posttraumatic disorders of the distal radio-ulnar joint with the Sauvé-Kapandji surgical procedure].

    PubMed

    Voche, P; Van Overstraeten, L; Merle, M

    1993-01-01

    The Sauve-Kapandji procedure was performed on 21 patients with posttraumatic lesions between May of 1985 and May of 1991; average clinical and radiological follow-up was 3.4 years. Causal mechanisms were as follows: 12 cases were sequelae of fractures of the distal extremity of the radius; 5 cases were sequelae of fractures of the diaphyses of the two forearm bones and/or of the head of the radius; 2 cases of instability of the distal radio-ulnar joint; 2 cases of posttraumatic isolated arthritis of the distal radio-ulnar joint. Subjective evaluation by the patients of the results of surgery was as follows: 8 excellent, 6 good, 2 satisfactory and 5 poor. The most consistent improvement was a gain of mobility in pronation and supination which averaged 87 per cent of that of the healthy contralateral side. Nine patients were free of pain, 6 experienced some pain only during effort, and 6 still suffered constant pain. Grip strength was the factor that changed the most: it averaged 55 per cent of that of the healthy contralateral side. Indications for the Sauve-Kapandji procedure and its results in posttraumatic lesions are discussed. This procedure is compared to other techniques used to correct posttraumatic disorders of the distal radio-ulnar joint.

  10. [Urinary stress incontinence in the female: comparison of incontinence theories and new tension-free surgical procedures].

    PubMed

    Perucchini, D; Fink, D

    2002-01-01

    Urethral sphincter competence involves a complicated inter action of many factors which act in concert. Stress incontinence occurs due to damage to the urethral support and loss or deterioration of urethral sphincter function as a consequence of delivery or aging. Recent research indicates that a more integrated, comprehensive view regarding the different structures, both inside and outside the urethra, is needed to explain the mechanism of incontinence. According to the theories of de Lancey, urinary stress incontinence is caused by defects in the supporting tissues that both actively and passively stabilize the urethra in its correct anatomical position. The integral theory of Petros and Ulmstein explains how laxity in the vagina or its supporting ligaments may cause stress incontinence favored by laxity in the ligamentous insertion points of the vagina. Colposuspension procedures have dominated incontinence surgery for the last 50 years. The introduction of the tension-free vaginal tape procedure was a real innovation that has challenged our understanding of the continence mechanism and taught us the importance of the midurethra. Different modifications of the tension-free procedures have been introduced recently and are discussed in this paper.

  11. Subtotal laryngectomy: outcomes of 469 patients and proposal of a comprehensive and simplified classification of surgical procedures.

    PubMed

    Rizzotto, G; Crosetti, E; Lucioni, M; Succo, G

    2012-06-01

    Long-term oncological and functional results from a retrospective study on 469 patients over a 10-year period of subtotal laryngectomies (SL), 399 supracricoid partial laryngectomies (SCL) and 70 supratracheal partial laryngectomies (STL) are presented. The mean follow-up time was 97 months (range 60–165 months). Acute complications, types and rates of late sequelae, functional results, 2-year post-operative scores of laryngeal function and quality of life are reported. The observed long-term results were: SCL, 5-year overall and disease-free survival: 95.6, and 90.9%, respectively; 2-year post-operative laryngeal function preservation: 95.7%; STL, 5-year overall and disease-free survival: 80 and 72.9%, respectively; 2-year post-operative laryngeal function preservation: 80%. The performance status scale for laryngeal function preservation showed very high 2-year scores, with no significant differences depending on the type and extent of surgery. The adopted type of function-sparing surgery provided overall and disease-free survival rates that were somewhat better than those reported in studies based on organ-sparing protocols with chemoradiotherapy. The rate of total laryngectomy of completion in this series was 4.4%. A new classification of the current horizontal partial laryngectomies is also proposed, namely “Horizontal Laryngectomy System” (HOLS), based on the extent of surgical removal of laryngeal structures.

  12. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience.

    PubMed

    Sherrod, Brandon A; Arynchyna, Anastasia A; Johnston, James M; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry; Rocque, Brandon G

    2017-02-10

    OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations. SSI included deep (intracranial abscesses, meningitis, osteomyelitis, and ventriculitis) and superficial wound infections. The authors performed univariate analyses of SSI association with procedure, demographic, comorbidity, operative, and hospital variables, with subsequent multivariate logistic regression analysis to determine independent risk factors for SSI within 30 days of the index procedure. A similar analysis was performed using a detailed institutional infection database from Children's of Alabama (COA). RESULTS A total of 9296 nonshunt procedures were identified in NSQIP-P with an overall 30-day SSI rate of 2.7%. The 30-day SSI rate in the COA institutional database was similar (3.3% of 1103 procedures, p = 0.325). Postoperative time to SSI in NSQIP-P and COA was 14.6 ± 6.8 days and 14.8 ± 7.3 days, respectively (mean ± SD). Myelomeningocele (4.3% in NSQIP-P, 6.3% in COA), spine (3.5%, 4.9%), and epilepsy (3.4%, 3.1%) procedure categories had the highest SSI rates by procedure category in both NSQIP-P and COA. Independent SSI risk factors in NSQIP-P included postoperative pneumonia (OR 4.761, 95% CI 1.269-17.857, p = 0.021), immune disease/immunosuppressant use (OR 3.671, 95% CI 1.371-9.827, p = 0.010), cerebral palsy (OR 2.835, 95% CI 1.463-5.494, p = 0.002), emergency operation (OR 1

  13. Aesthetic self-esteem.

    PubMed

    Kaplan, Julie Bass

    2015-01-01

    The concept of aesthetic self-esteem was explored for utilization in the medical spa environment. The aims and purposes of the analysis were outlined. The literature review identified various uses of the self-esteem concept as well as published definitions of the word. Defining attributes were also explored and examined, including positive and negative connotations of self-esteem. Two tools were utilized to help aesthetic nurse specialists assess patients for self-esteem and assess for a possible mental illness that may present as low self-esteem. A culturally sensitive theoretical definition of self-esteem was constructed to fit the needs and environment of medical spas. A model case of this definition, as well as a borderline and contrary case, was presented. Antecedents and consequences, as well as empirical referents of the concept, were explored.

  14. The Utilization of Opioid Analgesics Following Common Upper Extremity Surgical Procedures: A National, Population-Based Study

    PubMed Central

    Waljee, Jennifer F.; Zhong, Lin; Hou, Hechuan; Sears, Erika; Brummet, Chad; Chung, Kevin C.

    2016-01-01

    Background The misuse of opioid analgesics is a major public health concern, and guidelines regarding postoperative opioid use are sparse. We examined the use of opioids following outpatient upper extremity procedures. We hypothesized that opioid use varies widely by procedure and patient factors. Methods We studied opioid prescriptions among 296,452 adults ages ≥ 18 years who underwent carpal tunnel release, trigger finger release, cubital tunnel release, and thumb carpometacarpal (CMC) arthroplasty from 2009 to 2013. We analyzed insurance claims drawn using Truven Health MarketScan Commercial Claims and Encounters, which encompasses over 100 health plans in the United States. Using multivariable regression, we compared the receipt of opioids, number of days supplied, indicators of inappropriate prescriptions, and number of refills by patient factors. Results In this cohort, 59% filled a postoperative prescription for opioid medication, and 8.8% patients had an indicator of inappropriate prescribing. The probability of filling an opioid prescription declined linearly with advancing age. In multivariate analysis, patients who had previously received opioids were more likely to fill a postoperative opioid prescription (66% vs. 59%), receive longer prescriptions (24 vs. 5 days), receive refills following surgery (24% vs. 5%), and have at least one indicator of potentially inappropriate prescribing (19% vs 6%). Conclusions Current opioid users are more likely to require postoperative opioid analgesics for routine procedures, and more likely to receive inappropriate prescriptions. More evidence is needed to identify patients who derive the greatest benefit from opioids in order to curb opioids prescriptions when alternative analgesics may be equally effective and available. PMID:26818326

  15. Aesthetic Pleasure versus Aesthetic Interest: The Two Routes to Aesthetic Liking

    PubMed Central

    Graf, Laura K. M.; Landwehr, Jan R.

    2017-01-01

    Although existing research has established that aesthetic pleasure and aesthetic interest are two distinct positive aesthetic responses, empirical research on aesthetic preferences usually considers only aesthetic liking to capture participants’ aesthetic response. This causes some fundamental contradictions in the literature; some studies find a positive relationship between easy-to-process stimulus characteristics and aesthetic liking, while others suggest a negative relationship. The present research addresses these empirical contradictions by investigating the dual character of aesthetic liking as manifested in both the pleasure and interest components. Based on the Pleasure-Interest Model of Aesthetic Liking (PIA Model; Graf and Landwehr, 2015), two studies investigated the formation of pleasure and interest and their relationship with aesthetic liking responses. Using abstract art as the stimuli, Study 1 employed a 3 (stimulus fluency: low, medium, high) × 2 (processing style: automatic, controlled) × 2 (aesthetic response: pleasure, interest) experimental design to examine the processing dynamics responsible for experiencing aesthetic pleasure versus aesthetic interest. We find that the effect of stimulus fluency on pleasure is mediated by a gut-level fluency experience. Stimulus fluency and interest, by contrast, are related through a process of disfluency reduction, such that disfluent stimuli that grow more fluent due to processing efforts become interesting. The second study employed product designs (bikes, chairs, and lamps) as stimuli and a 2 (fluency: low, high) × 2 (processing style: automatic, controlled) × 3 (product type: bike, chair, lamp) experimental design to examine pleasure and interest as mediators of the relationship between stimulus fluency and design attractiveness. With respect to lamps and chairs, the results suggest that the effect of stimulus fluency on attractiveness is fully mediated by aesthetic pleasure, especially in the

  16. Aesthetic Retainer cum Trainer

    PubMed Central

    Kalra, Shilpa; Rai, Priyank

    2017-01-01

    Tongue thrust habit is one of the contributing factors in the relapse of orthodontic treatment results. Compliance with removable habit breaking appliance is a major issue to the dental practitioners treating patients of any age group. Through this case we introduce a more aesthetic and comfortable option to the patients requiring habit control for tongue thrusting and retention of treatment results. Hence, this appliance acts as a retainer cum trainer in such patients. PMID:28274080

  17. [Aesthetic surgery and history].

    PubMed

    Glicenstein, J

    2003-10-01

    The history of aesthetic surgery is linked to that of the 20th century. The first operations allowed by the progress of anesthesia and asepsis are the correction of "prominent ears" by Ely then rhinoplasty with endonasal incision by Roe. Considered by some as a precursor and a quack by others, C.C. Miller was the first surgeon to specialize and write books on the subject. Before world war I, aesthetic surgery was seldom practiced and publications were few. The war was at the origin of several units of maxillo-facial surgery created for the huge number of casualties with face trauma due to trench warfare. Many of those who will become great names in plastic surgery operated in these units: Blair, Davis, Léon Dufourmentel, Virenque, Morestin and Gillies. After the war, American surgeons were regrouped in scientific societies. Plastic surgery was privileged and aesthetic surgery was lifted for "quacks". In France, several surgeons such as Suzanne Noël, Passot, Bourguet, Dartigues showed an important creativity and described several techniques that inspired recent ones. The Dujarier case discredited French aesthetic surgery but did not stop the creation of the first French Society of Plastic Surgery in 1930. World war II led to new orientations. In England, the East Grinstead center with Gillies and McIndoe during and after the war was at the origin of many vocations. After the war, many national and international societies of plastic surgery started to appear. The French Society of Plastic Surgery was born in 1952.

  18. Aesthetic Retainer cum Trainer.

    PubMed

    Tripathi, Tulika; Kalra, Shilpa; Rai, Priyank

    2017-01-01

    Tongue thrust habit is one of the contributing factors in the relapse of orthodontic treatment results. Compliance with removable habit breaking appliance is a major issue to the dental practitioners treating patients of any age group. Through this case we introduce a more aesthetic and comfortable option to the patients requiring habit control for tongue thrusting and retention of treatment results. Hence, this appliance acts as a retainer cum trainer in such patients.

  19. What is the influence of single-entry models on access to elective surgical procedures? A systematic review

    PubMed Central

    Damani, Zaheed; Conner-Spady, Barbara; Nash, Tina; Tom Stelfox, Henry; Noseworthy, Tom W; Marshall, Deborah A

    2017-01-01

    Background Single-entry models (SEMs) for the management of patients awaiting elective surgical services are designed to increase access and flow through the system of care. We assessed scope of use and influence of SEMs on access (waiting times/throughput) and patient-centredness (patient/provider acceptability). Methods Systematic review of articles published in 6 relevant electronic databases included studies from database inception to July 2016. Included studies needed to (1) report on the nature of the SEM; (2) specify elective service and (3) address at least 1 of 3 research questions related to (1) scope of use of SEMs; (2) influence on timeliness and access; (3) patient-centredness and acceptability. Article quality was assessed using a modified Downs and Black checklist. Results 11 studies from Canada, Australia and the UK were included with mostly weak observational design—2 simulations, 5 before–after, 2 descriptive and 2 cross-sectional studies. 9 studies showed a decrease in patient waiting times; 6 showed that more patients were meeting benchmark waiting times; and 5 demonstrated that waiting lists decreased using an SEM as compared with controls. Patient acceptability was examined in 6 studies, with high levels of satisfaction reported. Acceptability among general practitioners/surgeons was mixed, as reported in 1 study. Research varied widely in design, scope, reported outcomes and overall quality. Conclusions This is the first review to assess the influence of SEMs on access to elective surgery for adults. This review demonstrates a potential ability for SEMs to improve timeliness and patient-centredness of elective services; however, the small number of low-quality studies available does not support firm conclusions about the effectiveness of SEMs to improve access. Further evaluation with higher quality designs and rigour is required. PMID:28237954

  20. Analysis of Malpractice Claims Associated with Surgical Site Infection in the Field of Plastic Surgery

    PubMed Central

    2016-01-01

    Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns. PMID:27822936

  1. Comparative clinical study of the effect of LLLT in the immediate and late treatments of hypoesthesia due to surgical procedures

    NASA Astrophysics Data System (ADS)

    Ladalardo, Thereza C.; Brugnera, Aldo, Jr.; Pinheiro, Antonio L. B.; Castanho Garrini, Ana E.; Bologna, Elisangela D.; Takamoto, Marcia; Siqueira, Jose T.; Dias, Pedro; Campos, Roberto A. d. C.

    2002-06-01

    We evaluated the effect of LLLT in 68 patients who presented hypoesthesia due to odontological surgery procedures: dental implant surgeries (N=51); extraction of impacted lower third molars (N=10); endodontics in lower first molars (N=7). Lesions treated within 30 days after the nerve injury had occurred were part of the immediate group, and lesions with more than 30 days from the occurrence of the injury were part of the late group. Treatments were carried out with an infrared diode laser of 40 mW-830nm, continuous wave emission, spot size 3 mm2, and a total dosage of 18 joules per session in a contact mode of application, 20 sessions altogether. The efficacy of laser therapy in peripheral nerve regeneration is also related to the degree of the peripheral nerve lesion, and not only to the lesion duration. LLLT resulted in neurosensory functional improvement in both immediate and late treatments of hypoesthesia.

  2. Regional anesthesia or patient-controlled analgesia and compartment syndrome in orthopedic surgical procedures: a systematic review

    PubMed Central

    Driscoll, Elizabeth BS; Maleki, Ana Hosseinzadeh; Jahromi, Leila; Hermecz, Brittany Nelson; Nelson, Lauren E; Vetter, Imelda L; Evenhuis, Spencer; Riesenberg, Lee Ann

    2016-01-01

    A systematic review of the literature on the use of regional anesthesia (RA) and patient-controlled analgesia (PCA) was conducted in patients who require orthopedic extremity procedures to determine whether either analgesic technique contributes to a delayed diagnosis of compartment syndrome (CS). A total of 34 relevant articles (28 case reports and six research articles) were identified. Of all case report articles published after 2009, the majority (75%) concluded that RA does not put the patient at an increased risk of a delayed diagnosis of CS. Of these, only two relevant prospective research studies focusing on RA or PCA and their relationship to CS were identified. Neither study resulted in any cases of CS. However, both had relatively small sample sizes. Given the lack of evidence identified in this systematic review, prospective studies or large-scale retrospective data reviews are needed to more strongly advocate the use of one modality of analgesia over the other in this patient population. PMID:27785097

  3. Surgical Lasers In Gynecology

    NASA Astrophysics Data System (ADS)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  4. Relationship between periodontics and restorative procedures: surgical treatment of the restorative alveolar interface (rai)--case series.

    PubMed

    Almeida, A L P F; Esper, L A; Sbrana, M C; Cunha, M J S; Greghi, S L A; Carrilho, G P B; Pegoraro, L F

    2013-12-01

    Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren't respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorative alveolar interface (RAI) technique was described as the portion of the root surface extending from the alveolar crest apically to the restorative margin coronally. RAI consists of modifying the restorative margin position into a healthier environment, respecting the biological width and therefore allowing effective plaque control. This paper describes four clinical cases with indication for the RAI technique for maintenance of periodontal health. The cases were associated with prostheses. All cases were evaluated at 90 days and exhibited a healthy periodontal tissue. Successful outcomes were observed in the different indications for the RAI technique.

  5. Polyarticular lipoma arborescens--a clinical and aesthetical case.

    PubMed

    Silva, Lígia; Terroso, Georgina; Sampaio, Luzia; Monteiro, Eurico; Pimenta, Sofia; Pinto, Fernanda; Pinto, José A; Ventura, Francisco S

    2013-06-01

    Lipoma arborescens is a benign tumor, but it may be a reactive process to other disorders, and its clinical, analytical, radiological and ultrasound presentation may be redundant to any synovial tumor. Despite the characteristic feature on magnetic resonance imaging (MRI), the correct differential diagnosis in atypical presentation, and the need for timely removal of the lesion to prevent joint damage, forces, ultimately, to invasive procedures. The clinical case reported here, fourth described in English language publications on the polyarticular form, also presented other specificities related to one of the swellings, in the knee. Because of its atypical location in the popliteal fossa, recurrent episodes of joint effusion, personal history of knee trauma, pulmonary tuberculosis, and family history of rheumatoid arthritis required particular attention. This process was hampered by the refusal of knee (and ankle) surgery by the patient. He accepted surgical removal of the swellings of the wrists, for aesthetical reasons, with pathologic confirmation of the diagnosis, and clinical success in that location. MRI of the knee showed the typical image of lipoma arborescens, but also other changes that compromise the prognosis.

  6. [Aesthetic surgery, the liability].

    PubMed

    Branchet, F

    2003-10-01

    Which are the specific risks for the plastic surgeons in aesthetic surgery? There are several: first of all, patients consult by desire and not because of health problems; it is often during difficult moments in their life (job loss.). Moreover, the surgeon must give the most complete information to the patient: he must describe the surgery, the risks (even the most exceptional ones). The surgeons have to "use the best practices": what does it mean? This sentence deals with the idea that the surgeons must have all the necessary skills to perform an aesthetic surgery and to ensure the cares after the operation (experience, diploma, staff, equipment.). They do not have to guarantee a result. As they do not operate in a hurry, they must renounce to a surgery if there is a doubt concerning the risk or the result the patient is waiting for. For years we have been observing that the requests for getting compensations have been left to drift for a lot of reasons (deception with the result, youth not found again.). The capacity to discover the real reasons of an aesthetic surgery, the listening, the courage to refuse to operate if the patient expects too much. depends on the surgeon (and insurer) future quiet. Despite all these precautions, we can notice that each surgeon is involved one time in a 4-years period: he will waste his time (forensic examinations.). As a conclusion, we can say that the respect of the rules of ethics is the key to battle against the increase of files in proceedings.

  7. Functional and Aesthetic Thorax Reconstruction after Desmoid Tumor Resection

    PubMed Central

    Acosta-Ponce de Leon, Eric; Sanchez-Sosa, Sergio

    2017-01-01

    Summary: This study describes a case report of a 31-year-old patient who presented with a left thoracic tumor on costal cartilages 5 and 6 that was diagnosed as a desmoid tumor 3 years after receiving retropectoral breast implants for cosmetic reasons. The integral reconstruction of the thoracic wall, functional and aesthetic, was planned for a single surgical period. The defect secondary to the tumor resection, which left the pericardium and lung exposed, was closed using the pectoral muscle as a “pre-expanded” flap by the breast implant, and the breast aesthetic was treated bilaterally with new implants in the retromammary position. After 12 months, the patient remained free from tumor recurrence and had a satisfactory aesthetic result. PMID:28280682

  8. What Can the Aesthetic Movement Tell Us about Aesthetic Education?

    ERIC Educational Resources Information Center

    Kjeldsen, Jette

    2001-01-01

    In this article, the author presents two quotations from Walter Pater which suggest a provoking and demanding recipe by which to live one's aesthetic life and point out where all aesthetic education must begin. The author also exemplifies Walter Pater's ideas through two works by the painter James McNeill Whistler and the poet Algernon Swinburne…

  9. Chronological hypoplasia: aesthetic management

    PubMed Central

    Jayam, Cheranjeevi; Bandlapalli, Anila; Patel, Nikunj; Choudhary, Rama Shankar Kashinath

    2014-01-01

    Enamel hypoplasia is defined as a break in the continuity of enamel with a reduction in the layers leading to depressions or grooves. Chronological hypoplasia is differentiated from other forms of hypoplasia due to its characteristic presentation (multiple, symmetrical, chronological pattern). Chronological hypoplasias are seen at the time tooth erupts into the oral cavity leading to several problems like aesthetic problems, tooth sensitivity, caries and early pulpal involvement. Prevention of interaction of aetiological factors is not possible because multiple factors are required for enamel synthesis. This paper highlights how to diagnose, intercept and treat chronological hypoplasias. It also mentions reasons for treating a case and different modalities available. PMID:24907208

  10. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure

    PubMed Central

    SALLUM, Rubens Antonio Aissar; PADRÃO, Eduardo Messias Hirano; SZACHNOWICZ, Sergio; SEGURO, Francisco C. B. C.; BIANCHI, Edno Tales; CECCONELLO, Ivan

    2015-01-01

    Background Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. Aim To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Methods Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. Results From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Conclusions Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the

  11. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  12. Aesthetic ultrasound therapy

    NASA Astrophysics Data System (ADS)

    Barthe, Peter G.; Slayton, Michael H.

    2012-10-01

    Ultrasound provides key benefits in aesthetic surgery compared to laser and RF based energy sources. We present results of research, development, pre-clinical and clinical studies, regulatory clearance and commercialization of a revolutionary non-invasive aesthetic ultrasound imaging and therapy system. Clinical applications for this platform include non-invasive face-lifts, brow-lifts, and neck-lifts achieved through fractionated treatment of the superficial musculoaponeurotic system (SMAS) and subcutaneous tissue. Treatment consists of placing a grid of micro-coagulative lesions on the order of 1 mm3 at depths in skin of 1 to 6 mm, source energy levels of 0.1 to 3 J, and spacing on the order of 1.5 mm, from 4 to 10 MHz dual-mode image/treat transducers. System details are described, as well as a regulatory pathway consisting of acoustic and bioheat simulations, source characterization (hydrophone, radiation force, and Schlieren), pre-clinical studies (porcine skin ex vivo, in vivo, and human cadaver), human safety studies (treat and resect) and efficacy trials which culminated in FDA clearance (2009) under a new device classification and world-wide usage. Clinical before and after photographs are presented which validate the clinical approach.

  13. Towards an Aesthetics of Care

    ERIC Educational Resources Information Center

    Thompson, James

    2015-01-01

    This article is an enquiry into the possible shape of "an aesthetics of care" drawn from the experience of looking after a Congolese colleague after he was injured in a massacre in the DR Congo. The mix of different professional and personal circumstances directs the writing towards concerns with the ethics and aesthetics of caring for…

  14. Aesthetic valence of visual illusions

    PubMed Central

    Stevanov, Jasmina; Marković, Slobodan; Kitaoka, Akiyoshi

    2012-01-01

    Visual illusions constitute an interesting perceptual phenomenon, but they also have an aesthetic and affective dimension. We hypothesized that the illusive nature itself causes the increased aesthetic and affective valence of illusions compared with their non-illusory counterparts. We created pairs of stimuli. One qualified as a standard visual illusion whereas the other one did not, although they were matched in as many perceptual dimensions as possible. The phenomenal quality of being an illusion had significant effects on “Aesthetic Experience” (fascinating, irresistible, exceptional, etc), “Evaluation” (pleasant, cheerful, clear, bright, etc), “Arousal” (interesting, imaginative, complex, diverse, etc), and “Regularity” (balanced, coherent, clear, realistic, etc). A subsequent multiple regression analysis suggested that Arousal was a better predictor of Aesthetic Experience than Evaluation. The findings of this study demonstrate that illusion is a phenomenal quality of the percept which has measurable aesthetic and affective valence. PMID:23145272

  15. Visual aesthetics and human preference.

    PubMed

    Palmer, Stephen E; Schloss, Karen B; Sammartino, Jonathan

    2013-01-01

    Human aesthetic preference in the visual domain is reviewed from definitional, methodological, empirical, and theoretical perspectives. Aesthetic science is distinguished from the perception of art and from philosophical treatments of aesthetics. The strengths and weaknesses of important behavioral techniques are presented and discussed, including two-alternative forced-choice, rank order, subjective rating, production/adjustment, indirect, and other tasks. Major findings are reviewed about preferences for colors (single colors, color combinations, and color harmony), spatial structure (low-level spatial properties, shape properties, and spatial composition within a frame), and individual differences in both color and spatial structure. Major theoretical accounts of aesthetic response are outlined and evaluated, including explanations in terms of mere exposure effects, arousal dynamics, categorical prototypes, ecological factors, perceptual and conceptual fluency, and the interaction of multiple components. The results of the review support the conclusion that aesthetic response can be studied rigorously and meaningfully within the framework of scientific psychology.

  16. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  17. Aesthetic meanings and aesthetic emotions: how historical and intentional knowledge expand aesthetic experience.

    PubMed

    Silvia, Paul J

    2013-04-01

    This comment proposes that Bullot & Reber's (B&R's) emphasis on historical and intentional knowledge expands the range of emotions that can be properly viewed as aesthetic states. Many feelings, such as anger, contempt, shame, confusion, and pride, come about through complex aesthetic meanings, which integrate conceptual knowledge, beliefs about the work and the artist's intentions, and the perceiver's goals and values.

  18. Aesthetic restoration in maxillo-mandibular malformations: the role of genioplasty

    PubMed Central

    Ungari, Claudio; Riccardi, Emiliano; Reale, Gabriele; Agrillo, Alessandro; Rinna, Claudio; Mitro, Valeria; Filiaci, Fabio

    2015-01-01

    Summary Aim The aim of this study was to determinate how orthognatic surgery aids to cure many skull and face abnormalities and to help re-establishing the correct occlusive relation thanks to the repositioning of the maxillo-mandibular skeleton basis. Methods The study included 183 male patients and 338 female patients, with an average age of 23 years. The sample series was divided according to specific pathologies. All patients underwent surgical procedures and the therapeutic strategy was determined based on the anomalies presented. Results 113 patients had a II class dental skeletal occlusion, 180 patients had a III class dental-skeletal occlusion and 222 patients had skull-facial abnormalities. 5 patients underwent only a genioplasty, 82 patients underwent a genioplasty associated with BSSO, 175 patients underwent a genioplasty associated with Le Fort I osteotomy and the remaining 253 patients underwent a genioplasty associated with BSSO and Le Fort I osteotomy. Conclusion The experience shows that genioplasty has been successfully introduced in orthognathic surgical therapeutic procedures, for dental-skeleton abnormalities and mandibular asymmetries treatment. In recent years, the evolution of computer systems has allowed an accurate assessment and programming, by means of the three-dimensional display, which are of great help in the course of diagnosis and evaluation of the displacements to be carried out, in order to obtain optimal aesthetic results. PMID:26941899

  19. PSYCHOANALYSIS AS APPLIED AESTHETICS.

    PubMed

    Richmond, Stephen H

    2016-07-01

    The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed.

  20. SLAC site design aesthetics

    SciTech Connect

    Hall, F.F.

    1985-10-01

    Stanford Linear Accelerator Center (SLAC) is a single mission laboratory dedicated to basic research in high energy particle physics. SLAC site also houses Stanford Synchrotron Radiation Laboratory (SSRL) which is a multi-mission laboratory for research using beams of ultraviolet light and low energy photons as emitted tangentially from SLAC colliding beam facilities. This paper discusses various aspects of SLAC site design aesthetics under the following headings: (1) imposed footprint of SLAC, (2) description of selected site, (3) use of earth cover for radiation and sight screens, (4) use of landscaping for cosmetic purposes, (5) use of exterior paint colors to soften SLAC impact on neighbors, (6) relocation of SLAC main entrance, (7) relocation of SLAC collider arcs and experimental hall, (8) parking lots and storage yards, and (9) land use zoning at SLAC.

  1. Conscious sedation for surgical procedures

    MedlinePlus

    Anesthesia - conscious ... have, what medicines you are taking, and what anesthesia or sedation you have had before. You may ... M. Intravenous anesthetics. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  2. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... using only the opposite ear to maintain balance. Chemical labyrinthectomy A chemical labyrinthectomy is also known as transtympanic or intratympanic ... ear by filling the scala tympani with a chemical solution. Click here to download the "Surgery for ...

  3. Improving outcomes in aesthetic facial reconstruction.

    PubMed

    Hofer, Stefan O P; Mureau, Marc A M

    2009-07-01

    Aesthetic facial reconstruction is a challenging art. Improving outcomes in aesthetic facial reconstruction requires a thorough understanding of the basic principles of the functional and aesthetic requirements for facial reconstruction. From there, further refinement and attention to detail can be provided. This paper discusses basic principles of aesthetic facial reconstruction.

  4. Postparalysis Facial Synkinesis: Clinical Classification and Surgical Strategies

    PubMed Central

    Chang, Tommy Nai-Jen; Lu, Johnny Chuieng-Yi

    2015-01-01

    Background: Postparalysis facial synkinesis (PPFS) can occur after any cause of facial palsy. Current treatments are still inadequate. Surgical intervention, instead of Botox and rehabilitation only, for different degrees of PPFS was proposed. Methods: Seventy patients (43 females and 27 males) with PPFS were enrolled since 1986. They were divided into 4 patterns based on quality of smile and severity of synkinesis. Data collection for clinically various presentations was made: pattern I (n = 14) with good smile but synkinesis, pattern II (n = 17) with acceptable smile but dominant synkinesis, pattern III (n = 34) unacceptable smile and dominant synkinesis, and pattern IV (n = 5) poor smile and synkinesis. Surgical interventions were based on patterns of PPFS. Selective myectomy and some cosmetic procedures were performed for pattern I and II patients. Extensive myectomy and neurectomy of the involved muscles and nerves followed by functioning free-muscle transplantation for facial reanimation in 1- or 2-stage procedure were performed for pattern III and many pattern II patients. A classic 2-stage procedure for facial reanimation was performed for pattern IV patients. Results: Minor aesthetic procedures provided some help to pattern I patients but did not cure the problem. They all had short follow-up. Most patients in patterns II (14/17, 82%) and III (34/34, 100%) showed a significant improvement of eye and smile appearance and significant decrease in synkinetic movements following the aggressively major surgical intervention. Nearly, all of the patients treated by the authors did not need repeated botulinum toxin A injection nor require a profound rehabilitation program in the follow-up period. Conclusions: Treatment of PPFS remains a challenging problem. Major surgical reconstruction showed more promising and long-lasting results than botulinum toxin A and/or rehabilitation on pattern III and II patients. PMID:25878931

  5. Benign tumours affecting the deep lobe of the parotid gland: how to select the optimal surgical approach.

    PubMed

    Casani, A P; Cerchiai, N; Dallan, I; Seccia, V; Sellari Franceschini, S

    2015-04-01

    Many types of approaches allow extra-capsular dissection in the deep parotid parenchyma in the treatment of benign tumours. A transcervical approach (TCA), transparotid approach (TPA) and a combined transcervical-transparotid approach (TPTCA) are the three main procedures performed to expose the deep parenchyma. We conducted a retrospective chart review enrolling 24 consecutive patients treated for benign tumours affecting the deep lobe of the parotid. Review of the surgical data was accompanied by careful follow-up to establish surgical morbidity, functional (Frey's Syndrome and first-bite syndrome) and aesthetical outcomes. A TPA was performed in the majority of cases; in 26% superficial parotidectomy was not required (selective deep parotidectomy). Minor's test showed a low rate of Frey's syndrome (3 cases of 23, 13%). No long-lasting first-bite syndrome was reported. Some additional procedures were easily performed in order to improve aesthetical results (rotational flap of sternocleidomastoid muscle, free abdominal fat transfer); these had the same results as selective deep parotidectomy. TCA (or TPTCA) ensures the best control of the facial nerve, providing good exposure and good functional and aesthetical results (without sparing the superficial parenchyma if additional techniques are performed with the aim of reducing skin depression in the treated area). The choice of the approach should have only the aim of safe resection and should not be influenced by aesthetical outcome; the craniocaudal level of the tumour seems to be the best indicator of the feasibility of the procedure also considering the branches of the facial nerve. In our experience, mandibulotomy can always be avoided.

  6. Male Aesthetics: A Review of Facial Anatomy and Pertinent Clinical Implications.

    PubMed

    Farhadian, Joshua A; Bloom, Bradley S; Brauer, Jeremy A

    2015-09-01

    Aesthetics continues to be a rapidly growing field within dermatology. In 2014, Americans spent 5 billion dollars on an estimated 9 million minimally invasive cosmetic procedures. Between 1997 and 2014, the number of aesthetic procedures performed on men increased by 273%. The approach to male aesthetics differs from that of females. Men have a squarer face, a more angled and larger jaw, and equally balanced upper and lower facial proportions. Facial muscle mass, subcutaneous tissue, and blood vessel density are also increased in men relative to women. While many of the same cosmetic procedures are performed in males and females, the approach, assessment, and treatment parameters are often different. Improper technique in a male patient can result in feminizing facial features and patient dissatisfaction. With an increasing number of men seeking aesthetic procedures, it behooves dermatologists to familiarize themselves with male facial anatomy and the practice of cosmetic dermatology in this population.

  7. Substitution of Usual Perioperative Care by eHealth to Enhance Postoperative Recovery in Patients Undergoing General Surgical or Gynecological Procedures: Study Protocol of a Randomized Controlled Trial

    PubMed Central

    Huirne, Judith AF; Bouwsma, Esther VA; van Dongen, Johanna M; Terwee, Caroline B; van de Ven, Peter M; den Bakker, Chantal M; van der Meij, Suzan; van Baal, W Marchien; Leclercq, Wouter KG; Geomini, Peggy MAJ; Consten, Esther CJ; Schraffordt Koops, Steven E; van Kesteren, Paul JM; Stockmann, Hein BAC; ten Cate, A Dorien; Davids, Paul HP; Scholten, Petrus C; van den Heuvel, Baukje; Schaafsma, Frederieke G; Meijerink, Wilhelmus JHJ; Bonjer, H Jaap; Anema, Johannes R

    2016-01-01

    Background Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. Objective With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care. Methods This is a multicenter randomized, single-blinded, controlled trial. At least 308 patients between 18 and 75 years old who are on the waiting list for a laparoscopic cholecystectomy, inguinal hernia surgery, or laparoscopic adnexal surgery for a benign indication will be included. Patients will be randomized to an intervention or control group. The intervention group will have access to an innovative, perioperative eHealth care program. This intervention program consists of a website, mobile phone app, and activity tracker. It aims to improve patient self-management and empowerment by providing guidance to patients in the weeks before and after surgery. The control group will receive usual care and will have access to a nonintervention (standard) website consisting of the digital information brochure about the surgical procedure being performed. Patients are asked to complete questionnaires at 5 moments during the first 6 months after surgery. The primary outcome measure is time to return to normal activities based on a patient-specific set of 8 activities selected from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning item bank version 1.2. Secondary outcomes include social

  8. Comparing open and minimally invasive surgical procedures for oesophagectomy in the treatment of cancer: the ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) feasibility study and pilot trial.

    PubMed Central

    Metcalfe, Chris; Avery, Kerry; Berrisford, Richard; Barham, Paul; Noble, Sian M; Fernandez, Aida Moure; Hanna, George; Goldin, Robert; Elliott, Jackie; Wheatley, Timothy; Sanders, Grant; Hollowood, Andrew; Falk, Stephen; Titcomb, Dan; Streets, Christopher; Donovan, Jenny L; Blazeby, Jane M

    2016-01-01

    BACKGROUND Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery. OBJECTIVES The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy. Objectives were to quantify the number of eligible patients in a pilot trial; develop surgical manuals as the basis for quality assurance; standardise pathological processing; establish a method to blind patients to their allocation in the first week post surgery; identify measures of postsurgical outcome of importance to patients and clinicians; and establish the main cost differences between the surgical approaches. DESIGN Pilot parallel three-arm randomised controlled trial nested within feasibility work. SETTING Two UK NHS departments of upper gastrointestinal surgery. PARTICIPANTS Patients aged ≥ 18 years with histopathological evidence of oesophageal or oesophagogastric junctional adenocarcinoma, squamous cell cancer or high-grade dysplasia, referred for oesophagectomy or oesophagectomy following neoadjuvant chemo(radio)therapy. INTERVENTIONS Oesophagectomy, with patients randomised to open surgery, a hybrid open chest and minimally invasive abdomen or totally minimally invasive access. MAIN OUTCOME MEASURE The primary outcome measure for the pilot trial was the number of patients recruited per month, with the main trial considered feasible if at least 2.5 patients per month were recruited. RESULTS During 21 months of recruitment, 263 patients were assessed for eligibility; of these, 135 (51%) were found to be eligible and 104 (77%) agreed to participate, an average of five patients per month. In total, 41 patients were allocated to open surgery, 43 to the

  9. Bariatric Surgery Procedures

    MedlinePlus

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... minimally invasive techniques (laparoscopic surgery). The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric ...

  10. Treatment planning of implants in the aesthetic zone.

    PubMed

    Jivraj, S; Chee, W

    2006-07-22

    Aesthetic restoration of anterior teeth with implant supported restorations is one of the most difficult procedures to execute. Bone resorption following anterior tooth extraction often compromises gingival tissue levels for the implant restoration. In the last 10 years the focus has shifted from osseointegration, to creation of an implant borne restoration which is in harmony with the surrounding hard and soft tissue. Complete reconstruction of tooth and gingival related aesthetics remains the primary objective and in some instances can be very difficult to achieve.

  11. The Sauvé-Kapandji Procedure

    PubMed Central

    Lluch, Alberto

    2013-01-01

    Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, and its only disadvantage is the loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji (S-K) procedure. The Sauvé-Kapandji differs from the Darrach procedure in that it preserves ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are maintained. Aesthetic appearance is also superior after the S-K procedure, as the normal prominence of the ulnar head, most noticeable when the forearm is in pronation, is maintained. However, the S-K is not free of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these complications can be prevented if a careful surgical technique is used. PMID:24436787

  12. The sauvé-kapandji procedure.

    PubMed

    Lluch, Alberto

    2013-02-01

    Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, and its only disadvantage is the loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji (S-K) procedure. The Sauvé-Kapandji differs from the Darrach procedure in that it preserves ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are maintained. Aesthetic appearance is also superior after the S-K procedure, as the normal prominence of the ulnar head, most noticeable when the forearm is in pronation, is maintained. However, the S-K is not free of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these complications can be prevented if a careful surgical technique is used.

  13. [Long-term results of peripheral vascular injuries in patients' limbs following reconstructive surgical procedures and influence on the quality of life].

    PubMed

    Deja, Włodzimierz; Wieczorek, Dariusz; Deja, Agata; Lasek, Jerzy; Kawecka, Aleksandra; Marks, Wojciech

    2006-01-01

    Major vascular injuries in extremities are rare and constitute problems for surgeons and their sequelae strongly influence remote future of the patients. The aim of study is to evaluate surgical treatment of vascular injuries in extremities and some aspects of quality of life. Since 1983 until 2002 sixty four patients with vascular limbs injuries were treated in the department. Remote evaluation has been performed in 33 persons. Severity of limb injuries was measured by Mangled Extremity Severity Score (MESS). In 20 patients (60.6%) very good and good recent results were obtained, satisfactory in 24.2% and bad results in 15.2% persons. Evaluation of functional status has been made by means of locomotion test and Jebsen-Taylor's test, social approval questionnaire, depression Beck's scale, the scale of hypochondria and by an original questionnaire to evaluate the quality of life. As considerable interdependence has been found between the functional status and the following factors: injury severity expressed in MESS (p < 0.01), clinic reception procedure (p < 0.001), ischemia time (p < 0.01), coincidence of other injuries (fractures and dislocations, muscle, tendon and nerve lesions) (p < 0.01), limb amputation (p < 0.01). Hand function significantly influences the quality of life. Patients who were in shock after trauma in the remote assessment showed susceptibility to the lowered mood and depression (p < 0.05). Quality of life is strongly connected with the features of personality, correlating mainly with the mood and tendencies of concentration upon somatic symptoms. Function of the hand influences strongly the quality of life. Amputated patients may in spite of their crippling limitations are able to adapt to everyday life.

  14. Aesthetic properties of everyday objects.

    PubMed

    Stich, Christine; Knäuper, Bärbel; Eisermann, Jens; Leder, Helmut

    2007-06-01

    This research addresses whether one underlying concept of appreciation exists across different classes of objects. Three studies were done. To identify aesthetic properties relevant for the aesthetic judgment of everyday objects and paintings, in Study 1 expert interviews were conducted with 12 interior designers, object-oriented designers and architects, and 12 students of art history. In Study 2, multidimensional unfolding (MDU) was used to examine whether common judgment criteria can be identified for the objects of the different classes. A sample of 217 German subjects participated. 2- or 3-dimensional MDU solutions resulted for each object class. The identified dimensions were labeled using the aesthetic properties derived from the expert interviews (Study 1). These dimensions represent relevant dimensions of aesthetic judgment on which object properties vary. Study 2 suggested that people use different dimensions of aesthetic judgment for different object classes. The identified dimensions were then used to construct three sets of systematically varied everyday objects and one set of systematically varied paintings. Using this stimulus material in Study 3, conjoint analysis indicated these dimensions are differentially important for the overall aesthetic judgment.

  15. The aesthetics of laboratory inscription: Claude Bernard's Cahier Rouge.

    PubMed

    Sattar, Atia

    2013-03-01

    This essay explores the aesthetic sensibilities of the French physiologist Claude Bernard (1813-1878). In particular, it analyzes the Cahier Rouge (1850-1860), Bernard's acclaimed laboratory notebook. In this notebook, Bernard articulates the range of his experience as an experimental physiologist, juxtaposing without differentiation details of laboratory procedure and more personal queries, doubts, and reflections on experimentation, life, and art. Bernard's insights, it is argued, offer an aesthetic and phenomenological template for considering experimentation. His physiological point of view ranges from his own bodily aesthesis or sensory perception, through personal reflections on scientific discovery as an artistic process, to a broader metaphysical conception of life as an artistic creation. Such an aesthetic approach to physiology enables Bernard to reconcile his empirical methodology and his romantic idealism; it offers the history of laboratory science a framework for considering the individual, bodily, and emotional labor inherent in physiological experimentation.

  16. [Surgical treatment with an artificial iris].

    PubMed

    Mayer, C S; Hoffmann, A E

    2015-10-01

    Iris defects with their disturbed pupillary function, visual impairment and glare constitute a therapeutic challenge in surgical reconstruction. A new therapeutic option for distinctive defects consists in the implantation of a custom-made silicone iris. This new and challenging therapy provides the opportunity to achieve an individual, aesthetically appealing and good functional result for the patient.

  17. Aesthetic Essentiality Regained Using Implant- A Case Report

    PubMed Central

    Rai, Rathika; Rathee, Suprabha; Chirom, Babina; V, Menaga

    2014-01-01

    The goal of implant therapy is to provide patients with a predictable, aesthetically and functionally satisfying treatment outcome with a low risk of aesthetic complications. Dental implants have been utilized by mankind for thousands of years, but only recently they have achieved widespread acceptance from the profession. Anterior sites are more likely related to aesthetic expectations and often represent a considerable challenge for involved clinicians and dental technicians, since various local risk factors have the potential to compromise the predictability of the result. In recent years, substantial efforts have been made to increase the appeal of implant therapy by shortening the overall treatment time and minimizing the number of surgical intervention. According to traditional protocol, a 12 month healing after extraction was suggested, but over the past few years alternative approaches have been proposed, such as immediate implant placement at the time of extraction or early implant placement following weeks of soft tissue healing. Common to all of these approaches is the requirement of adequate remaining bone volume. If there is no adequate bone volume, techniques like guided bone regeneration (GBR) are used for ridge augmentation before implant placement. The present case has utilized an endosteal root form implant and the advantage of guided bone regeneration technique in regaining aesthetic demands of the patient. PMID:25300892

  18. Efficacy and Safety of a Hyaluronic Acid Filler to Correct Aesthetically Detracting or Deficient Features of the Asian Nose: A Prospective, Open-Label, Long-Term Study

    PubMed Central

    Liew, Steven; Scamp, Terrence; de Maio, Mauricio; Halstead, Michael; Johnston, Nicole; Silberberg, Michael; Rogers, John D.

    2016-01-01

    Background There is increasing interest among patients and plastic surgeons for alternatives to rhinoplasty, a common surgical procedure performed in Asia. Objectives To evaluate the safety, efficacy, and longevity of a hyaluronic acid filler in the correction of aesthetically detracting or deficient features of the Asian nose. Methods Twenty-nine carefully screened Asian patients had their noses corrected with the study filler (Juvéderm VOLUMA [Allergan plc, Dublin, Ireland] with lidocaine injectable gel), reflecting individualized treatment goals and utilizing a standardized injection procedure, and were followed for over 12 months. Results A clinically meaningful correction (≥1 grade improvement on the Assessment of Aesthetic Improvement Scale) was achieved in 27 (93.1%) patients at the first follow-up visit. This was maintained in 28 (96.6%) patients at the final visit, based on the independent assessments of a central non-injecting physician and the patients. At this final visit, 23 (79.3%) patients were satisfied or very satisfied with the study filler and 25 (86.2%) would recommend it to others. In this small series of patients, there were no serious adverse events (AEs), with all treatment-related AEs being mild to moderate, transient injection site reactions, unrelated to the study filler. Conclusions Using specific eligibility criteria, individualized treatment goals, and a standardized injection procedure, the study filler corrected aesthetically detracting or deficient features of the Asian nose, with the therapeutic effects lasting for over 12 months, consistent with a high degree of patient satisfaction. This study supports the safety and efficacy of this HA filler for specific nose augmentation procedures in selected Asian patients. Level of Evidence: 3 Therapeutic PMID:27301371

  19. Aesthetic results following partial mastectomy and radiation therapy

    SciTech Connect

    Matory, W.E. Jr.; Wertheimer, M.; Fitzgerald, T.J.; Walton, R.L.; Love, S.; Matory, W.E.

    1990-05-01

    This study was undertaken to determine the aesthetic changes inherent in partial mastectomy followed by radiation therapy in the treatment of stage I and stage II breast cancer. A retrospective analysis of breast cancer patients treated according to the National Surgical Adjuvant Breast Project Protocol B-06 was undertaken in 57 patients from 1984 to the present. The size of mastectomy varied between 2 x 1 cm and 15 x 8 cm. Objective aesthetic outcome, as determined by physical and photographic examination, was influenced primarily by surgical technique as opposed to the effects of radiation. These technical factors included orientation of resections, breast size relative to size of resection, location of tumor, and extent and orientation of axillary dissection. Regarding cosmesis, 80 percent of patients treated in this study judged their result to be excellent or good, in comparison to 50 percent excellent or good as judged by the plastic surgeon. Only 10 percent would consider mastectomy with reconstruction for contralateral disease. Asymmetry and contour abnormalities are far more common than noted in the radiation therapy literature. Patients satisfaction with lumpectomy and radiation, however, is very high. This satisfaction is not necessarily based on objective criteria defining aesthetic parameters, but is strongly influenced by retainment of the breast as an original body part.

  20. Non-surgical deep intrauterine transfer of superfine open pulled straw (SOPS)-vitrified porcine embryos: evaluation of critical steps of the procedure.

    PubMed

    Gomis, J; Cuello, C; Sanchez-Osorio, J; Gil, M A; Parrilla, I; Angel, M A; Maside, C; del Olmo, D; Vazquez, J M; Roca, J; Martinez, E A

    2012-10-01

    Previous trials achieved extremely poor results when using the one-step warming method in a syringe in combination with non-surgical deep intrauterine transfer (NET) of superfine open pulled straw (SOPS)-vitrified embryos. This study aimed to assess the effect of the warming procedure on the in vitro and in vivo development of SOPS-vitrified embryos. The effect of the passage of the vitrified-warmed (VW) embryos through the NET catheter was also evaluated. Groups of 4 to 6 morulae and blastocysts, collected from weaned sows, were SOPS-vitrified in 1 μL of vitrification medium, warmed by the one-step warming method in a dish or in a 1-mL syringe and cultured in vitro for 48 h to evaluate the embryo survival (ES) and hatching rates (HR). Warming in syringe had a deleterious effect (P < 0.05) on the in vitro ES (60.5 ± 10.4%) and HR (39.6 ± 9.5%) of VW embryos in comparison with embryos warmed in a dish (85.4 ± 10.6% and 69.0 ± 8.4%, respectively). This decreased embryonic development was due to the increased time required between the removal of the straws from the liquid nitrogen and the contact of the embryos with the warming medium when the warming was performed in a syringe in comparison with that for the warming in a dish. After verifying that the passage of VW embryos through the NET catheter does not have a damaging effect on their further in vitro development, the negative effect of warming in a syringe was also confirmed after NET. Fifteen fresh and SOPS-vitrified embryos warmed in a syringe or in a dish were transferred to each recipient (n = 28) and recovered 24 h later to assess their developmental progression. All embryos from the syringe group were found to have degenerated at recovery. The in vivo ES and HR from the dish group (80.4 ± 3.4% and 14.2 ± 7.2%, respectively) were lower (P < 0.05) than those from the fresh group (94.0 ± 4.1% and 36.8 ± 7.8%, respectively). Combining the warming in a dish and the NET procedure, 35 VW embryos were

  1. [Surgical site infections].

    PubMed

    Sganga, Gabriele

    2014-01-01

    Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2-5% of all surgical procedures. SSIs represent the third most frequent nosocomial infection, accounting for 14-16% of all infections observed in hospitalized patients and up to 38% of those observed among surgical patients. Knowledge of incidence, epidemiology, classification, process of wound healing, and pathogenesis of surgical site infection is of great importance. Given the high economic burden that infections provoke, beyond the increased morbidity and mortality, it appears mandatory to improve our tools in order to reduce their incidence, as a reduction of only 0.1% can result in a considerable saving of economic resources to be allocated to other activities, such as screening and prevention programs.

  2. The Phenomenology of Aesthetic Peak Experiences.

    ERIC Educational Resources Information Center

    Panzarella, Robert

    1980-01-01

    Descriptions of music and visual art peak experiences obtained from persons were content analyzed and factor analyzed. The peak experience accounts for mirrored conflicts in aesthetic norms and suggests a greater role for individual differences in aesthetic theories. (Author)

  3. Surgical treatment of skin lesions in lupus erythematosus

    PubMed Central

    Lewandowicz, Edward; Zieliński, Tomasz; Iljin, Aleksandra; Fijałkowska, Marta; Kasielska-Trojan, Anna

    2014-01-01

    Lipodystrophies are a wide group of diseases with various etiology, mainly genetic, metabolic or autoimmune. The treatment of these diseases is chronic and not always effective. Major concerns for patients with lipodystrophies are also esthetic defects, especially deformities in the face, neck and upper limbs. There are many surgical methods that can be used to improve patient's appearance like fillers, autologous fat transfer and skin flaps. The aim of this paper is to present and discuss surgical techniques used for correction of lipoatrophy and other skin lesions present in lupus erythematosus. In the first presented patient, lipodermal grafts were performed in two stages (first – to both zygomatic areas, the second – to both nasolabial folds). Moreover, the patient was qualified for arm scar plasty. Deepithelialized skin in the affected area was covered with advanced local skin flaps. In the second patient, an extensive scarring lesion on the scalp was excised and the defect was closed with an expanded scalp flap. Patients with lipodystrophies may require aesthetic surgical procedures to improve their appearance. In patients with lupus erythematosus, autologous fat graft in the face area seems to be a safe and effective method of refilling the volume of atrophic tissues. On the basis of our experience, it is worth emphasizing that the process of fat graft resorption is typical. In patients with scalp scars, an effective method of their removal and hairline restoring is usage of the tissue expander. PMID:25610357

  4. Embodied Aesthetics, Evocative Art Criticism: Aesthetically Based Research

    ERIC Educational Resources Information Center

    White, Boyd

    2011-01-01

    This study introduces one approach to arts-based research, one that emerges from aesthetic encounters and ensuing art criticism. Examples are drawn from one preservice teacher's attempts to write art criticism, both discursive and evocative, based on her personal responses to a chosen artwork. The articulation of her responses is a form of…

  5. "Aesthetic Emotion": An Ambiguous Concept in John Dewey's Aesthetics

    ERIC Educational Resources Information Center

    Hohr, H.

    2010-01-01

    This article analyses the concept of "aesthetic emotion" in John Dewey's "Art as experience". The analysis shows that Dewey's line of investigation offers valuable insights as to the role of emotion in experience: it shows emotion as an integral part and structuring force, as a cultural and historical category. However, the notion of aesthetic…

  6. Environmental Aesthetics, Social Engagement and Aesthetic Experiences in Central Asia

    ERIC Educational Resources Information Center

    Breed, Amanda

    2015-01-01

    In this essay, I explore the Youth Theatre for Peace (YTP) project in relation to environmental aesthetics and engaged participatory practices towards tolerance building in Central Asia. My main argument is that cultural histories of storytelling, "manas" (an oral and now literary Kyrgyz epic) and trickster tales incorporate ideas and…

  7. North Korean Aesthetic Theory: Aesthetics, Beauty, and "Man"

    ERIC Educational Resources Information Center

    David-West, Alzo

    2013-01-01

    Aesthetics is not a subject usually associated with North Korea in Western scholarship, the usual tropes being autocracy, counterfeiting, drugs, human-rights abuse, famine, nuclear weapons, party-military dictatorship, Stalinism, and totalitarianism. Where the arts are concerned, they are typically seen as crude political propaganda. One British…

  8. Multiscale Surgical Telerobots

    SciTech Connect

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  9. Are the surgeon's movements repeatable? An analysis of the feasibility and expediency of implementing support procedures guiding the surgical tools and increasing motion accuracy during the performance of stereotypical movements by the surgeon.

    PubMed

    Podsędkowski, Leszek Robert; Moll, Jacek; Moll, Maciej; Frącczak, Łukasz

    2014-03-01

    The developments in surgical robotics suggest that it will be possible to entrust surgical robots with a wider range of tasks. So far, it has not been possible to automate the surgery procedures related to soft tissue. Thus, the objective of the conducted studies was to confirm the hypothesis that the surgery telemanipulator can be equipped with certain routines supporting the surgeon in leading the surgical tools and increasing motion accuracy during stereotypical movements. As the first step in facilitating the surgery, an algorithm will be developed which will concurrently provide automation and allow the surgeon to maintain full control over the slave robot. The algorithm will assist the surgeon in performing typical movement sequences. This kind of support must, however, be preceded by determining the reference points for accurately defining the position of the stitched tissue. It is in relation to these points that the tool's trajectory will be created, along which the master manipulator will guide the surgeon's hand. The paper presents the first stage, concerning the selection of movements for which the support algorithm will be used. The work also contains an analysis of surgical movement repeatability. The suturing movement was investigated in detail by experimental research in order to determine motion repeatability and verify the position of the stitched tissue. Tool trajectory was determined by a motion capture stereovision system. The study has demonstrated that the suturing movement could be considered as repeatable; however, the trajectories performed by different surgeons exhibit some individual characteristics.

  10. 21 CFR 878.4340 - Contact cooling system for aesthetic use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Contact cooling system for aesthetic use. 878.4340 Section 878.4340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4340 Contact...

  11. 21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Focused ultrasound stimulator system for aesthetic use. 878.4590 Section 878.4590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  12. 21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Focused ultrasound stimulator system for aesthetic use. 878.4590 Section 878.4590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  13. 21 CFR 878.4340 - Contact cooling system for aesthetic use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Contact cooling system for aesthetic use. 878.4340 Section 878.4340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4340 Contact...

  14. 21 CFR 878.4340 - Contact cooling system for aesthetic use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Contact cooling system for aesthetic use. 878.4340 Section 878.4340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4340 Contact...

  15. 21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Focused ultrasound stimulator system for aesthetic use. 878.4590 Section 878.4590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  16. 21 CFR 878.4340 - Contact cooling system for aesthetic use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Contact cooling system for aesthetic use. 878.4340 Section 878.4340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4340 Contact...

  17. Aesthetics, Popular Visual Culture, and Designer Capitalism

    ERIC Educational Resources Information Center

    Duncum, Paul

    2007-01-01

    While rejecting modernist philosophical aesthetics, the author argues for the use in art education of a current, ordinary-language definition of aesthetics as visual appearance and effect, and its widespread use in many diverse cultural sites is demonstrated. Employing such a site-specific use of aesthetics enables art education to more clearly…

  18. It's Catch-up Time for Aesthetics.

    ERIC Educational Resources Information Center

    Hicks, John

    1999-01-01

    Attempts to refocus aesthetic education for art teachers and argues the need to see aesthetics in society. Discusses the ideas of T. Irene Sanders, Bernd Schmitt, and Alex Simonson to demonstrate real-world support for aesthetic education. Uses two examples: eye glasses and bathrooms. (CMK)

  19. Holding Aesthetics and Ideology in Tension

    ERIC Educational Resources Information Center

    Duncum, Paul

    2008-01-01

    Studying imagery, irrespective of the kind, must focus equally upon its aesthetic attractiveness, its sensory lures, and its oftentimes dubious social ideology. The terms "aesthetic" and "ideology" are addressed as problematic and are defined in current, ordinary language terms: aesthetics as visual appearances and their effects and ideology as a…

  20. The Aesthetics of Behavioral Arrangements

    ERIC Educational Resources Information Center

    Hineline, Philip N.

    2005-01-01

    With their origins in scientific validation, behavior-analytic applications have understandably been developed with an engineering rather than a crafting orientation. Nevertheless, traditions of craftsmanship can be instructive for devising aesthetically pleasing arrangements--arrangements that people will try, and having tried, will choose to…

  1. Aesthetic Education: Questions and Issues

    ERIC Educational Resources Information Center

    Smith, Ralph A.

    2005-01-01

    An aesthetically educated person may be understood to subscribe to values and possess dispositions that in important respects are distinctive. The respects in which such values and dispositions are unique and the methods by which they might be developed are, however, subject to interpretation. This article provides brief summaries of three…

  2. Cognitive aesthetics of alchemical imagery.

    PubMed

    Connolly, Angela M

    2013-02-01

    Jung's contribution to the understanding of the relevance of psychology to alchemy has become increasingly invalidated by the ahistorical nature of his approach, just as his tendency to ignore the importance of cognitive aesthetics for an improved comprehension of the functions of alchemical images has prevented Jungians from further extending Jung's insight of the importance of alchemy for psychology. This paper explores the history of the development of alchemical illustrations in Western Europe from the 14(th) to the 16(th) century, tracing the emergent processes over time. It is only when we take into consideration the historical dimension and the aesthetics of alchemical imagery that it becomes possible to demonstrate how the increasing use of certain aesthetic techniques such as the disjunction and recombination of separate metaphorical elements of previous illustrations, the use of compressive combinations and the use of framing devices worked to gradually increase the cognitive function and the symbolical power of the images. If alchemy is still relevant to psychotherapy it is exactly because it helps us to understand the importance of cognitive aesthetics in our approach to the images, metaphors and narratives of our patients.

  3. Lip asymmetry and smile aesthetics.

    PubMed

    Batwa, Waeil; McDonald, Fraser; Cash, Alex

    2013-11-01

    Objective : To determine if lip asymmetry can affect lip aesthetics. Setting and Participants : A group of dentists (n = 40) and cleft patients (n = 40) were recruited from the dental hospital and cleft service. Interventions : Still photographic digital images of lips and teeth were manipulated to produce a computerized gradient of smile appearance with different degrees of upper-lip vertical asymmetry. These five photographs (with 0 mm representing "symmetry," and 1, 2, 2.5, and 3 mm, asymmetries) were assessed by participants using a 5-point Likert scale. Statistics : Descriptive statistics in addition to chi-square test were used to analyze the data. In order to satisfy the requirement of the chi-square test, the five smile ratings were reduced to three. Results : Lip asymmetry did affect relative smile aesthetics, as determined by dentists and cleft patients. Both the dentists and cleft patients rated the 0-mm photograph more attractive than the 2.5-mm and 3-mm smiles (P < .05). The 0-, 1-, and 2-mm smiles were indistinguishable for both dentists and cleft patients. Conclusion : Lip asymmetry affects smile aesthetics. However, cleft patients and dentists were tolerant of minor asymmetries. This suggests that small degrees of lip asymmetry do not affect relative smile aesthetics as much as large degrees of lip asymmetry (2.5 mm or more).

  4. Aesthetics, Affect, and Educational Politics

    ERIC Educational Resources Information Center

    Means, Alex

    2011-01-01

    This essay explores aesthetics, affect, and educational politics through the thought of Gilles Deleuze and Jacques Ranciere. It contextualizes and contrasts the theoretical valences of their ethical and democratic projects through their shared critique of Kant. It then puts Ranciere's notion of dissensus to work by exploring it in relation to a…

  5. A mandibular surgical training model.

    PubMed

    Leser, Casey P; Jepsen, Shawn A

    2008-01-01

    Performing surgical procedures on the mandible can present many challenges due to the anatomy and the limited access available to the various areas of the mandibular arch. The experience of the surgeon and the complexity of the surgery must be considered before attempting treatment. A static mandibular training model provides dentists with the opportunity to practice multiple surgical procedures to develop the skills that are necessary to treat patients competently and comprehensively. The mandible's unique anatomy presents a number of challenges when performing surgical procedures. A surgical model that makes it possible to practice multiple techniques benefits the surgeon by building the confidence to attempt more complex surgical procedures and thus provide patients with additional treatment options. This mandibular surgical model serves as a learning tool and provides an avenue for learning different surgical techniques that may be performed in various areas of the mandible. A number of procedures can be performed on the model, including the extraction of third molars, incision and drainage of a vestibular/buccal swelling, excisional biopsy of intrabony lesions, tori removal, initial implant alignment procedures, and suturing/flap designs. A number of these procedures can be performed on one model.

  6. Aesthetic Lateral Canthoplasty Using Tarso-Conjunctival Advancement Technique.

    PubMed

    Lee, Eun Jung; Lew, Dae Hyun; Song, Seung Han; Lee, Myung Chul

    2017-01-01

    Reduced horizontal length of the palpebral fissure is a distinctive characteristic of Asian eyelids, and aesthetic lateral canthal lengthening techniques have been performed for a refinement. The aim of this study is to describe a novel lateral canthoplasty using tarso-conjunctival advancement with a lid margin splitting procedure on the upper eyelids and to report the postoperative results. From December 2011 to June 2014, patients who underwent lateral canthoplasty using the tarso-conjunctival advancement procedure for aesthetic purposes were reviewed retrospectively. The predictor variables were grouped into demographic and operative categories. The primary outcome variables were the distances from the mid-pupillary line to the lateral canthus and the horizontal length of the palpebral aperture (distance from the medial to lateral canthus). Data analyses were performed using descriptive and univariate statistics. Patients who showed increment in objective measurements were considered significant. Aesthetic appearance was also evaluated based on pre- and postoperative clinical photographs. A total of 45 patients were enrolled in this study. Both the distance from the mid-pupil to the lateral canthus (ΔDpupil-lateral; 2.78 ± 0.54 mm, P <0.05) and the palpebral aperture horizontal length (ΔDmedial-lateral 2.93 ± 0.81 mm, P <0.05) increased significantly from pre- to postoperative state. All the patients demonstrated satisfactory results aesthetically during the follow-up. The tarso-conjunctival advancement technique for lateral canthoplasty produced satisfactory aesthetic results with an enlarged palpebral aperture. Future research is required to fully delineate the risk of possible complications, including injury to the eyelashes and meibomian glands.

  7. Magic and the aesthetic illusion.

    PubMed

    Balter, Leon

    2002-01-01

    The aesthetic illusion is the subjective experience that the content of a work of art is reality. It has an intrinsic relation to magic, an intrapsychic maneuver oriented toward modification and control of the extraspyschic world, principally through ego functioning. Magic is ontogenetically and culturally archaic, expresses the omnipotence inherent in primary narcissism, and operates according to the logic of the primary process. Magic is a constituent of all ego functioning, usually latent in later development. It may persist as an archaic feature or may be evoked regressively in global or circumscribed ways. It causes a general disinhibition of instincts and impulses attended by a sense of confidence, exhiliration, and exuberance. The aesthetic illusion is a combination of illusions: (1) that the daydream embodied by the work of art is the beholder's own, the artist being ignored, and (2) that the artistically described protagonist is a real person with a real "world." The first illusion arises through the beholder's emotional-instinctual gratification from his or her own fantasy-memory constellations; the second comes about because the beholder, by taking the protagonist as proxy, mobilizes the subjective experience of the imaginary protagonist's "reality." The first illusion is necessary for the second to take place; the second establishes the aesthetic illusion proper. Both illusions are instances of magic. Accordingly, the aesthetic illusion is accompanied by a heady experience of excitement and euphoria. The relation among the aesthetic illusion, magic, and enthusiasm is illustrated by an analytic case, J. D. Salinger's "The Laughing Man," Woody Allen's Play It Again, Sam, Don Quixote, and the medieval Cult of the Saints.

  8. Surgical approach to oral lichen planus by submucosal autologous fat grafting.

    PubMed

    Arcuri, Francesco; Stellin, Livia; Gatti, Alessandro; Benech, Arnaldo

    2013-05-01

    Oral lichen planus is a chronic autoinflammatory mucositis. Oral lesions are predominantly white; they tend to be bilateral while involving the buccal mucosa especially cheek, tongue, gums, lips, and palate. Many topical and systemic agents are currently used with unpredictable results. Fat grafting is characterized by the placement of multiple parcels of purified fat with blunt cannulas; at the beginning, it was introduced to improve facial aesthetics. Recently, it has been translated to other surgical cases such as posttraumatic deformities and craniofacial anomalies and as ancillary reconstructive procedure after tumor resections. The successful results of this procedure encouraged us to use this approach to a clinical case of oral lichen planus refractory to conventional therapy.

  9. Surgical management of hemorrhoids.

    PubMed

    Agbo, S P

    2011-07-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding.

  10. Functional Aesthetic Occlusal Plane (FAOP)

    PubMed Central

    Câmara, Carlos Alexandre; Martins, Renato Parsekian

    2016-01-01

    ABSTRACT Introduction: A reasonable exposure of incisors and gingival tissues is generally considered more attractive than excess or lack of exposure. A reasonable gingival exposure is considered to be around 0 to 2 mm when smiling and 2-4 mm exposure of the maxillary incisor edge when the lips are at rest. Objective: The aim of this paper is to present the Functional Aesthetic Occlusal Plane (FAOP), which aims to help in the diagnosis of the relationships established among molars, incisors and the upper lip. Conclusion: FAOP can complement an existing and established orthodontic treatment plan, facilitating the visualization of functional and aesthetic demands by giving a greater focus on the position of incisors in the relationship established among the incisors, molars and the upper lip stomion. PMID:27653271

  11. Postoperative pharyngolaryngeal adverse events with laryngeal mask airway (LMA Supreme) in laparoscopic surgical procedures with cuff pressure limiting 25 cmH₂O: prospective, blind, and randomised study.

    PubMed

    Kang, Joo-Eun; Oh, Chung-Sik; Choi, Jae Won; Son, Il Soon; Kim, Seong-Hyop

    2014-01-01

    To reduce the incidence of postoperative pharyngolaryngeal adverse events, laryngeal mask airway (LMA) manufacturers recommend maximum cuff pressures not exceeding 60 cmH₂O. We performed a prospective randomised study, comparing efficacy and adverse events among patients undergoing laparoscopic surgical procedures who were allocated randomly into low (limiting 25 cmH₂O, L group) and high (at 60 cmH₂O, H group) LMA cuff pressure groups with LMA Supreme. Postoperative pharyngolaryngeal adverse events were evaluated at discharge from postanaesthetic care unit (PACU) (postoperative day 1, POD 1) and 24 hours after discharge from PACU (postoperative day 2, POD 2). All patients were well tolerated with LMA without ventilation failure. Before pneumoperitoneum, cuff volume and pressure and oropharyngeal leak pressure (OLP) showed significant differences. Postoperative sore throat at POD 2 (3 versus 12 patients) and postoperative dysphagia at POD 1 and POD 2 (0 versus 4 patients at POD 1; 0 versus 4 patients at POD 2) were significantly lower in L group, compared with H group. In conclusion, LMA with cuff pressure limiting 25 cmH₂O allowed both efficacy of airway management and lower incidence of postoperative adverse events in laparoscopic surgical procedures. This clinical trial is registered with KCT0000334.

  12. Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities.

    PubMed

    Dexter, F; Epstein, R H; Dexter, E U; Lubarsky, D A; Sun, E C

    2017-03-01

    We considered whether senior hospital managers and department chairs need to be concerned that small reductions in average hospital length of stay (LOS) may be associated with greater rates of re-admission, use of home health care, and/or transfers to short-term care facilities. The 2013 United States Nationwide Readmissions Database was used to study surgical Diagnosis Related Groups (DRG) with 1) national median LOS ≥3 days and 2) ≥10 hospitals in the database that each had ≥100 discharges for the DRG. Dependent variables were considered individually: 1) re-admission within 30 days of discharge, 2) discharge disposition to home health care, and/or 3) discharge disposition of transfer to short-term care facility (i.e., inpatient rehabilitation hospital or skilled nursing facility). While controlling for DRG, each one-day decrease in hospital median LOS was associated with an odds of re-admission nationwide of 0.95 (95% confidence interval [CI] 0.92-0.99; P=0.012), odds of disposition upon discharge being home care of 0.95 (95% CI 0.83-1.10; P=0.64), and odds of transfer to short-term care facility of 0.68 (95% CI 0.54-0.85; P=0.0008). Results were insensitive to the addition of patient-specific data. In the USA, patients at hospitals with briefer median LOS across multiple common surgical procedures did not have a greater risk for either hospital re-admission within 30 days of discharge or transfer to an inpatient rehabilitation hospital or a skilled nursing facility. The generalisable implication is that, across many surgical procedures, DRG-based financial incentives to shorten hospital stays seem not to influence post-acute care decisions.

  13. Back to Basics: Surgical Skin Antisepsis.

    PubMed

    Spruce, Lisa

    2016-01-01

    The fundamental basis for preventing surgical site infections is the antiseptic preparation of the skin at the surgical site. All perioperative nurses must learn this skill. The goal of surgical skin antisepsis, frequently referred to as prepping the skin, is to remove soil and transient (ie, temporary) microorganisms living on the skin that could pose a risk for surgical site infections. This Back to Basics article examines the origin of surgical skin antisepsis and the steps perioperative nurses should take to provide the patient with an aseptic surgical site before any surgical or other invasive procedure.

  14. Comparative Efficacy of Pulse-Spray Thrombolysis and Angioplasty Versus Surgical Salvage Procedures for Treatment of Recurrent Occlusion of PTFE Dialysis Access Grafts

    SciTech Connect

    Polak, Joseph F.; Berger, Markus F.; Pagan-Marin, Heriberto; Aruny, John E.; Meyerovitz, Michael F.

    1998-07-15

    Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone (p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty [0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision.

  15. Surgical sentinel lymph node biopsy in early breast cancer. Could it be avoided by performing a preoperative staging procedure? A pilot study

    PubMed Central

    Testori, Alberto; Meroni, Stefano; Moscovici, Oana Codrina; Magnoni, Paola; Malerba, Paolo; Chiti, Arturo; Rahal, Daoud; Travaglini, Roberto; Cariboni, Umberto; Alloisio, Marco; Orefice, Sergio

    2012-01-01

    Summary Background The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy. Material/Methods This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a “hot spot” corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy. Results Preoperative sentinel node identification was successful in all patients. Conclusions The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks. PMID:22936189

  16. Domain specificity and mental chronometry in empirical aesthetics.

    PubMed

    Jacobsen, Thomas

    2014-11-01

    This article is a commentary on 'Ten years of a model of aesthetic appreciation and aesthetic judgments: The aesthetic episode - developments and challenges in empirical aesthetics' (Leder & Nadal, 2014, this issue). It focuses on domain specificity and mental chronometry in empirical aesthetics.

  17. The effect of increased consumer demand on fees for aesthetic surgery: an economic analysis.

    PubMed

    Krieger, L M; Shaw, W W

    1999-12-01

    Economic theory dictates that changes in consumer demand have predictable effects on prices. Demographics represents an important component of demand for aesthetic surgery. Between the years of 1997 and 2010, the U.S. population is projected to increase by 12 percent. The population increase will be skewed such that those groups undergoing the most aesthetic surgery will see the largest increase. Accounting for the age-specific frequencies of aesthetic surgery and the population increase yields an estimate that the overall market for aesthetic surgery will increase by 19 percent. Barring unforeseen changes in general economic conditions or consumer tastes, demand should increase by an analogous amount. An economic demonstration shows the effects of increasing demand for aesthetic surgery on its fees. Between the years of 1992 and 1997, there was an increase in demand for breast augmentation as fears of associated autoimmune disorders subsided. Similarly, there was increased male acceptance of aesthetic surgery. The number of breast augmentations and procedures to treat male pattern baldness, plastic surgeons, and fees for the procedures were tracked. During the study period, the supply of surgeons and consumer demand increased for both of these procedures. Volume of breast augmentation increased by 275 percent, whereas real fees remained stable. Volume of treatment for male pattern baldness increased by 107 percent, and the fees increased by 29 percent. Ordinarily, an increase in supply leads to a decrease in prices. This did not occur during the study period. Economic analysis demonstrates that the increased supply of surgeons performing breast augmentation was offset by increased consumer demand for the procedure. For this reason, fees were not lowered. Similarly, increased demand for treatment of male pattern baldness more than offset the increased supply of surgeons performing it. The result was higher fees. Emphasis should be placed on using these economic

  18. Outcomes of Surgical Treatment of Vascular Anomalies on the Vermilion

    PubMed Central

    Park, Sang Min; Lee, Jae Woo; Kim, Hoon Soo; Lee, In Sook

    2016-01-01

    Background The vermilion plays an important role in both the aesthetic and functional aspects of facial anatomy. Due to its structural features, the complete excision of vascular anomalies on the vermilion is challenging, making it difficult to determine the appropriate treatment strategy. Thus, the authors analyzed the results of surgical treatment of vascular anomalies on the vermilion. Methods The medical records of 38 patients with vascular anomalies on the vermilion who underwent surgery from 1995 to 2013 were analyzed. Nine of the cases had an involuted hemangioma, and 29 cases had a vascular malformation; of the vascular malformations, 13, 11, one, and four cases involved were capillary malformations (CMs), venous malformations (VMs), lymphatic malformations (LMs), and arteriovenous malformations (AVMs), respectively. We investigated the surgical methods used to treat these patients, the quantity of surgical procedures, complications and instances of recurrence, and self-assessed satisfaction scores. Results A total of 50 operations were carried out: 28 horizontal partial excisions, eight vertical partial excisions, and 14 operations using other surgical methods. All cases of AVM underwent complete excision. Six cases experienced minor complications and one case of recurrence was observed. The overall average satisfaction score was 4.1 out of 5, while the satisfaction scores associated with each lesion type were 4.2 for hemangiomas, 3.9 for CMs, 4.2 for VMs, 5.0 for LMs, and 4.0 for AVMs. Conclusions It is difficult to completely excise vascular anomalies that involve the vermilion. This study suggests that partial excision focused on correcting the overall contour of the lips is effective and leads to satisfactory results. PMID:26848441

  19. Leadership and Management in Aesthetic Medicine.

    PubMed

    Brennan, Connie

    2016-01-01

    The aesthetic provider is obligated to leverage their leadership, management, and teamwork skills on a daily basis in order to deliver optimum aesthetic outcomes for their clients. This article discusses leadership and motivational theories, leadership and management traits, complexity theory, Gardner's tasks of leadership, and the role of emotional intelligence in leading, managing, and following, so the aesthetic provider can identify and align with a particular leadership and management style that suits their practice philosophy.

  20. 3D Surgical Simulation

    PubMed Central

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  1. Aesthetic facial surgery for the asian male.

    PubMed

    Lam, Samuel M

    2005-11-01

    Cosmetic surgery of the Asian face has become increasingly popular in the Far East and the West. The Asian male identity has undergone an evolution in Western media toward a more positive change. The standards of beauty have also changed, being defined by more multicultural models and styles of dress than before. To undertake cosmetic surgery of the Asian face, particularly of the Asian male, requires a different psychological understanding of the individual as well as an entirely different surgical technique in most cases. This brief article does not delve into the technical details of each procedure but concentrates on the salient differences in how to approach the Asian male patient for each of the different procedures, including Asian blepharoplasty, augmentation rhinoplasty, lip reduction, dimple fabrication, otoplasty, facial contouring and aging face procedures, and hair restoration.

  2. A procedure for tissue freezing and processing applicable to both intra-operative frozen section diagnosis and tissue banking in surgical pathology.

    PubMed

    Steu, Susanne; Baucamp, Maya; von Dach, Gabriela; Bawohl, Marion; Dettwiler, Susanne; Storz, Martina; Moch, Holger; Schraml, Peter

    2008-03-01

    Different methods for snap freezing surgical human tissue specimens exist. At pathology institutes with higher work loads, solid carbon dioxide, freezing sprays, and cryostat freezing are commonly used as coolants for diagnosing frozen tissue sections, whereas for tissue banking, liquid nitrogen or isopentane cooled with liquid nitrogen is preferred. Freezing tissues for diagnostic and research purposes are therefore often time consuming, laborious, even hazardous, and not user friendly. In tissue banks, frozen tissue samples are stored in cryovials, capsules, cryomolds, or cryocassettes. Tissues are additionally embedded using freezing media or wrapped in plastic bags or aluminum foils to prevent desiccation. The latter method aggravates enormously further tissue handling and processing. Here, we describe an isopentane-based workflow which concurrently facilitates tissue freezing and processing for both routine intra-operative frozen section and tissue banking and satisfies the qualitative demands of pathologists, cancer researchers, laboratory technicians, and tissue bankers.

  3. Cone-beam computed tomography as a surgical guide to impacted anterior teeth

    PubMed Central

    Jeremias, Fabiano; Fragelli, Camila Maria Bullio; Mastrantonio, Simone Di Salvo; dos Santos-Pinto, Lourdes; dos Santos-Pinto, Ary; Pansani, Cyneu Aguiar

    2016-01-01

    Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT), compared to the conventional radiography, has a greater potential to provide complementary information because of its three-dimensional (3D) images, reducing the possibility of failures in surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide. After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization of supernumerary teeth, aiding the professional in the treatment planning, and consequently in the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and providing a better recovering of the patients. PMID:26962322

  4. Surgical and Prosthetic Rehabilitation of Combination Syndrome

    PubMed Central

    Carlino, Paolo; Pettini, Francesco; Cantore, Stefania; Grassi, Felice Roberto; Pepe, Valentina

    2014-01-01

    The aim of this report is to analyze the clinical symptoms, ethologic factors, and prosthetic rehabilitation in a case of Combination Syndrome (CS). The treatment of CS can be conventional or surgical, with or without the bone reconstruction of maxilla. The correct prosthetic treatment helps this kind of patients to restore the physiologic occlusion plane to allow a correct masticatory and aesthetic function. Management of this kind of patients can be a challenge for a dental practitioner. PMID:24511397

  5. Surgical reconstruction of TMJ.

    PubMed

    Ramil Novo, V M; Garcìa, A G; Berini Aytès, L; Escoda, C G

    1999-01-01

    Certain situations and pathological processes that arise with temporomandibular joint destruction can only be resolved with surgical reconstructive procedures in order to attempt a functional and anatomical rehabilitation of this joint. Many of these situations can be surgically treated with the patient's own autologous tissues. However, in some patients reconstruction is complex and the use of autologous tissues is unadvisable whereas reconstruction utilizing alloplastic materials may be an appropriate alternative. The following report describes 4 clinical cases in which autologous grafts or Christensen joint prosthesis are employed in temporomandibular joint reconstruction.

  6. Surgical treatment for epilepsy

    PubMed Central

    Engel, Jerome; Wiebe, Samuel; Radhakrishnan, Kurupath; Palmini, André

    2016-01-01

    Surgical treatment for epilepsy remains highly underutilized: in the United States, there has been no increase in the number of surgical procedures performed annually since 19901; for most patients referred, the average duration of epilepsy is 22 years2; and there has been no change in this delay to surgery3, despite two randomized controlled trials4, 5 and an American Academy of Neurology practice parameter that recommended surgery as the treatment of choice for medically refractory temporal lobe epilepsy6. This session addressed issues relevant to increasing the availability of epilepsy surgery, particularly in countries with limited resources.

  7. Research on seamless development of surgical instruments based on biological mechanisms using CAD and 3D printer.

    PubMed

    Yamamoto, Ikuo; Ota, Ren; Zhu, Rui; Lawn, Murray; Ishimatsu, Takakazu; Nagayasu, Takeshi; Yamasaki, Naoya; Takagi, Katsunori; Koji, Takehiko

    2015-01-01

    In the area of manufacturing surgical instruments, the ability to rapidly design, prototype and test surgical instruments is critical. This paper provides a simple case study of the rapid development of two bio-mechanism based surgical instruments which are ergonomic, aesthetic and were successfully designed, prototyped and conceptually tested in a very short period of time.

  8. Early Surgical Management of Large Scalp Infantile Hemangioma Using the TopClosure® Tension-Relief System

    PubMed Central

    Zhu, Zhanyong; Yang, Xilin; Zhao, Yueqiang; Fan, Huajun; Yu, Mosheng; Topaz, Moris

    2015-01-01

    Abstract Infantile hemangiomas (IHs) are the most common benign vascular neoplasms of infancy and childhood. The majority do not need medical intervention. However, large ulcerated scalp IHs may lead to fatal bleeding as well as severe cosmetic disfigurement that indicate early surgical excision, inflicting substantial surgical risks, with short- and long-term morbidity. The TopClosure Tension-Relief System (TRS) is an innovative skin stretching and wound closure-secure system that facilitates primary closure of relatively large skin defects. This system has been shown as a substitute for skin grafts, flaps, or tissue expanders. We describe a case of a giant IH of the scalp usually requiring a complex surgical approach, which was immediately primarily closed applying the TRS. A 3-day-old female infant presented with a giant scalp hemangioma at birth that rapidly grew in the neonatal period with early signs of ulceration. The patient underwent surgical resection of the giant scalp hemangioma with immediate primary closure of the defect using the TRS. Surgical procedure and postoperative period were uneventful. Early surgical resections of IHs at infancy carry substantial surgical risks and morbidity. This is the first reported case of early resection of a scalp hemangioma in the neonatal period, with successful immediate primary closure by application of stress-relaxation technique through the TRS. The application of the TopClosure TRS in this age group has significant advantages. It reduces the complexity and length of surgery, reducing blood loss, eliminating donor site morbidity, improving wound aesthetics, and minimizing the need for future reconstructive procedures. PMID:26632734

  9. Early Surgical Management of Large Scalp Infantile Hemangioma Using the TopClosure® Tension-Relief System.

    PubMed

    Zhu, Zhanyong; Yang, Xilin; Zhao, Yueqiang; Fan, Huajun; Yu, Mosheng; Topaz, Moris

    2015-11-01

    Infantile hemangiomas (IHs) are the most common benign vascular neoplasms of infancy and childhood. The majority do not need medical intervention. However, large ulcerated scalp IHs may lead to fatal bleeding as well as severe cosmetic disfigurement that indicate early surgical excision, inflicting substantial surgical risks, with short- and long-term morbidity.The TopClosure Tension-Relief System (TRS) is an innovative skin stretching and wound closure-secure system that facilitates primary closure of relatively large skin defects. This system has been shown as a substitute for skin grafts, flaps, or tissue expanders.We describe a case of a giant IH of the scalp usually requiring a complex surgical approach, which was immediately primarily closed applying the TRS.A 3-day-old female infant presented with a giant scalp hemangioma at birth that rapidly grew in the neonatal period with early signs of ulceration. The patient underwent surgical resection of the giant scalp hemangioma with immediate primary closure of the defect using the TRS. Surgical procedure and postoperative period were uneventful.Early surgical resections of IHs at infancy carry substantial surgical risks and morbidity. This is the first reported case of early resection of a scalp hemangioma in the neonatal period, with successful immediate primary closure by application of stress-relaxation technique through the TRS. The application of the TopClosure TRS in this age group has significant advantages. It reduces the complexity and length of surgery, reducing blood loss, eliminating donor site morbidity, improving wound aesthetics, and minimizing the need for future reconstructive procedures.

  10. Autologous fat transfer to the subcutaneous tissue in the context of breast reconstructive procedures

    PubMed Central

    Zadrozny, Marek; Rykala, Jan; Banasiak, Lukasz; Witmanowski, Henryk

    2016-01-01

    Autologous fat transfer (AFT) is an appropriate technique for aesthetic rejuvenation of the face, aesthetic enhancement of hands, correction of the facial appearance in various disorders and constitutes a surgical alternative of treatment of numerous breast deformities ranging from distorting posttraumatic scars, post-eczema lesions, post-burn deformities to partial or total breast reconstruction. Our work is aimed to familiarize dermatologists with the technique of harvesting and implanting the aspirate of adipose cells in patients consulted for deformities of the breast. In addition, the review summarizes the most common applications of AFT in the breast reconstructive procedures. In summary, AFT is an oncologically safe, relatively complication-free, minimally invasive surgical technique, which can be used to correct a wide range of deformities, which are commonly seen by dermatologists, in the area of the face, trunk and extremities. The procedure can correct a wide range of breast deformities, from contour or single quadrant deformities up to the state after mastectomy. PMID:27881936

  11. Evolution of a Surgical Philosophy in Orthognathic Surgery.

    PubMed

    Rosen, Harvey M

    2017-04-01

    A surgical philosophy of orthognathic surgery is presented. It has evolved over an entire surgical career as orthognathic surgical goals have evolved to become primarily aesthetic. In this context, the occlusal result serves as a means of achieving the aesthetic ends. It relies on the physical examination, using qualitative concepts of facial appearance, to be the most important determinant of treatment plans. It makes a distinction between a quantitatively normal face and one that is visually well proportioned and emphasizes the attributes of the soft tissue. The emotional expression of the patient is also considered in treatment planning. By using surgical tactics that provide control of facial projection and height, this philosophy affords the surgeon an opportunity to manipulate the skeletal elements to the extent that one can simultaneously achieve a well-proportioned face and favorably influence the appearance of the soft tissues and facial countenance.

  12. [Surgical management of animal bites in children].

    PubMed

    Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C

    2016-10-01

    Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase.

  13. Aesthetic management of dental fluorosis.

    PubMed

    Khandelwal, Vishal; Nayak, Ullal Anand; Nayak, Prathibha Anand; Ninawe, Nupur

    2013-05-22

    Significant numbers of patients visiting the paediatric dental clinics have aesthetically objectionable brown stains and desire treatment for them. Intrinsic tooth discolouration can be a significant aesthetic, and in some instances, functional, problem. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce a cosmetically unsatisfactory dentition. The aetiology of intrinsic discolouration of enamel may sometimes be deduced from the patient's history, and one factor long associated with the problem has been a high level of fluoride intake. Optimal use of topical fluorides leads to a decrease in the caries prevalence but may show an increase in the prevalence of fluorosis staining because of metabolic alterations in the ameloblasts, causing a defective matrix formation and improper calcification. A 12-year-old male patient was screened at the dental clinic for routine dental care. He wanted us to remove and/or minimise the noticeable brown/yellow staining of his teeth. He requested the least invasive and most cost-effective treatment to change his smile. Various treatment modalities are present for the treatment of fluorosis stains. This report discusses the microabrasion technique in the patient having dental fluorosis.

  14. Aesthetic management of dental fluorosis

    PubMed Central

    Khandelwal, Vishal; Nayak, Ullal Anand; Nayak, Prathibha Anand; Ninawe, Nupur

    2013-01-01

    Significant numbers of patients visiting the paediatric dental clinics have aesthetically objectionable brown stains and desire treatment for them. Intrinsic tooth discolouration can be a significant aesthetic, and in some instances, functional, problem. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce a cosmetically unsatisfactory dentition. The aetiology of intrinsic discolouration of enamel may sometimes be deduced from the patient's history, and one factor long associated with the problem has been a high level of fluoride intake. Optimal use of topical fluorides leads to a decrease in the caries prevalence but may show an increase in the prevalence of fluorosis staining because of metabolic alterations in the ameloblasts, causing a defective matrix formation and improper calcification. A 12-year-old male patient was screened at the dental clinic for routine dental care. He wanted us to remove and/or minimise the noticeable brown/yellow staining of his teeth. He requested the least invasive and most cost-effective treatment to change his smile. Various treatment modalities are present for the treatment of fluorosis stains. This report discusses the microabrasion technique in the patient having dental fluorosis. PMID:23704468

  15. Nietzsche's aesthetic critique of Darwin.

    PubMed

    Pence, Charles H

    2011-01-01

    Despite his position as one of the first philosophers to write in the "post-Darwinian" world, the critique of Darwin by Friedrich Nietzsche is often ignored for a host of unsatisfactory reasons. I argue that Nietzsche's critique of Darwin is important to the study of both Nietzsche's and Darwin's impact on philosophy. Further, I show that the central claims of Nietzsche's critique have been broadly misunderstood. I then present a new reading of Nietzsche's core criticism of Darwin. An important part of Nietzsche's response can best be understood as an aesthetic critique of Darwin, reacting to what he saw as Darwin having drained life of an essential component of objective aesthetic value. For Nietzsche, Darwin's theory is false because it is too intellectual, because it searches for rules, regulations, and uniformity in a realm where none of these are to be found - and, moreover, where they should not be found. Such a reading goes furthest toward making Nietzsche's criticism substantive and relevant. Finally, I attempt to relate this novel explanation of Nietzsche's critique to topics in contemporary philosophy of biology, particularly work on the evolutionary explanation of culture.

  16. Engineering aesthetics and aesthetic ergonomics: theoretical foundations and a dual-process research methodology.

    PubMed

    Liu, Yili

    Although industrial and product designers are keenly aware of the importance of design aesthetics, they make aesthetic design decisions largely on the basis of their intuitive judgments and "educated guesses". Whilst ergonomics and human factors researchers have made great contributions to the safety, productivity, ease-of-use, and comfort of human-machine-environment systems, aesthetics is largely ignored as a topic of systematic scientific research in human factors and ergonomics. This article discusses the need for incorporating the aesthetics dimension in ergonomics and proposes the establishment of a new scientific and engineering discipline that we can call "engineering aesthetics". This discipline addresses two major questions: How do we use engineering and scientific methods to study aesthetics concepts in general and design aesthetics in particular? How do we incorporate engineering and scientific methods in the aesthetic design and evaluation process? This article identifies two special features that distinguish aesthetic appraisal of products and system designs from aesthetic appreciation of art, and lays out a theoretical foundation as well as a dual-process research methodology for "engineering aesthetics". Sample applications of this methodology are also described.

  17. Aesthetic Education in the Performance Classroom.

    ERIC Educational Resources Information Center

    Rudgers, Gregory B.

    1996-01-01

    Addresses the question of how to infuse an artistic aesthetic into classroom music performance. Recommends using material that offers students an aesthetic opportunity yet remains within their intellectual and artistic grasp. Discusses types of compositions that meet these requirements and suggests some creative rehearsal techniques. (MJP)

  18. Aesthetic Education and the Third Domain: Synaesthetics.

    ERIC Educational Resources Information Center

    Munson, Richard S.

    The author states that art and the aesthetic have historically become inseparable. For art education this raises the question: is the role of art in education functioning in the same capacity as art in society? It is conceivable that overreliance on past orientation, or even that any reference whatever to that limited vision of the art-aesthetic,…

  19. Aesthetic Guidelines to Printed Instructional Materials.

    ERIC Educational Resources Information Center

    LeMay, Jo

    Principles of aesthetic design for printed instructional materials are discussed in this paper, and a checklist is provided to aid in evaluating the aesthetics of such materials. The principles that are discussed relate to the following areas: format (spatial arrangement of a page and design principles involving simplicity, unity, emphasis,…

  20. Aesthetical Information Impact of a Literary Text.

    ERIC Educational Resources Information Center

    Malik, M. F.

    The aim of this study was to explore the aesthetic impact of a literary text on the human mind and to extend the knowledge on how and when the information from a book enters the human brain, and if and when it starts to be processed and, possibly, memorized. Readers' responses to aesthetic texts were measured through a series of biometric…

  1. Introducing Aesthetic Features in Gymnastic Skills

    ERIC Educational Resources Information Center

    Pollatou, Elisana; Savrami, Katia; Karadimou, Konstanding

    2004-01-01

    This paper focuses on an aesthetic approach that takes the simplest functional skill, such as walking, and develops it into an artistic skill. The aim then is to identify aesthetic characteristics and examine ways to apply them in gymnastic classes. Because walking is the child's first experience with bipedal locomotion, the initial walking action…

  2. 40 CFR 230.53 - Aesthetics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Characteristics § 230.53 Aesthetics. (a) Aesthetics associated with the aquatic ecosystem consist of the... aquatic ecosystems apply to the quality of life enjoyed by the general public and property owners. (b... characteristics of an aquatic area which make it valuable to property owners. Activities which degrade...

  3. Grounding Moralism: Moral Flaws and Aesthetic Properties

    ERIC Educational Resources Information Center

    Smuts, Aaron

    2011-01-01

    Can moral flaws lessen an artwork's aesthetic value? Answering yes to this question requires both that artworks can be morally flawed and that moral flaws within a work of art can have an aesthetic impact. For present purposes, the author will assume that artworks can be morally flawed by such means as endorsing immoral perspectives, culpably…

  4. Aesthetic Learning, Creative Writing and English Teaching

    ERIC Educational Resources Information Center

    Gilbert, Francis

    2016-01-01

    My article argues that the concept of "aesthetic learning" can be helpful for English teachers on two levels. First, it can be a useful identity for English teachers and students to adopt, based upon my own experiences as a secondary English teacher, creative writer and PhD student. Second, I argue that "aesthetic learning" is…

  5. On the Uses of Aesthetic Theory.

    ERIC Educational Resources Information Center

    Spitz, Ellen Handler

    1982-01-01

    Describes ways that aesthetic theories can be integrated into children's art education. The author illustrates elements of E.H. Gombrich's theory of aesthetic perception using as examples art activities designed to increase student awareness of their "mental sets" and their understanding of how mental sets influence visual perception. (AM)

  6. Philosophy for Children and Aesthetic Education.

    ERIC Educational Resources Information Center

    Hamrick, William S.

    1989-01-01

    Describes elements in the Philosophy for Children program that have relevance for aesthetic education. Outlines some of the main philosophical themes associated with aesthetic education. Discusses both materials and methods, paying particular attention to the text "Suki." Reviews ways in which the program holds students' attention and…

  7. 40 CFR 230.53 - Aesthetics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Characteristics § 230.53 Aesthetics. (a) Aesthetics associated with the aquatic ecosystem consist of the... aquatic ecosystems apply to the quality of life enjoyed by the general public and property owners. (b... ecosystems by degrading water quality, creating distracting disposal sites, inducing...

  8. Surgical bleeding in microgravity

    NASA Technical Reports Server (NTRS)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  9. Aesthetic Multiple-Toe Reconstruction With Combined Iliac Bone Graft and Wraparound Free Anterolateral Thigh Flap-A Case Report and Literature Review.

    PubMed

    Kwon, Soo-Ha; Lao, William; Yen, Cheng-I; Lin, Yu-Te; Wu, Katie Pei-Hsuan; Chang, Tommy Nai-Jen

    2017-03-01

    Compared with upper extremity injuries, toe amputations and their replantations are rare because of the difficulty of their relatively thinner soft tissue envelope. Consequently, fewer reconstructive options are available for toes and they are rarely reported in the literature. In this study, we reported a case of right third to fifth toe amputations and their subsequent reconstruction with iliac bone grafts and a free anterolateral thigh flap. After serial debulking and division procedures, 3 toes were divided successfully. Ten months after the initial operation, the patient regained pain-free functional ambulation despite some bone resorption noted on follow-up radiographs. The patient showed high satisfaction on her new toes in terms of aesthetical and functional outcomes. She was able to stand for over 30 minutes without pain. At the 2-year follow-up, the Foot Function Index was 18.3%. Although toe reconstruction is frequently considered unnecessary because of its relative high demand of surgical techniques and little gain on gait; nonetheless, in selected cases, toe reconstruction may still be beneficial if the metatarsophalangeal joints were intact and there is a strong individual desire for aesthetical restoration.

  10. Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis

    PubMed Central

    Blaya, Carolina; Tenório, Juliana L.C.; Saltz, Renato; Ely, Pedro B.; Ferrão, Ygor A.

    2016-01-01

    Background: Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis. Methods: The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantitative analyses of the gathered data. We calculated a random effect meta-analysis with Der Simonian and Laird as variance estimator to compare pre- and postoperative QoL standardized mean difference. To check if there is difference between aesthetic surgeries, we compared reduction mammoplasty to other aesthetic surgeries. Results: Of 1,715 identified, 20 studies were included in the qualitative analysis and 16 went through quantitative analysis. The random effect of all aesthetic surgeries shows that QoL improved after surgery. Reduction mammoplasty has improved QoL more than other procedures in social functioning and physical functioning domains. Conclusions: Aesthetic plastic surgery increases QoL. Reduction mammoplasty seems to have better improvement compared with other aesthetic surgeries. PMID:27757327

  11. Surgical technique of double switch procedure: Senning with arterial switch operation for congenitally corrected transposition of the great arteries with ventricular septal defect.

    PubMed

    Ilin, Alexey S; Teplov, Pavel V; Sakovich, Valeriy A; Ohye, Richard G

    2016-01-01

    We present a case of 12-month-old boy with congenitally corrected transposition of great arteries with L-looped ventricles and L-transposition of great arteries and ventricular septal defect. When admitted to the hospital, the patient had the appearance of congestive heart failure due to moderate to severe tricuspid valve regurgitation and right ventricle dysfunction. The pulmonary artery (PA) banding was required first because of low systolic pressure in the morphological left ventricle less than 70% confirmed by catheterization. Three months later, the patient appeared to be a good candidate for anatomical repair and a double switch procedure-Senning with arterial switch-was performed. The early postoperative period was relatively smooth and uneventful. Tricuspid valve insufficiency was resolved immediately after surgery. Mild systolic dysfunction of the left ventricle with mild mitral insufficiency was confirmed by the 2D strain method of echocardiography on the second day of the postoperative period and it improved over the next 21 days. Thirty days later after the procedure, the patient underwent catheterization of his superior vena cava tunnel because of the slightly increased blood flow velocity diagnosed by echocardiography. In 3 months after the surgery, the boy was asymptomatic and was doing well. The patient's functional status was I according to the NYHA classification.

  12. A dietary intervention to elicit rapid and complex dietary changes for studies investigating the effects of diet on tissues collected during invasive surgical procedures.

    PubMed

    Schenk, Jeannette M; Neuhouser, Marian L; Lin, Daniel W; Kristal, Alan R

    2009-03-01

    Nutrition intervention trials in patients undergoing surgical treatment for cancer offer a unique opportunity to study the mechanisms and pathways that underlie diet and cancer associations in target tissues. However, due to the short time period between diagnosis and treatment, traditional dietary intervention methods are not feasible. This report describes a novel dietary intervention program designed to elicit rapid and complex dietary change during a condensed study period. The intervention, based on Consumer Information Processing, used standardized menus and exchange lists to guide food choices, and was delivered using a single, in-person session followed by telephone-based counseling. This intervention program was used in a small pilot study evaluating the short-term effects of dietary change in men with newly diagnosed prostate cancer. Eight men were randomly assigned to either a low-fat/low-glycemic load or standard American diet during the 4 weeks preceding prostate surgery. Participants completed 24-hour dietary recalls each week, and were weighed at baseline and at surgery. Compared to men in the standard American arm (n=4), men in the low-fat/low-glycemic arm (n=4) reported consuming less total fat (51.0+/-36.0 vs 93.5+/-8.4 g/day, P=0.06), and had a lower glycemic load (134.8+/-6.0 vs 266.3+/-36.8 units/day, P<0.001). Men in the low-fat/low-glycemic arm lost a mean of 5.3+/-1.7 kg and men in the standard American arm gained 0.8+/-4.5 kg (P=0.04). Results of this small pilot study suggest that a relatively simple and minimally burdensome dietary intervention can elicit rapid and complex dietary changes that are maintained over a 4-week study period. Further studies in larger and more diverse populations are needed to fully understand the potential of this novel intervention approach.

  13. New fillers under consideration: what is the future of injectable aesthetics?

    PubMed

    Rivkin, Alexander

    2009-05-01

    The past 5 years in the United States have seen an explosion in the popularity of noninvasive aesthetic procedures. Not only have fillers and Botox turned out to be fantastically reliable and effective aesthetic tools, but also they have vastly expanded the accessibility of cosmetic procedures. Our cosmetic filler options are growing quickly as more and more fillers are coming before the U.S. Food and Drug Administration (FDA), seeking entry into the lucrative U.S. market. This article outlines the approval process that foreign fillers go through in their home countries and gives an idea of the fillers that are currently under consideration by the FDA. As our armamentarium of injectable fillers grows, it will be essential to know each product's strengths and weaknesses so that we can provide our patients with the best possible aesthetic results.

  14. [Optimizing surgical hand disinfection].

    PubMed

    Kampf, G; Kramer, A; Rotter, M; Widmer, A

    2006-08-01

    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  15. [Surgical management of chronic pancreatitis].

    PubMed

    Regimbeau, Jean-Marc; Dumont, Frédéric; Yzet, Thierry; Chatelain, Denis; Bartoli, Eacute Ric; Brazier, Franck; Bréhant, Olivier; Dupas, Jean-Louis; Mauvais, François; Delcenserie, Richard

    2007-01-01

    Surgical indications for chronic pancreatitis can be schematically separated into five main groups: pain, effects of fibrosis on adjacent organs, the consequences of main pancreatic duct rupture above an obstruction, and suspected cancer. Finally surgery is also indicated in patients who cannot undergo endoscopic procedures (no accessible papilla) or who have too recently undergone this procedure. Surgical procedures include derivation (pancreatic, cystic, biliary) or mixed procedures combining derivation/resection or pancreatic resection. Finally splanchnicectomy can be discussed. Whatever the indication, surgical treatment must meet several goals: the approach to surgery must be multidisciplinary, surgery must be associated with low morbidity and mortality, preserve as much endocrine function as possible, improve quality of life, and be evaluated in the long term, as well as prospectively if possible. We clarify some important points about the management of patients with chronic pancreatitis before discussing the various treatments in detail.

  16. A standardized formula for aesthetic mandibular reconstruction using an osteocutaneous fibular free flap.

    PubMed

    Kim, Soung Min; Amponsah, Emmanuel K; Kim, Hui Young; Kwon, Ik Jae; Myoung, Hoon; Lee, Jong Ho

    2016-09-01

    Ameloblastoma is the most common benign odontogenic tumor of the jaw, and expansional growth of a huge untreated ameloblastoma can result in disturbances in facial aesthetics and function, such as difficulty with mouth opening, swallowing, chewing, breathing, neurologic deficits, and pathologic fractures. Radical wide resection with safety margins and subsequent reconstruction is generally recommended. A fibular free flap (FFF) is commonly used to reconstruct the mandible in order to adequately restore both aesthetic appearance and function. The aim of this brief clinical report is to present a case of huge ameloblastoma after wide resection with free safety margins, and describe the immediate one-step mandibular reconstruction using a vascularized composite FFF. The sterolithographic( rapid prototype, RP) model, a wax pattern of the resected mandible, and a surgical fibular stent made from the wax pattern were constructed preoperatively. We suggest a standardized surgical protocol for mandibular reconstruction with FFF.

  17. Parma tracheostomy technique: a hybrid approach to tracheostomy between classical surgical and percutaneous tracheostomies

    PubMed Central

    Benassi, Filippo; Manca, Tullio; Ramelli, Andrea; Vezzani, Antonella; Nicolini, Francesco; Romano, Giorgio; Ricci, Matteo; Carino, Davide; Di Chicco, Maria Vincenza; Gherli, Tiziano

    2016-01-01

    Background The aim of our study is to compare the classical surgical tracheostomy (TT) technique with a modified surgical technique designed and created by the cardiothoracic surgery staff of our department to reduce surgical trauma and postoperative complications. This modified technique combines features of percutaneous TT and surgical TT avoiding the use of specialized tools, which are required in percutaneous TT. Methods From October 2008 to March 2014 we performed 67 tracheostomies using this New Modified Surgical Technique (NMST) and 56 TT with the Classical Surgical Technique (CST). We collected data about the early clinical complications, deaths TT-related, deaths due to other complications and the presence of late TT’s complications were performed by a telephone follow-up. SPSS software (IMB version 21) was used for the statistical analysis. Categorical data were treated with chi-square test and continuous data were treated with t-test for independent samples. Results NMST group had a significant lower number of early complications (P=0.005) compared to CST group (5 vs. 15). In-hospital mortality was significantly higher in CST group (18 deaths vs. 4 in NMST group, P=0.001) but we registered only one case of TT-related mortality in CST group (P=0.280). We did not note other differences between the two groups regarding short or mid-long term complications. Conclusions In our experience the NMST demonstrated to be easily safe and reproducible with an amount of early, mid- and long-term complications similar to the CST; furthermore the aesthetic results of the procedure appear similar to those of percutaneous TT. PMID:28149558

  18. Non-surgical treatment of early breast cancer: techniques on the way.

    PubMed

    Hamza, Alaa; Elrefaey, Shymaa

    2014-08-01

    Trials are still on the way to evaluate different non-surgical techniques to treat early breast cancer with achieving maximum oncological control and aesthetic outcome. Also these techniques can help old patients to bypass surgical and radiation complications and facilitate the treatment of early breast cancer with minimum side effects.

  19. Aesthetic issues for drinking water.

    PubMed

    Dietrich, Andrea M

    2006-01-01

    Although many people expect their drinking water to be "flavorless", natural and processed drinking waters have flavors due to minerals and organics in the natural water, inputs from any step of water processing or transport, and interaction of these chemicals with an individuals' nose and mouth. Since people can detect the flavor of water, the idea has been proposed that drinking water consumers be considered as sentinels who monitor water quality. This paper explores specific sensory components of drinking water, how humans perceive their drinking water, and future directions for aesthetic research that can better explain causes of and treatments for tastes and odors in drinking water and the human factors that make water a desirable beverage.

  20. Facial aesthetics and perceived need for further treatment among adults with repaired cleft as assessed by cleft team professionals and laypersons.

    PubMed

    Foo, Peter; Sampson, Wayne; Roberts, Rachel; Jamieson, Lisa; David, David

    2013-06-01

    The objectives of this study were to compare the ratings of professionals and laypeople with and without a cleft regarding the facial aesthetics of adult patients previously treated for orofacial clefting. The necessity for further treatment, as perceived by the respective groups, is also compared. The design of the study was a cross-sectional study. Professionals (two plastic surgeons, one dentist, one orthodontist, and one psychologist) and laypeople (one male and one female adult without a cleft and one male and one female adult with a cleft) were recruited to rate photographs of 80 non-syndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009. Facial aesthetics were measured by a visual analogue scale (VAS; 0-100 mm). High values indicated good aesthetics. Necessity for further treatment was also measured by a VAS (0-100 mm). High values indicated high perceived need for further treatment. The professionals rated facial aesthetics significantly lower and had a lower perception of need for further treatment than the raters with and without a cleft. The laypeople with a cleft rated facial aesthetics significantly higher and had a lower perceived need for further treatment than laypeople without a cleft. The non-surgical professionals rated facial aesthetics significantly lower and had a lower perceived need for further treatment than the surgical professionals. Differences exist in the facial aesthetics ratings and perceived need for further surgery between professionals and laypeople with and without a cleft. This should be considered when managing cleft treatment expectations.

  1. Deep Aesthetic Quality Assessment With Semantic Information.

    PubMed

    Kao, Yueying; He, Ran; Huang, Kaiqi

    2017-03-01

    Human beings often assess the aesthetic quality of an image coupled with the identification of the image's semantic content. This paper addresses the correlation issue between automatic aesthetic quality assessment and semantic recognition. We cast the assessment problem as the main task among a multi-task deep model, and argue that semantic recognition task offers the key to address this problem. Based on convolutional neural networks, we employ a single and simple multi-task framework to efficiently utilize the supervision of aesthetic and semantic labels. A correlation item between these two tasks is further introduced to the framework by incorporating the inter-task relationship learning. This item not only provides some useful insight about the correlation but also improves assessment accuracy of the aesthetic task. In particular, an effective strategy is developed to keep a balance between the two tasks, which facilitates to optimize the parameters of the framework. Extensive experiments on the challenging Aesthetic Visual Analysis dataset and Photo.net dataset validate the importance of semantic recognition in aesthetic quality assessment, and demonstrate that multitask deep models can discover an effective aesthetic representation to achieve the state-of-the-art results.

  2. Intense Pulsed Light (IPL) in Aesthetic Dermatology

    NASA Astrophysics Data System (ADS)

    Pytras, B.; Drozdowski, P.; Zub, K.

    2011-08-01

    Introduction. Newer and newer technologies have been widely developed in recent years due to increasing need for aesthetic medicine procedures. Less invasive methods of skin imperfection and time-related lesions removal, IPL (Intense Pulse Light) being one of them, are gaining more and more interest. The shorter the "downtime" for the patient is and the more efficient the procedure results, the more popular the method becomes. Materials and methods_Authors analyse the results of treatment of a 571 patients-group (501 women and 70 men) aged 5-72 years in the period: October 2006-August 2010. IPL™ Quantum (Lumenis Ltd.) device with 560 nm. cut-off filter was used. Results. The results were regarded as: very good, good or satisfying (%):Skin photoaging symptomes 37/40/23, Isolated facial dyschromia 30/55/25, Isolated facial erythema 62/34/4, Lower limbs teleangiectasia 12/36/52, Keratosis solaris on hands 100/-/-. Approximately half of the patients developed transitory erythema and 25%- transitory, mild, circumscribed oedema. Following undesirable effects were noted: skin thermal irritation (6,1% of the patients) and skin hypopigmentation (2% of the patients). Discussion. Results and post-treatment management proposed by authors are similar to those reported by other authors. Conclusions. Treatment results of the 571-patients group prove IPL to be a very efficient method of non-ablative skin rejuvenation. It turned out effective also in lower limbs teleangiectasia treatment. It presents low risk of transitory and mild side effects. Futhermore, with short or no downtime, it is well-tolerated by the patients.

  3. [Treatment with inhibitors of new oral direct anticoagulants in patients with severe bleedings or urgent surgical procedures. The new dabigatran antidote: the place of idarucizumab in clinical practice].

    PubMed

    Boda, Zoltán

    2016-03-20

    Only vitamin K antagonists could be applied as oral anticoagulants over the past six decades. Coumarols have narrow therapeutic range, and unpredictable anticoagulant effects are resulted by multiple drug interactions. Therefore, regular routine monitoring of the international normalized ratio is necessary. There are two groups of factor-specific anticoagulants: molecules with anti-FIIa (dabigatran) and anti-FXa (rivaroxaban, apixaban and edoxaban) effect. Author summarizes the most important clinical features of the new oral anticoagulants, their indications and the possibilities of laboratory controls. Bleedings are the most important side effects of anticoagulants. This review summarizes the current published evidences for new oral anticoagulants reversal (non-specific and specific) agents, especially in cases with severe acute bleedings or urgent surgery procedures. It reports on how to use inhibitors, the recommended doses and the most important clinical results. The review focuses on idarucizumab - already approved by the U.S. Food and Drug Administration and the European Medicines Agency - which has a key role as the first specific inhibitor of dabigatran.

  4. Surgical treatment of cranial neuralgias.

    PubMed

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni

    2010-01-01

    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  5. Exploring the Relationship between Humor and Aesthetic Experience

    ERIC Educational Resources Information Center

    Gordon, Mordechai

    2012-01-01

    The connection between humor and aesthetic experience has already been recognized by several thinkers and aesthetic educators. For instance, humor theorist John Morreall writes that "humor is best understood as itself a kind of aesthetic experience, equal in value at least to any other kind of aesthetic experience." For Morreall, both humor and…

  6. Aesthetic Education between Critique and Self-Certainty.

    ERIC Educational Resources Information Center

    Mollenhauer, Klaus

    1990-01-01

    Discusses the limits to fitting aesthetic experiences into theories of education or curricula, claiming that this often results in aesthetic alphabetization. Contrasts this to the aesthetic education possibilities in art therapy. Beginning with a statement by Hugo von Hofmannsthal, theorizes about the existence of an aesthetic self-identity. (CH)

  7. Reimer through Confucian Lenses: Resonances with Classical Chinese Aesthetics

    ERIC Educational Resources Information Center

    Tan, Leonard

    2015-01-01

    In this paper, I compare all three editions of Bennett Reimer's "A Philosophy of Music Education" with early Chinese philosophy, in particular, classical Chinese aesthetics. I structure my analysis around a quartet of interrelated themes: aesthetic education, education of feeling, aesthetic experience, and ethics and aesthetics. This…

  8. Does Preoperative Urodynamic Testing Improve Surgical Outcomes in Patients Undergoing the Transobturator Tape Procedure for Stress Urinary Incontinence? A Prospective Randomized Trial

    PubMed Central

    Rathi, Sudheer; Patnaik, Pranab; Shaw, Dipak; Jain, Madhu; Trivedi, Sameer; Dwivedi, Udai Shankar

    2014-01-01

    Purpose Urodynamic studies are commonly performed as part of the preoperative work-up of patients undergoing surgery for stress urinary incontinence (SUI). We aimed to assess the extent to which these urodynamic parameters influence patient selection and postoperative outcomes. Materials and Methods Patients presenting with SUI were randomly assigned to two groups: one undergoing office evaluation only and the other with a preoperative urodynamic work-up. Patients with unfavorable urodynamic parameters (detrusor overactivity [DO] and/or Valsalva leak point pressure [VLPP]<60 cm H2O and/or maximum urethral closure pressure [MUCP]<20 cm H2O) were excluded from the urodynamic testing group. All patients in both groups underwent the transobturator midurethral sling procedure. Evaluation for treatment success (reductions in urogenital distress inventory and incontinence impact questionnaire scoring along with absent positive stress test) was done at 6 months and 1 year postoperatively. Results A total of 72 patients were evaluated. After 12 patients with any one or more of the abnormal urodynamic parameters were excluded, 30 patients were finally recruited in each of the "urodynamic testing" and "office evaluation only" groups. At both the 6- and the 12-month follow-ups, treatment outcomes (reduction in scores and positive provocative stress test) were significantly better in the urodynamic testing group than in the office evaluation only group (p-values significant for all outcomes). Conclusions Our findings showed statistically significantly better treatment outcomes in the urodynamic group (after excluding those with poor prognostic indicators such as DO, low VLPP, and MUCP) than in the office evaluation only group. We recommend exploiting the prognostic value of these urodynamic parameters for patient counseling and treatment decisions. PMID:25512817

  9. Aesthetic Chills: Knowledge-Acquisition, Meaning-Making, and Aesthetic Emotions

    PubMed Central

    Schoeller, Felix; Perlovsky, Leonid

    2016-01-01

    This article addresses the relation between aesthetic emotions, knowledge-acquisition, and meaning-making. We briefly review theoretical foundations and present experimental data related to aesthetic chills. These results suggest that aesthetic chills are inhibited by exposing the subject to an incoherent prime prior to the chill-eliciting stimulation and that a meaningful prime makes the aesthetic experience more pleasurable than a neutral or an incoherent one. Aesthetic chills induced by narrative structures seem to be related to the pinnacle of the story, to have a significant calming effect and subjects describe a strong empathy for the characters. We discuss the relation between meaning-making and aesthetic emotions at the psychological, physiological, narratological, and mathematical levels and propose a series of hypotheses to be tested in future research. PMID:27540366

  10. Choosing the Best Procedure to Augment the Chin: Is Anything Better than an Implant?

    PubMed

    Sykes, Jonathan M; Fitzgerald, Rebecca

    2016-10-01

    The chin plays a very important role in overall facial appearance, and aesthetic procedures to augment the chin in patients with microgenia can improve overall facial balance. Many procedures exist to enhance the appearance of a small chin. Procedures include surgeries such as placement of an alloplast implant and bony osteotomy of the mentum (sliding genioplasty). The advantages and disadvantages of each surgical technique are well documented. Although surgical augmentation of the chin has been the gold standard of therapy, recent development of injectable filler products with lifting capacity has changed the way that many practitioners alter chin shape and size. Filler agents allow augmentation of the chin in horizontal (projection), vertical, and transverse dimensions. Injectable fillers are a simple, noninvasive procedure that causes minimal to no downtime, incurs minimal risks, and allows the practitioner to shape the chin in three dimensions. This procedure allows patients to enhance their chin size without requiring an operative visit. As more and varied filler products become FDA-approved, the versatility and application of these agents will increase.

  11. Double eyelid blepharoplasty incorporating epicanthoplasty using Y-V advancement procedure.

    PubMed

    Li, F C; Ma, L H

    2008-08-01

    Ethnic characteristics of the Asian upper eyelid include the lack of a superior palpebral fold, excessive fat, laxity of pretarsal skin, and medial epicanthal fold. Historically, these features have characterised a unique beauty in Asians. With the increase of cultural exchange, the sense of beauty has changed greatly among Asians and most Asians regard eyes with double eyelids as beautiful. Therefore, surgical creation of a superior palpebral fold (so-called double eyelidplasty) has become the most common cosmetic operation in Asia. However, the presence of an epicanthal fold weakens the aesthetic results of the operation. The size of the epicanthal fold in Asians, whilst varying widely among individuals, is usually relatively small, and thus aesthetically successful effacement rarely requires more complex procedures as performed in the West. The incision for epicanthoplasty should therefore be as simple as possible and be confined to the eyelid area. From October 2001 to May 2006, Y-V advancement procedure for epicanthoplasty was used in combination with double eyelid surgery in 92 cases. Most of the patients attained satisfactory results. There were few complications in our series. A hypertrophic scar was recorded in three early cases and faded within 2 to 3 months with satisfactory results. This procedure is simple and more suitable for people of oriental origin.

  12. Surgical education through video broadcasting.

    PubMed

    Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex

    2014-09-01

    Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.

  13. The "nuts & bolts" of becoming an aesthetic provider: part 2-building your aesthetic practice.

    PubMed

    Brennan, Connie

    2014-01-01

    Part 2 of this three-part series of articles on becoming an aesthetic provider centers on the steps necessary to build an aesthetic practice. We will discuss the legal (e.g., licensure, scope of practice, malpractice, and documentation) and the business aspects (e.g., "your brand," staff development, networking, marketing, and revenue possibilities) of building a successful aesthetic practice. On the basis of years of experience, "pearls and pitfalls" will be discussed so novice, intermediate, and advanced aesthetic providers can minimize mistakes and maximize their success in this exciting and growing profession.

  14. Procedural pediatric dermatology.

    PubMed

    Metz, Brandie J

    2013-04-01

    Due to many factors, including parental anxiety, a child's inability to understand the necessity of a procedure and a child's unwillingness to cooperate, it can be much more challenging to perform dermatologic procedures in children. This article reviews pre-procedural preparation of patients and parents, techniques for minimizing injection-related pain and optimal timing of surgical intervention. The risks and benefits of general anesthesia in the setting of pediatric dermatologic procedures are discussed. Additionally, the surgical approach to a few specific types of birthmarks is addressed.

  15. The Exploration of a "Tactile Aesthetic"

    ERIC Educational Resources Information Center

    Rubin, Judith A.

    1976-01-01

    Investigated was whether or not six blind children had a "tactile aesthetic" qualitatively different from that of three sighted and six partially sighted children (all between 10 and 16 years of age). (Author/PT)

  16. 40 CFR 230.53 - Aesthetics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... perception of beauty by one or a combination of the senses of sight, hearing, touch, and smell. Aesthetics of...) Possible loss of values: The discharge of dredged or fill material can mar the beauty of natural...

  17. Cultural history and aesthetics of nursing care.

    PubMed

    Siles González, José; Ruiz, Maria del Carmen Solano

    2011-01-01

    The aim of this study was to clarify the role of aesthetics in the organization and motivation of care through history. The guiding questions were: What values and aesthetic feelings have supported and motivated pre-professional and professional care? and Based on what structures has pre-professional and professional care been historically socialized? Primary and secondary sources were consulted, selected according to established criteria with a view to avoiding search and selection bias. Data analysis was guided by the categories: "habitus" and "logical conformism". It was found that the relation between social structures and pre-professionals (motherhood, religiosity) and professional aesthetic standards (professionalism, technologism) of care through history is evidenced in the caregiving activity of the functional unit, in the functional framework and the functional element. In conclusion, in social structures, through the socialization process, "logical conformism" and "habitus" constitute the aesthetic standards of care through feelings like motherhood, religiosity, professionalism, technologism and humanism.

  18. Nietzsche and the Aesthetics of Rhetoric.

    ERIC Educational Resources Information Center

    Whitson, Steve; Poulakos, John

    1993-01-01

    Addresses the debate over rhetoric's epistemic status in terms of Nietzsche's critique of epistemology. Suggests that Nietzsche's aestheticism provides an alternative to the debate. Focuses on differences between the rhetorics of the epistemic and the aesthetic. (SR)

  19. Silberman and the British on Aesthetic Enterprise

    ERIC Educational Resources Information Center

    Smith, Ralph A.

    1973-01-01

    Author describes two instructive ways of illustrating the principal business of aesthetic education and summarizes the way in which the notion of a form of understanding is dealt with by Dearden. (Author/RK)

  20. 40 CFR 230.53 - Aesthetics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... perception of beauty by one or a combination of the senses of sight, hearing, touch, and smell. Aesthetics of...) Possible loss of values: The discharge of dredged or fill material can mar the beauty of natural...

  1. through the Use of Aesthetic Representations

    ERIC Educational Resources Information Center

    Crim, Courtney L.; Kennedy, Kimberley D.; Thornton, Jenifer S.

    2013-01-01

    multiple intelligences, and aesthetic representations. Next, it presents the methodology, reports findings, and discusses themes related to the authors' research questions. Finally, it concludes that tapping into students' multiple intelligence strength(s) is an…

  2. Aesthetics in synthesis and synthetic biology.

    PubMed

    Benner, Steven A

    2012-12-01

    Physicists frequently allow aesthetics to guide their science. Chemists sometimes do. Biologists rarely do. They have encountered too frequently the consequences of the Darwinian 'hack'. The biological parts delivered by Darwinian processes are rarely simple, efficient, or elegant solutions to the biological problems that they address. Nevertheless, as humans, we seek to find aesthetics within our activities. In general, however, it is hard to distinguish what we say is beautiful from what is, in reality, utilitarian.

  3. Orthodontics in the "Art" of Aesthetics.

    PubMed

    Thomas, Mayuri

    2015-01-01

    Aesthetics in dentistry has of late become an awakening/actor among patients and often serves as a major reason for seeking dental treatment and care. Ever since the introduction of orthodontics as a separate specialty branch in dentistry, a variety of techniques have evolved, and methods developed both in the type of devices/instruments used and treatments planned. The discipline of orthodontic aesthetics involves micro and macro aesthetics, gingival, and facial aesthetics. This article helps focus on the artistic part of the orthodontic science. It brings out various important factors involved in customizing aesthetic orthodontic treatment planning according to the individual needs of the patient. Through this kind of treatment planning not only are the functional and biological needs of the patient met, they also provide a stable and durable results. Less invasive treatment planning makes it easier for the patient to select future treatment options as new technologies keep evolving. The review was selected by typing aesthetic orthodontics in the Google search engine, Pubmed, and Pubmed Central. Literature review of articles reflecting history, different analysis, factors responsible, and the latest technique was conducted.

  4. Surgical management of ectopic pregnancy.

    PubMed

    Stock, Laura; Milad, Magdy

    2012-06-01

    Surgery remains an acceptable, and sometimes necessary, modality for the treatment of ectopic pregnancy. Laparoscopy is the preferred method of access, yet controversy remains regarding the optimal procedure and postoperative management. Generally, salpingostomy is employed with the goal of maintaining fertility, although data to support this tenet are lacking. In most cases, the decision to perform conservative versus radical surgery is on the basis of the patient's history, her desire for future fertility, and surgical findings. The procedures of salpingostomy and salpingectomy, techniques to prevent and control blood loss at the time of surgery, and surgical options for nontubal ectopic pregnancies are reviewed.

  5. Biomechanical metrics of aesthetic perception in dance.

    PubMed

    Bronner, Shaw; Shippen, James

    2015-12-01

    The brain may be tuned to evaluate aesthetic perception through perceptual chunking when we observe the grace of the dancer. We modelled biomechanical metrics to explain biological determinants of aesthetic perception in dance. Eighteen expert (EXP) and intermediate (INT) dancers performed développé arabesque in three conditions: (1) slow tempo, (2) slow tempo with relevé, and (3) fast tempo. To compare biomechanical metrics of kinematic data, we calculated intra-excursion variability, principal component analysis (PCA), and dimensionless jerk for the gesture limb. Observers, all trained dancers, viewed motion capture stick figures of the trials and ranked each for aesthetic (1) proficiency and (2) movement smoothness. Statistical analyses included group by condition repeated-measures ANOVA for metric data; Mann-Whitney U rank and Friedman's rank tests for nonparametric rank data; Spearman's rho correlations to compare aesthetic rankings and metrics; and linear regression to examine which metric best quantified observers' aesthetic rankings, p < 0.05. The goodness of fit of the proposed models was determined using Akaike information criteria. Aesthetic proficiency and smoothness rankings of the dance movements revealed differences between groups and condition, p < 0.0001. EXP dancers were rated more aesthetically proficient than INT dancers. The slow and fast conditions were judged more aesthetically proficient than slow with relevé (p < 0.0001). Of the metrics, PCA best captured the differences due to group and condition. PCA also provided the most parsimonious model to explain aesthetic proficiency and smoothness rankings. By permitting organization of large data sets into simpler groupings, PCA may mirror the phenomenon of chunking in which the brain combines sensory motor elements into integrated units of behaviour. In this representation, the chunk of information which is remembered, and to which the observer reacts, is the elemental mode shape of

  6. Efficacy and safety of a recombinant factor IX (Bax326) in previously treated patients with severe or moderately severe haemophilia B undergoing surgical or other invasive procedures: a prospective, open-label, uncontrolled, multicentre, phase III study.

    PubMed

    Windyga, J; Lissitchkov, T; Stasyshyn, O; Mamonov, V; Ghandehari, H; Chapman, M; Fritsch, S; Wong, W-Y; Pavlova, B G; Abbuehl, B E

    2014-09-01

    Haemostatic management of haemophilia B patients undergoing surgery is critical to patient safety. The aim of this ongoing prospective trial was to investigate the haemostatic efficacy and safety of a recombinant factor IX (rFIX) (Bax326) in previously treated subjects (12-65 years, without history of FIX inhibitors) with severe or moderately severe haemophilia B, undergoing surgical, dental or other invasive procedures. Haemostatic efficacy was assessed according to a predefined scale. Blood loss was compared to the average and maximum blood loss predicted preoperatively. Haemostatic FIX levels were achieved peri- and postoperatively in 100% of subjects (n = 14). Haemostasis was 'excellent' intraoperatively in all patients and postoperatively in those without a drain, and 'excellent' or 'good' at the time of drain removal and day of discharge in those with a drain employed. Following the initial dose, the mean FIX activity level rose from 6.55% to 107.58% for major surgeries and from 3.60% to 81.4% for minor surgeries. Actual vs. predicted blood loss matched predicted intraoperative blood loss but was equal to or higher than (but less than 150%) the maximum predicted postoperative blood loss reflecting the severity of procedure and FIX requirements. There were no related adverse events, severe allergic reactions or thrombotic events. There was no evidence that BAX326 increased the risk of inhibitor or binding antibody development to FIX. BAX326 was safe and effective for peri-operative management of 14 subjects with severe and moderately severe haemophilia B.

  7. Aesthetics, the Arts, and Education: The Painter as a Model in Aesthetic Education.

    ERIC Educational Resources Information Center

    Munski, Marilyn L.

    Arguing that the visual arts serve as the focus for potential aesthetic experience in the discipline of art education, this paper describes the influence of the sensory elements of aesthetic experience in nature and other art forms on the work of three artists--Kandinsky, Van Gogh, and Picasso--and suggests that teachers can enrich students'…

  8. The "Magic" of Music: Archaic Dreams in Romantic Aesthetics and an Education in Aesthetics

    ERIC Educational Resources Information Center

    Kertz-Welzel, Alexandra

    2005-01-01

    The main intent of this article is to describe some opportunities for an education in aesthetics by referring to similarities between intensive experiences of music in the individual life and in the history of aesthetics. Here, the author discusses Romanticism through the writings of Wilhelm Heinrich Wackenroder. Among other things, she discusses…

  9. The Teaching Process & Arts and Aesthetics. Third Yearbook on Research in Arts and Aesthetic Education.

    ERIC Educational Resources Information Center

    Knieter, Gerald L., Ed.; Stallings, Jane, Ed.

    Nine essays collected from a conference titled "The Teaching Process and the Arts and Aesthetics" examine the relationship between research and teaching in the arts and in aesthetic education. Issues which guided presentations and discussions were: the relationship between general research in education and the teaching process in the arts and…

  10. Aesthetic and Artistic; Two Separate Concepts: The Dangers of "Aesthetic Education." Perspectives

    ERIC Educational Resources Information Center

    Best, David

    2004-01-01

    In this essay, the author notes a danger concerning the general approach to teaching about the arts through improper use of the concepts "aesthetic" and "artistic." Observing that both concepts are often used interchangeably, with "aesthetic" being seen as the more generic term, the author argues that these concepts are separate and should be…

  11. Benign Prostatic Obstruction Relief in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Enlargement Undergoing Endoscopic Surgical Procedures or Therapy with Alpha-Blockers: A Review of Urodynamic Studies.

    PubMed

    Fusco, Ferdinando; Creta, Massimiliano; Imperatore, Vittorio; Longo, Nicola; Imbimbo, Ciro; Lepor, Herbert; Mirone, Vincenzo

    2017-04-01

    Benign prostatic obstruction (BPO) contributes to the genesis of lower urinary tract symptoms as well as to pathologic remodeling of the lower and upper urinary tract in patients with benign prostate enlargement. Urodynamic studies demonstrate that both medical therapy with alpha-blockers (ABs) and endoscopic surgical procedures provide BPO relief. However, the magnitude of improvement is higher after surgery. Among ABs, silodosin is associated with the highest improvement of bladder outlet obstruction index (BOOI). A complex relationship exists between BOOI improvement and variations of both maximum urinary flow (Q max) and detrusor pressure. When the reduction of BOOI is small, the improvement of Q max is clinically irrelevant and the BOOI is mainly influenced by a decrease of detrusor pressure. In contrast, when the magnitude of BOOI reduction is robust, a meaningful improvement of both detrusor pressure and urinary flow is evident. When clustering ABs according to their receptor pharmacologic selectivity and urodynamic efficacy, three subgroups can be identified,with silodosin being the only member of a subgroup characterized by the highest levels of BOOI improvement and α-1A/α-1B receptor affinity ratio.

  12. Surgical access to separate branches of the cat vestibular nerve

    NASA Technical Reports Server (NTRS)

    Radkevich, L. A.; Ayzikov, G. S.

    1981-01-01

    A posteroventral approach for access to separate branches of the cat vestibular nerve is presented which permits simultaneous surgical access to the ampullary and otolithic nerves. Surgical procedures are discussed.

  13. Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity

    PubMed Central

    Fakoor, Mohammad; Sarafan, Naser; Mohammadhoseini, Payam; Khorami, Mohsen; Arti, Hamidreza; Mosavi, SeyedShahnam; Aghaeeaghdam, Amir

    2014-01-01

    Background: Hallux valgus deformity is a common chronic problem with a reported prevalence of 28.4% and its chief complaint is pain. Thus far, different surgical procedures with their proposed indications have been introduced. This study compared three current procedures, namely the chevron and scarf osteotomies and the McBride procedure. Methods: This retrospective cohort was conducted at the Ahvaz University of Medical Sciences on 44 patients with moderate hallux valgus deformity from 2010 and 2013. All of the patients underwent one of the three procedures (chevron, scarf or McBride). Preoperative and follow up radiographies were evaluated in terms of hallux valgus and intermetatarsal angle correction. The Foot and Ankle Disability Index was filled out to assess the functional outcome and the Visual Analogue Scale was used to evaluate pain. Also, satisfaction, aesthetics and the rate of recurrence was evaluated. Results: Hallux valgus angle and intermetatarsal angle correction were significantly higher in scarf, but not in chevron and McBride. However, from amongst the three procedures, there was no significant difference in terms of the Foot and Ankle Disability Index score, aesthetics, satisfaction level, pain score and recurrence rate. Conclusions: Considering that scarf osteotomy had better results in this study, we think that scarf osteotomy can be considered as a first choice for the treatment of moderate hallux valgus deformity. PMID:25207310

  14. [Kidney donation by living donors. Surgical procedure].

    PubMed

    Baier, P K; Pisarski, P; Wimmenauer, S; Kirste, G

    1999-01-01

    The living donation of kidneys is gaining importance as a possible way to give a transplant to patients with terminal renal insufficiency. However we do not yet have experience with all the possibilities arising from this method. In particular, there is caution caused by the risks of the donor operation. In this context, the method is discussed according to the literature and our own experience of 89 living kidney donations. In our own practice with living donations, we have a success rate with 96% after 4 years and 82% after 16 years. We observed complications including wound infections (10.7%), haemorrhage, hernia and neurological complications (each 2.7%). When performed by specialists, the donor operation is safe and is a responsible alternative to the transplantation of cadaver kidneys, which opens up new possibilities in these times of organ shortage.

  15. Nasal reconstruction with the paramedian forehead flap using the aesthetic subunits principle.

    PubMed

    de Pochat, Victor Diniz; Alonso, Nivaldo; Ribeiro, Emilie Barreto; Figueiredo, Bruno Suffredini; de Magaldi, Eduarda Nilo; Cunha, Marcelo Sacramento; Meneses, José Valber Lima

    2014-11-01

    Reconstruction of nasal defects is challenging because it requires covering skin, supporting framework, and lining. Traditionally, the forehead flaps are transferred in 2 stages; however, it can be accomplished in a single stage or in 3 stages. Few published studies are available about the paramedian forehead flap using the intermediate stage (3-stage) and the aesthetic subunits principle. The purpose of this study is to evaluate the use of the paramedian forehead flap in 2 and 3 stages for nasal reconstructions, highlighting the indications, complications, and technical details and evaluating the patient's satisfaction through a questionnaire about the quality of life (Derriford Appearance Scale 24). A retrospective review was performed between 2011 and 2013 for a consecutive series of 11 patients who underwent nasal reconstructions using the paramedian forehead flap in 2 or 3 stages. All preoperative and postoperative data were collected, and outcomes were also assessed through a questionnaire about the patients' postoperative quality of life. The causes of nasal lesions varied among skin cancer, trauma, and infection. Two-stage paramedian forehead flap reconstruction was performed upon 4 patients, whereas the 3-stage reconstruction was performed for 7 patients. Of the 10 survey respondents, 6 were highly satisfied (score of 11-27), and 4 were moderately satisfied (score of 28-44), whereas no one was dissatisfied after his/her surgical nasal reconstruction procedure. Whether the approach is accomplished in 2 or 3 stages, all areas of the reconstructed nose must be firmly supported. Applying the nasal subunits principle seems to contribute to an overall satisfied population in our study, according to the score obtained by the questionnaire about quality of life.

  16. Towards a sensorimotor aesthetics of performing art.

    PubMed

    Calvo-Merino, B; Jola, C; Glaser, D E; Haggard, P

    2008-09-01

    The field of neuroaesthetics attempts to identify the brain processes underlying aesthetic experience, including but not limited to beauty. Previous neuroaesthetic studies have focussed largely on paintings and music, while performing arts such as dance have been less studied. Nevertheless, increasing knowledge of the neural mechanisms that represent the bodies and actions of others, and which contribute to empathy, make a neuroaesthetics of dance timely. Here, we present the first neuroscientific study of aesthetic perception in the context of the performing arts. We investigated brain areas whose activity during passive viewing of dance stimuli was related to later, independent aesthetic evaluation of the same stimuli. Brain activity of six naïve male subjects was measured using fMRI, while they watched 24 dance movements, and performed an irrelevant task. In a later session, participants rated each movement along a set of established aesthetic dimensions. The ratings were used to identify brain regions that were more active when viewing moves that received high average ratings than moves that received low average ratings. This contrast revealed bilateral activity in the occipital cortices and in right premotor cortex. Our results suggest a possible role of visual and sensorimotor brain areas in an automatic aesthetic response to dance. This sensorimotor response may explain why dance is widely appreciated in so many human cultures.

  17. Infection prevention: the surgical care continuum.

    PubMed

    Barnes, Sue

    2015-05-01

    Lack of careful attention to the increasing complexity of surgical procedures, instrument cleaning and processing, and the transition of surgical and other invasive procedures from the OR to areas outside the traditional hospital OR can contribute to surgical site infection (SSI) risk. Regardless of the location of an intervention, when basic infection prevention measures are applied reliably, even low infection rates can be reduced. To address infection prevention challenges, infection preventionists (IPs) must be well informed regarding infection risk and prevention during surgical and other invasive procedures and the effect a facility type may have on patients' infection risk. The IP must have a solid understanding of surgical asepsis, instrument disinfection, and sterilization to educate and support clinical teams in identifying opportunities for improvement relative to infection prevention.

  18. Intraoperative monitoring technician: a new member of the surgical team.

    PubMed

    Brown, Molly S; Brown, Debra S

    2011-02-01

    As surgery needs have increased, the traditional surgical team has expanded to include personnel from radiology and perfusion services. A new surgical team member, the intraoperative monitoring technician, is needed to perform intraoperative monitoring during procedures that carry a higher risk of central and peripheral nerve injury. Including the intraoperative monitoring technician on the surgical team can create challenges, including surgical delays and anesthesia care considerations. When the surgical team members, including the surgeon, anesthesia care provider, and circulating nurse, understand and facilitate this new staff member's responsibilities, the technician is able to perform monitoring functions that promote the smooth flow of the surgical procedure and positive patient outcomes.

  19. The Surgical Treatment of Mycetoma

    PubMed Central

    Suleiman, Suleiman Hussein; Wadaella, EL Sammani; Fahal, Ahmed Hassan

    2016-01-01

    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors’ experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan. PMID:27336736

  20. [Surgical treatment of rectal cancer].

    PubMed

    Vergara-Fernández, O; Salinas-Aragón, L E; Camacho-Mauries, D; Medina-Franco, H

    2010-01-01

    Rectal affection accounts for 30% of colorectal cancer. The standard of treatment is surgical resection, which often is curative. For superior and middle-rectal involvement, low anterior resection (LAR) is the preferred procedure. For tumors involving the lower portion of the rectum, abdominoperineal resection (APR) or LAR are the options of treatment, depending on sphincter involvement. The main surgical objective is to achieve a R0 resection with an appropriated total mesorrectal excision, greater number of lymph nodes and negative distal and radial margins. These surgical parameters have been used as quality indicators and have prognostic implications in terms of overall and disease-free survival. Total mesorectal excision with preservation of hypogastric nerves has shown a reduction in rates of sexual and bladder dysfunction as well as lower local recurrence. At specialized centers such procedures are performed by minimal invasive surgery; however the number of meta-analysis is scarce.

  1. [A "dialogue" between the aesthetics of nursing and philosophy].

    PubMed

    Chang, Chia-Hsiu; Chen, Chung-Hey

    2012-02-01

    Nursing aesthetics belong to the broader school of aesthetics, a branch of philosophy, as well as the nursing arts, an element of professional nursing. The philosophy of aesthetics recognizes the connection between an author and appreciators and identifies both substantive and abstract aesthetic experiences in interpersonal communication through the fine arts. Nursing aesthetics values the meaningful moments of patients, is sensitive to the influences of different circumstances and situations, and appreciates the unique qualities of humanness. Nursing aesthetics is emancipatory knowledge and involves empirical, ethical and personal knowing. The article is based on a search of OvidSP and Chinese Electronic Periodical Services (CEPS) database references using key words including aesthetic, aesthetics, art of nursing, or nursing aesthetics as well as a review of books related to aesthetics, knowledge construction, and nursing aesthetics. Authors determined definitions as defined by nursing experts and the applications thereof in clinical practice. This article aimed to illustrate that the ultimate concern of philosophy is "goodness" and that the foundation of caring behaviors is "love". In practice, nursing aesthetics is expressed through empathy, appreciation, inspiration and the therapeutic use of the self. Through aesthetic knowing and enhanced perceptual sensibility and reflection, nurses can transform intuitive knowing into art-acts and ultimately enhance nursing care quality.

  2. Improving Surgical Access in Rural Africa through a Surgical Camp Model

    PubMed Central

    Kituuka, O.; Elobu, E.; Jombwe, J.; Sekabira, J.; Butler, Elissa; Faulal, J.

    2016-01-01

    Introduction. Surgical camps are preplanned activities where volunteer surgical teams congregate at specified place(s) and perform a wide range of mostly elective procedures for a limited period of time. This is usually at no cost to the patients, who belong to vulnerable (poor and hard to reach) communities. We describe a surgical camp model and its challenges as a means of improving access to surgical services. Methods. A cross-sectional descriptive study. Data from a recent Association of Surgeons of Uganda surgical camp were collected and analyzed for demographics, costs, procedure types, and rates and, in addition, challenges encountered and solutions. Personnel that participated in this exercise included specialist surgeons, surgical residents, medical officers, clinical officers, anesthetists, and theater nurses (a total of 121 staff). Results. In total, 551 procedures were performed during a four-day-long camp. Mean age was 35 years (SD 23), M : F ratio was 2 : 1. Herniorrhaphy, skin lump excision, hydrocelectomy, and thyroidectomy formed 81% of all the procedures. Average cost per procedure was $73 USD. Conclusion. Surgical camps offer increased access to surgical services to vulnerable populations. Hernias and goiters were most common. Surgical camps should become an integral part of the Health Service delivery in low-resourced environments. PMID:27413775

  3. Subjective assessment of facial aesthetics after maxillofacial orthognathic surgery for obstructive sleep apnoea.

    PubMed

    Islam, Shofiq; Aleem, Fahd; Ormiston, Ian W

    2015-03-01

    We aimed to evaluate the subjective perception of facial appearance by patients after maxillofacial surgery for obstructive sleep apnoea (OSA), and explored the possible correlation between satisfaction and surgical outcome. A total of 26 patients, 24 men and 2 women (mean (SD) age 45 (7) years), subjectively assessed their facial appearance before and after operation using a visual analogue scale (VAS). To investigate a possible association between postoperative facial appearance and surgical outcome, we analysed postoperative scores for the apnoea/hypopnoea index (AHI) and Epworth sleepiness scale (ESS). Postoperatively, 14 (54%) indicated that their facial appearance had improved, 4 (15%) recorded a neutral score, and 8 (31%) a lower score. The rating of facial appearance did not correlate with changes in the AHI or ESS following surgery. This study supports the view that most patients are satisfied with their appearance after maxillofacial orthognathic surgery for OSA. The subjective perception of facial aesthetics was independent of the surgical outcome.

  4. Guideline implementation: Surgical attire.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  5. Surgical management of upper lid entropion.

    PubMed Central

    Kemp, E G; Collin, J R

    1986-01-01

    One hundred and eighty-three surgical procedures were conducted on 107 patients over seven years. 91% of the cases of upper lid entropion were corrected satisfactorily with only one operation. It is postulated that this level of success is achieved by grading the degree of surgical intervention according to the clinical established on systematic examination of upper lid entropion. PMID:3741821

  6. Enhanced aesthetics with all ceramics restoration

    PubMed Central

    Nayar, Sanjna; Aruna, U.; Bhat, Wasim Manzoor

    2015-01-01

    The demand for the dentist to achieve excellence in esthetics and function has driven modern advances in materials and restoration fabrication. The development of various casting alloys and precise casting systems has contributed to the successful use of metal-based restorations. However, patient requests for more aesthetic and biologically “safe” materials that have led to an increased demand for metal-free restorations. The following case presentation illustrates a successful aesthetic and functional application of this exciting computer-aided design/computer-aided manufacturing-digital zirconia-based system for a natural smile. PMID:26015733

  7. The biological roots of aesthetics and art.

    PubMed

    Heinrich, Bernd

    2013-07-18

    Animals' choice behavior is driven by motivation that is attributable to both innate urges and from positive and negative reinforcements. Using a comparative approach as well as experimental evidence, I explore how the first involves fitness-enhancing benefits from aesthetics that are derived from ancestral choices via natural selection. Innate urges and aesthetics help guide animals to produce appropriate positive and negative choices that are species-specific. Choices of food, habitat and mates or associates are considered. I propose that art is not a uniquely human product, but a representation or an extension of the maker, as are the ornaments, displays, and songs of a bird.

  8. Semi-automatic development of optimized surgical simulator with surgical manuals.

    PubMed

    Kuroda, Yoshihiro; Takemura, Tadamasa; Kume, Naoto; Okamoto, Kazuya; Hori, Kenta; Nakao, Megumi; Kuroda, Tomohiro; Yoshihara, Hiroyuki

    2007-01-01

    Recently, simulation platform and libraries are provided from several research groups. However, development of VR-based surgical simulator takes much effort not only for implementing simulation modules but also for setting surgical environment and choosing simulation modules. Surgical manual describes knowledge of manipulations in surgical procedure. In this study, language processing is used to extract anatomical objects and surgical manipulations in a scene from surgical manual. In addition, benchmark and LOD control of simulation modules optimize the simulation. We propose a framework of semi-automatic development of optimized simulator with surgical manuals. In the framework, SVM based machine learning is adapted in extracting surgical information and XML file was made. Simulation programs were created from XML file using a simulation library in different system configurations.

  9. Aesthetic problems in chemical peeling.

    PubMed

    Goldman, P M; Freed, M I

    1989-09-01

    Questionnaires were mailed to six physicians experienced in chemical peels regarding common problems encountered in the procedure. They are: Thomas H. Alt, M.D., Minneapolis, MN; Samuel J. Stegman, M.D., San Francisco, CA; James J. Stagnone, M.D., Albuquerque, NM; Robert Kotler, M.D., Los Angeles, CA; William H. Beeson, M.D., Indianapolis, IN; and Paul S. Collins, M.D., San Luis Obispo, CA. Their answers are presented in a panel format.

  10. James Mark Baldwin and the Aesthetic Development of the Individual.

    ERIC Educational Resources Information Center

    Parsons, Michael J.

    1980-01-01

    This paper recounts the ideas of the American cognitive-developmental psychologist James Mark Baldwin (1861-1934) on aesthetic experience: his conceptualization of aesthetic experience as immediate, semblant, personalized, and idealized; and his three-stage theory of aesthetic development. (SJL)

  11. A Scandinavian View on the Aesthetics as a Learning Media

    ERIC Educational Resources Information Center

    Austring, Bennye D.; Sorensen, Merete

    2012-01-01

    As the aesthetic learning process is always relational and developed in interaction with the surrounding culture, the participants in the aesthetic activities can develop cultural identity and social skills. Add to this that the individual can share its inner world with others through aesthetic activities in the potential space and in this way…

  12. Chairs, Cars, and Bridges: Teaching Aesthetics from the Everyday

    ERIC Educational Resources Information Center

    Zande, Robin Vande

    2007-01-01

    It is very typical for students in K-12 art education to study aesthetics based on artistic objects. Artistic objects, however, need not be the sole source for aesthetic investigation. In this article, the author discusses the use of designed objects such as chairs, cars, and bridges in the discussion of aesthetic concepts. Students, as consumers…

  13. Curator and Critic: Role of the Assessor in Aesthetic Fields

    ERIC Educational Resources Information Center

    Jacobs, Rachael

    2012-01-01

    Assessment in aesthetic fields presents a myriad of challenges in the higher education environment. This paper uses a metaphorical representation to explore the role of assessors within aesthetic assessment settings in higher education. It begins with a discussion of aesthetic fields and an exploration of the role of assessment in this area.…

  14. [The method of quantitative assessment of dentition aesthetic parameters].

    PubMed

    Ryakhovsky, A N; Kalacheva, Ya A

    2016-01-01

    This article describes the formula for calculating the aesthetic index of treatment outcome. The formula was derived on the basis of the obtained regression equations showing the dependence of visual assessment of the value of aesthetic violations. The formula can be used for objective quantitative evaluation of the aesthetics of the teeth when smiling before and after dental treatment.

  15. Aesthetic Discourses in Early Childhood Settings: Dewey, Steiner, and Vygotsky

    ERIC Educational Resources Information Center

    Lim, Booyeun

    2004-01-01

    Early childhood, when young children are already capable of undergoing aesthetic experience, must be the starting point for aesthetic education. Despite increasing attention to the significant values of the arts in early childhood classrooms, no theoretical framework to support aesthetic education has been established. This article introduces the…

  16. The Aesthetics of Representation: Dramatic Texts and Dramatic Engagement

    ERIC Educational Resources Information Center

    Gallagher, Kathleen

    2005-01-01

    There are several ways in which aesthetic discourses might be positioned in the field of drama education. While some might locate "aesthetics" in the cognitive or interpretive realm of learning, and others the affective or philosophical realm. In this article, the author has chosen to speak of the discourses of aesthetics as they relate…

  17. Repositioning template for mandibular reconstruction with fibular free flaps: an alternative technique to pre-plating and virtual surgical planning.

    PubMed

    Berrone, M; Crosetti, E; Succo, G

    2014-08-01

    Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging the period of ischaemia and not restoring the correct maxillomandibular and occlusal relationships can ultimately lead to a higher rate of complications as well as poor aesthetic and functional results. Recently, there has been rising interest in virtual surgical planning and computer-assisted mandibular reconstruction in pre-operative planning; however, this is not always possible because of the costs involved and the set-up time for the entire procedure. In this paper, we present a simple and inexpensive technique for fibular free flap modelling and repositioning after segmental resection of the mandible; the technique entails the pre-operative preparation of a resin repositioning template on a stereolithographic model. This technique has been successfully applied in four cases: two cases underwent resection involving only the mandibular body, one case involving the mandibular body and symphysis and one case in which a ramus to ramus resection was performed. In this preliminary report, we show that the resin repositioning template is an easy, safe and useful tool for mandibular reconstruction with a fibular free flap.

  18. Prospective Study of the Surgical Techniques Used in Primary Rhinoplasty on the Caucasian Nose and Comparison of the Preoperative and Postoperative Anthropometric Nose Measurements

    PubMed Central

    Berger, Cezar Augusto Sarraf; Freitas, Renato da Silva; Malafaia, Osvaldo; Pinto, José Simão de Paula; Macedo Filho, Evaldo Dacheux; Mocellin, Marcos; Fagundes, Marina Serrato Coelho

    2014-01-01

    Introduction The knowledge and study of surgical techniques and anthropometric measurements of the nose make possible a qualitative and quantitative analysis of surgical results. Objective Study the main technique used in rhinoplasty on Caucasian noses and compare preoperative and postoperative anthropometric measurements of the nose. Methods A prospective study with 170 patients was performed at a private hospital. Data were collected using the Electronic System Integrated of Protocols software (Sistema Integrado de Protocolos Eletrônicos, SINPE©). The surgical techniques used in the nasal dorsum and tip were evaluated. Preoperative and 12-month follow-up photos as well as the measurements compared with the ideal aesthetic standard of a Caucasian nose were analyzed objectively. Student t test and standard deviation test were applied. Results There was a predominance of endonasal access (94.4%). The most common dorsum technique was hump removal (33.33%), and the predominance of sutures (24.76%) was observed on the nasal tip, with the lateral intercrural the most frequent (32.39%). Comparison between preoperative and postoperative photos found statistically significant alterations on the anthropometric measurements of the noses. Conclusion The main surgical techniques on Caucasian noses were evaluated, and a great variety was found. The evaluation of anthropometric measurements of the nose proved the efficiency of the performed procedures. PMID:25992149

  19. "ZEAL": An Aesthetic Revolution for Education

    ERIC Educational Resources Information Center

    Clark, Barbara A.; French, James Joss

    2012-01-01

    Educators are hesitant to venture into the unknown landscape within a child's heart and mind because they have throughout their education experienced the same non-compassionate teachers. This research proposes an awakening, making a wave for a new revolution of compassionate teachers that institutes aesthetic methodology to address relevant…

  20. Original Sin and T. E. Hulme's Aesthetics

    ERIC Educational Resources Information Center

    Kishler, Thomas C.

    1976-01-01

    T. E. Hulme, a vigorous opponent of romanticism in art, poetry, and philosophy, insisted that the underlying flaw of the romantic view was its rejection of the dogma of Original Sin and the fall of man. His views are explored for the significant bearing they have on the development of aesthetic insight and indirectly on value and outlook.…

  1. Creative Writing and Schiller's Aesthetic Education

    ERIC Educational Resources Information Center

    Howarth, Peter

    2007-01-01

    For academics committed to the idea of an all-round aesthetic education, one of the great successes of the last thirty years has been the tremendous expansion of creative writing classes. Despite the dramatic expansion of creative writing as an academic discipline, the methods, ideals, and values of creative writing workshops have very often been…

  2. Reconceptualizing Play: Aesthetic Self-Definitions

    ERIC Educational Resources Information Center

    Guss, Faith

    2005-01-01

    This article aims to trouble the identity of children's dramatic play(ing). It contains two interweaving threads of discourse. In one thread lies a discussion of how children can trouble and extend their own identities through the aesthetic form-languages and conventions they employ and deploy in their dramatic playing/pretend playing. Whereas…

  3. Aesthetic Experiences with Music: Musicians versus Children

    ERIC Educational Resources Information Center

    Paul, Phyllis M.

    2009-01-01

    This study, which is a replication and extension of earlier research by Paul, examines the correspondence of perceived aesthetic experiences between musicians, in the present investigation, and children, from Paul's previous experiment. As did fourth-grade students (N = 60) in Paul's earlier study, 56 adult musicians listened to Rachmaninoff's…

  4. Aesthetic Solidarity "after" Kant and Lyotard

    ERIC Educational Resources Information Center

    Vandenabeele, Bart

    2008-01-01

    One of the most complex issues in Kant's "Critique of Judgment" is the aesthetic judgment's claim to universal validity and shareability. Kant is not very clear about the exact status of this claim. Kant's distinction between the beautiful and the sublime only complicates the matter, since the universal shareability of the judgment of the sublime…

  5. Typographical Design, Modernist Aesthetics, and Professional Communication.

    ERIC Educational Resources Information Center

    Kostelnick, Charles

    1990-01-01

    Suggests that text and information design are rooted in the visual aesthetics of modernism as articulated by the Bauhaus. Explores four key ideas affecting visual design: unity of text and form; emphasis on economy and simplicity; search for a universal, objective style; and faith in individual and collective intuition. (KEH)

  6. The Aesthetic Classroom and the Beautiful Game

    ERIC Educational Resources Information Center

    Baurain, Bradley

    2010-01-01

    This essay explores an analogy: A well-played soccer game has much in common with a well-taught lesson or course. Aesthetic pedagogy, as conceived by Dewey, Gadamer, and contemporary theorists and practitioners, is set alongside the world's favorite sport, including events from the 2006 World Cup and the autobiography of Pele. The discussion moves…

  7. Art's Detour: A Clash of Aesthetic Theories

    ERIC Educational Resources Information Center

    Wertz, S. K.

    2010-01-01

    Both John Dewey and Martin Heidegger thought that art's audience had to take a detour in order to appreciate or understand a work of art. They wrote about this around the same time (mid-1930s) and independently of one another, so this similar circumstance in the history of aesthetics is unusual since they come from very different philosophical…

  8. The Value of the Aesthetic in Marxism

    ERIC Educational Resources Information Center

    Rudich, Norman

    1975-01-01

    This paper defined and characterized the aesthetic by relating it to, rather than isolating it from, the economic, scientific, and political realities wich are its foundations, its living-sources, and the very materials of its forms and meanings. (Author/RK)

  9. Literature-Based Exploration: Efferent and Aesthetic.

    ERIC Educational Resources Information Center

    Prather, Kathryn

    Efferent teaching asks the student to read for a predetermined answer, focusing on another person's ideas of the text's meaning. Aesthetic teaching allows for literature to be read and experienced as art through the reader's personal transaction with the text which focuses on one's own interest to create and understand the meaning. This paper…

  10. In Search of Native American Aesthetics

    ERIC Educational Resources Information Center

    Meyer, Leroy N.

    2001-01-01

    The Native American Church meeting is one contemporary inter-tribal form of the ancient peyote spiritual tradition, represented throughout much of North America. With its deeply integrated elements of artistic expression, the cultural context of the peyote ceremony affords an approach to the major issues of Native American aesthetics. Is some…

  11. Therapy and the Aesthetics of the Self

    ERIC Educational Resources Information Center

    Guilfoyle, Michael

    2016-01-01

    Post-structuralists argue that personal identity is a function of societal power dynamics. This becomes especially problematic for persons recruited into problem-saturated identities. In this paper, inspired by Foucault's call for us to "create ourselves as a work of art" (p. 262), I explore the therapeutic value of an aesthetic approach…

  12. [Promoting aesthetics to enhance nursing services].

    PubMed

    Lee, Sheuan; Chang, Ting

    2011-10-01

    Nursing is a client-oriented profession dedicated to helping people. Nurses are responsible to both help relieve client physical and psychological symptoms and assist clients as necessary to die with dignity. As such, nursing schools should strengthen not only science and professional skills, but also student aesthetics. Today, fast changing medical technology is improving the treatment of diseases and extending average life spans. The National Health Insurance System in Taiwan, however, is increasingly restricting nursing manpower and raising staff workloads. Nurses are increasingly required to sacrifice ethical principles and conduct technical operations in medical settings defined by stringent cost controls. Nursing aesthetics cannot provide appropriate levels of care dignity and quality to clients under severe time and emotional distress constraints. Burnout, dissatisfaction, strained doctor-nurse relationships and lower quality care are all-too-frequent results. Under the circumstances, nursing functions are negatively influenced and fine nursing service is difficult to achieve. This article reviewed the literature to discuss the definition and meaning of aesthetics and relative factors that are difficult to define in clinical settings. This article may assist nurses to present aesthetics, upgrade care quality and further enhance nursing services.

  13. Incorporating the Aesthetic Dimension into Pedagogy

    ERIC Educational Resources Information Center

    Webster, R. Scott; Wolfe, Melissa

    2013-01-01

    This paper reports on a case study that was undertaken to discover not only the belief and intent behind the everyday opportunities that four exemplary teachers offered their high performing students but what activities they incorporated into their everyday lessons in an attempt to make sense of how aesthetic experiences may enhance learning. The…

  14. Evaluation of Eyelid Function and Aesthetics.

    PubMed

    Neimkin, Michael G; Holds, John B

    2016-05-01

    The eyes and periocular area are the central aesthetic unit of the face. Facial aging is a dynamic process that involves skin, subcutaneous soft tissues, and bony structures. An understanding of what is perceived as youthful and beautiful is critical for success. Knowledge of the functional aspects of the eyelid and periocular area can identify pre-preoperative red flags.

  15. Pragmatic Aesthetics and the Autistic Artist

    ERIC Educational Resources Information Center

    Hunter, Kyle; Barnbaum, Deborah

    2012-01-01

    There are many prominent examples of artists with autism. However, even when confronted with evidence of these accomplished "autistic savants", pragmatic aesthetic theories cannot adequately account for the work of these accomplished artists as "artists". This article first examines the nature of autism and explores a prominent psychological…

  16. Foucault, Counselling and the Aesthetics of Existence

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2005-01-01

    Michel Foucault was drawn late in life to study the "arts of the self" in Greco-Roman culture as a basis, following Nietzsche, for what he called an "aesthetics of existence." By this, he meant a set of creative and experimental processes and techniques by which an individual turns him- or herself into a work of art. For Nietzsche, it was above…

  17. McLuhan: The Aesthete as Historian.

    ERIC Educational Resources Information Center

    Curtis, James M.

    1981-01-01

    Attributes McLuhan's theories about media to his interpretation of history as an interpenetrating sequence of three processes: all history originated in oral societies, which were fragmented by literacy, but electronic media are returning society to that original state through implosion. Reviews the historical, literary, and aesthetic sources for…

  18. Symposium: Aesthetic Education in Japan Today

    ERIC Educational Resources Information Center

    Okazaki, Ako; Masuda, Kingo; Kaneda, Takuya; Hino, Yoko; Okamoto, Yasuaki; Fukumoto, Kinichi; Nagamori, Motoki; Yamada, Kazumi; Motomura, Kenta; Ishizaki, Kazhiro; Okada, Masashi; Kaneko, Yoshimasa; Naoe, Toshio; Fujie, Mitsuru; Iwano, Masako

    2003-01-01

    The purpose of this symposium is to provide readers with a general understanding of Japanese art and aesthetics education and its interaction with other cultures. The essays cover a variety of topics, including historical, cross-cultural, theoretical, and practical perspectives. Following an introduction by Ako Okazaki, the following papers are…

  19. Aesthetic Education for Morality: Schiller and Kant

    ERIC Educational Resources Information Center

    Tauber, Zvi

    2006-01-01

    Kant's "Critique of Judgment," which was published in 1790, referred in detail to the affinity between beauty and morality. Schiller's writings from the 1790s dealing with aesthetics and ethics are intertwined, simultaneously, both with an affirmative reception of Kant's ideas and with critical attitudes against them. This applies to essays such…

  20. Pathogenesis of postoperative oral surgical pain.

    PubMed Central

    Ong, Cliff K. S.; Seymour, R. A.

    2003-01-01

    Pain is a major postoperative symptom in many oral surgical procedures. It is a complex and variable phenomenon that can be influenced by many factors. Good management of oral surgical pain requires a detailed understanding of the pathogenesis of surgical pain. This article aims at reviewing postoperative pain from a broad perspective by looking into the nociception, neuroanatomy, neurophysiology, and neuropharmacology of pain. Therapeutic recommendations are made after reviewing the evidence from the literature for maximizing the efficacy of pain management techniques for oral surgical pain. PMID:12722900

  1. In vitro evaluation of decellularized ECM-derived surgical scaffold biomaterials.

    PubMed

    Luo, Xiao; Kulig, Katherine M; Finkelstein, Eric B; Nicholson, Margaret F; Liu, Xiang-Hong; Goldman, Scott M; Vacanti, Joseph P; Grottkau, Brian E; Pomerantseva, Irina; Sundback, Cathryn A; Neville, Craig M

    2017-04-01

    Decellularized extracellular matrix (ECM) biomaterials are increasingly used in regenerative medicine for abdominal tissue repair. Emerging ECM biomaterials with greater compliance target surgical procedures like breast and craniofacial reconstruction to enhance aesthetic outcome. Clinical studies report improved outcomes with newly designed ECM scaffolds, but their comparative biological characteristics have received less attention. In this study, we investigated scaffolds derived from dermis (AlloDerm Regenerative Tissue Matrix), small intestinal submucosa (Surgisis 4-layer Tissue Graft and OASIS Wound Matrix), and mesothelium (Meso BioMatrix Surgical Mesh and Veritas Collagen Matrix) and evaluated biological properties that modulate cellular responses and recruitment. An assay panel was utilized to assess the ECM scaffold effects upon cells. Results of the material-conditioned media study demonstrated Meso BioMatrix and OASIS best supported cell proliferation. Meso BioMatrix promoted the greatest migration and chemotaxis signaling, followed by Veritas and OASIS; OASIS had superior suppression of cell apoptosis. The direct adhesion assay indicated that AlloDerm, Meso BioMatrix, Surgisis, and Veritas had sidedness that affected cell-material interactions. In the chick chorioallantoic membrane assay, Meso BioMatrix and OASIS best supported cell infiltration. Among tested materials, Meso BioMatrix and OASIS demonstrated characteristics that facilitate scaffold incorporation, making them promising choices for many clinical applications. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 585-593, 2017.

  2. Visual, Physiological, and Aesthetic Factors and Pitfalls in Asian Blepharoplasty

    PubMed Central

    Chen, William Pai-Dei

    2016-01-01

    Double eyelid surgery to create an upper-lid crease in Asian patients is one of the more popular aesthetic surgeries among people of Asian descent. Much has been written about the myriad methods, but little has been written about the underlying factors that predispose a patient to complications and suboptimal results. This article touches on some of the possible errors in placement of crease height in upper blepharoplasty and the pitfalls that can be associated with permanent placement of nondissolvable sutures that encircle the complex layers of the upper eyelid, as well as the ideal eyelid crease wound closure and its biodynamics. One should consider these factors in any form of upper eyelid procedure, as they are not merely applicable to upper blepharoplasty. PMID:26673576

  3. [Management of complications after aesthetic hyaluronic acid injections].

    PubMed

    Jahn, K; Homey, B; Gerber, P A

    2014-10-01

    The use of hyaluronic acid fillers for treatment of rhytides (wrinkles) is widespread in aesthetic dermatology and is considered a safe procedure; however, complications can occur especially if the injections are carried out by an inexperienced person and/or with a lack of anatomical knowledge. The two cases presented here exemplify this problem. In conclusion, both cases demonstrate complications after uncritical injection of hyaluronic acid fillers into "risk" or "expert" regions. While the patients in these two cases recovered completely, the injection of filler substances can also lead to the risk of potentially permanent side effects, such as granuloma, necrosis with scar tissue formation and even blindness. The frequency and severity of complications often show a direct correlation with the qualification or expertise of the person treating and hence injection treatments should be performed solely by physicians.

  4. Laser and Light-Based Aesthetics in Men.

    PubMed

    Green, Jeremy B; Metelitsa, Andrei I; Kaufman, Joely; Keaney, Terrence

    2015-09-01

    Men represent an important evolving segment of the cosmetic market. With the growing acceptability of cosmetic procedures along with societal and workplace pressure to maintain youthfulness, men increasingly seek the advice of aesthetic practitioners. Despite this so-called "Menaissance," there is a paucity of published literature regarding laser and light treatments of male skin. Herein the differences in male cutaneous physiology are addressed, followed by a review of light-based treatment of conditions largely unique to male skin, pseudofolliculitis barbae, and rhinophyma. Next, the publications related to laser treatment of male skin specifically are examined. We conclude with a discussion of personal observations derived from clinical experience with laser and light-based treatments in men.

  5. Surgical management of pediatric urinary incontinence.

    PubMed

    Dave, Sumit; Salle, Joao Luiz Pippi

    2013-08-01

    The surgical management of pediatric urinary incontinence secondary to neurogenic bladder and congenital anomalies is challenging, and continues to evolve with new surgical innovations. The goal of these surgical procedures is to achieve complete and socially acceptable urinary dryness, while preserving volitional voiding where possible, without causing damage to the upper tracts. This review focuses on recent studies and highlights the pros and cons of these advances, based on our experience. The short-term success in achieving urinary continence has to be tempered with the long-term implications of these reconstructive procedures, about which our knowledge is limited.

  6. Surgical Management of Male Voiding Dysfunction.

    PubMed

    Mandeville, Jessica; Mourtzinos, Arthur

    2016-06-01

    Benign prostatic hypertrophy (BPH) is a common cause of voiding dysfunction. BPH may lead to bladder outlet obstruction and resultant troublesome lower urinary tract symptoms. Initial management of BPH and bladder outlet obstruction is typically conservative. However, when symptoms are severe or refractory to medical therapy or when urinary retention, bladder stone formation, recurrent urinary tract infections, or upper urinary tract deterioration occur, surgical intervention is often necessary. Numerous options are available for surgical management of BPH ranging from simple office-based procedures to transurethral operative procedures and even open and robotic surgeries. This article reviews the current, most commonly used techniques available for surgical management of BPH.

  7. A Novel Surgical Technique to Correct Intrareolar Polythelia

    PubMed Central

    Cherubino, Mario; Pellegatta, Igor; Frigo, Claudia; Scamoni, Stefano; Taibi, Dominic; Maggiulli, Francesca; Valdatta, Luigi

    2014-01-01

    Polythelia is a rare congenital malformation that occurs in 1–2% of the population. Intra-areolar polythelia is the presence of one or more supernumerary nipples located within the areola. This is extremely rare. This article presents 3 cases of intra-areolar polythelia treated at our Department. These cases did not present other associated malformation. Surgical correction was performed for psychological and cosmetic reasons using advancement flaps. The aesthetic and functional results were satisfactory.

  8. PORTS MINIMIZATION WITH MINI-PORT AND LIVER FLEXIBLE RETRACTOR: AN ERGONOMIC AND AESTHETIC ALTERNATIVE FOR SINGLE PORT IN LAPAROSCOPIC GASTRIC BYPASS

    PubMed Central

    de MOURA-JÚNIOR, Luiz Gonzaga; de CASTRO-FILHO, Heládio Feitosa; MACHADO, Francisco Heine Ferreira; BABADOPULOS, Rodrigo Feitosa; FEIJÓ, Francisca das Chagas; FERNANDES, Silvana Duarte

    2014-01-01

    Background The laparoscopic access, with its classically known benefits, pushed implementation in other components, better ergonomy and aesthetic aspect. Aim To minimize the number and diameter of traditional portals using miniport and flexible liver retractor on bariatric surgery. Method This prospective study was used in patients with less than 45 kg/m2, with peripheral fat, normal umbilicus implantation, without previous abdominoplasties. Were used one 30o optical device with 5 mm in diameter, four accesses (one mini of 3 mm to the left hand of the surgeon, one of 5 mm to the right hand alternating with optics, one of 12 mm for umbilical for surgical maneuvers as dissection, clipping, in/out of gauze, and one portal of 5 mm for the assistant surgeon), resulting in a total of 25 mm linear incision; additionally, one flexible liver retractor (covered with a nelaton probe to protect the liver parenchyma, anchored in the right diaphragmatic pillar and going out through the surgeon left portal) to visualize the esophagogastric angle. Results In selected patients (48 operations), gastric bypass was performed at a similar time to the procedures with larger diameters (5 or 6 portals and 10 mm optics, with sum of linear incision of 42 mm) including oversuture line on excluded stomach, gastric tube and mesenteric closing. The non sutured portal of 3 mm and the two of 5 mm with subdermal sutures, were hardly visible in the folds of the skin; the one of 12 mm was buried inside the umbilicus or in the abdominoplasty incision. Conclusion Minimizing portals is safe, effective, good ergonomic alternative with satisfactory aesthetic profile without need for specific instruments, new learning curve and limited movement of the instruments, as required by the single port. PMID:25409973

  9. A Novel Option of Uninterrupted Closure of Surgical Wounds

    PubMed Central

    Sulamanidze, Marlen A; Sulamanidze, George M

    2009-01-01

    Background: A cosmetically pleasing postoperative scar is an important aim of all aesthetic surgeries. Use of proper suture materials for delicate and gentle suturing of the operative injury is an important requirement for achieving satisfactory scars. However, closure of the edges of wounds by means of conventional suture materials does not always meet the requirements to achieve this objective. Aim: To simplify and facilitate the process of surgical wound closure, to improve the quality of scar, and to achieve a good cosmetic effect through the introduction of a new type of suture material. Materials and Methods: We have introduced a new surgical suturing material—a nontraumatic, barbed thread connected with the suture needle—APTOS SUTURE (European patent 1075843 as of 1999). Presented herein is a new modification of the technique of uninterrupted subcutaneous and intracutaneous suturing of wound edges, and the details of our experience with this material. Results: Our experience shows that, with use of APTOS, wound closure is carried out easily and quickly. The wound remains stable, the time of healing is shortened, and the process of suture removal is simplified, resulting in an aesthetically pleasing scar. Conclusions: The technique of surgical wound suturing proposed herein is a simple, facilitated, and efficient option of wound-edge closure, which can successfully be used, both in general and in aesthetic surgery for wound closure, such as plasty of scars, face lift, mammoplasty, and abdominal plasty. PMID:20808595

  10. [Evidence-based surgical techniques for caesarean section].

    PubMed

    Aabakke, Anna J M; Secher, Niels Jørgen; Krebs, Lone

    2014-02-10

    Caesarean section (CS) is a common surgical procedure, and in Denmark 21% of deliveries is by CS. There is an increasing amount of scientific evidence to support the different surgical techniques used at CS. This article reviews the literature regarding CS techniques. There is still a lack of evidence especially about the long-term consequences of the surgical techniques.

  11. Combined orthodontic-surgical approach in the treatment of impacted maxillary canines: three clinical cases

    PubMed Central

    SPUNTARELLI, M.; CECCHETTI, F.; ARCURI, L.; TESTI, D.; MELONE, P.; BIGELLI, E.; GERMANO, F.

    2015-01-01

    SUMMARY Impaction of maxillary canine is a relatively frequent orthodontic anomaly which could represent fuctional and aesthetic problems for patients. Nowadays, the conventional technique to impacted canines consists of a combined orthodontic and surgical approach, aimed to guide cuspids at the center of the alveolar ridge in a stable position and surrounded by healthy hard and soft tissues. This article presents three cases studies with different combined surgical-orthodontic approaches for the treatment of infraosseous impacted canines. An impacted maxillary canine could be guided, after adequate space is created orthodontically, to the center of the ridge through an orthodontic traction directly applied to the crown of impacted cuspid. Several surgical techniques have been proposed to expose the crown of impacted tooth. Location (buccal or palatal side) of impactation and depth influence surgical approach in order to obtain best aesthetic and functional results. PMID:27555906

  12. SURGICAL EMERGENCIES

    PubMed Central

    Rossi, Felix R.

    1950-01-01

    Action according to preconceived plans may be life-saving at the scene of accidents involving serious injury to several persons. Severe hemorrhage and respiratory obstruction must be dealt with immediately. As the latter may not be apparent at a glance, it should be looked for specifically. Artificial respiration may be necessary. Spinal puncture is a procedure in first aid which should be carried out at the site of an accident if there are symptoms of cerebral edema or of increased cerebral pressure. Routine plans should be laid to meet the emergency of cardiac arrest on the operating table. The surgeon must be prepared to begin cardiac massage within three minutes in such instances. PMID:18731685

  13. Surgical Management of Pericardial Diseases.

    PubMed

    Johnston, Douglas R

    Disease of the pericardium represents a relatively rare indication for cardiac surgery, and there exist no widely accepted guidelines for surgical management. As such, the surgical approach to the pericardium has relied largely on institutional experience with a slow evolution based on published studies. In particular, management of pericardial constriction has varied widely from surgeon to surgeon and institution to institution, in large part due to a perception of inherent high risk to the procedure. This review covers the current practice of surgery for disease of the pericardium, with particular focus on the evolution of indications for pericardiectomy, new applications in inflammatory or relapsing pericarditis, and the progressive refinement in surgical technique and operative planning which have led to significantly improved outcomes in experienced centers.

  14. [Surgical treatment of duodenal ulcer].

    PubMed

    Lese, M; Naghi, I; Pop, C

    2001-01-01

    The medical and endoscopic treatment of duodenal ulcer are decreasing the frequency of surgical treatment in this disease. The authors study the operations performed for duodenal ulcer within the period 1989-1999 in the County Hospital Baia Mare. The decrease of the rate of surgical interventions is the pure effect of the medical treatment, as long as the endoscopic treatment is not yet available in our service. The rate of ulcer--induced perforations remained, however, unmodified (48% of total operatory indications), as well as the postoperative morbidity and--mortality (18% respectively 9%). The last category seems not to be influenced by the type of chosen surgical procedure, but by the patient's age, duration of the disease, and associated pathology.

  15. Surgical Treatment of Facial Paralysis

    PubMed Central

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (<3 weeks duration), intermediate duration facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy. PMID:19434284

  16. Surgical mortality score: risk management tool for auditing surgical performance.

    PubMed

    Hadjianastassiou, Vassilis G; Tekkis, Paris P; Poloniecki, Jan D; Gavalas, Manolis C; Goldhill, David R

    2004-02-01

    Existing methods of risk adjustment in surgical audit are complex and costly. The present study aimed to develop a simple risk stratification score for mortality and a robust audit tool using the existing resources of the hospital Patient Administration System (PAS) database. This was an observational study for all patients undergoing surgical procedures over a two-year period, at a London university hospital. Logistic regression analysis was used to determine predictive factors of in-hospital mortality, the study outcome. Odds ratios were used as weights in the derivation of a simple risk-stratification model-the Surgical Mortality Score (SMS). Observed-to-expected mortality risk ratios were calculated for application of the SMS model in surgical audit. There were 11,089 eligible cases, under five surgical specialties (maxillofacial, orthopedic, renal transplant/dialysis, general, and neurosurgery). Incomplete data were 3.7% of the total, with no evidence of systematic underreporting. The SMS model was well calibrated [Hosmer-Lemeshow C-statistic: development set (3.432, p = 0.33), validation set (6.359, p = 0.10) with a high discriminant ability (ROC areas: development set [0.837, S.E.=0.013] validation set [0.816, S.E. = 0.016]). Subgroup analyses confirmed that the model can be used by the individual specialties for both elective and emergency cases. The SMS is an accurate risk- stratification model derived from existing database resources. It is simple to apply as a risk-management, screening tool to detect aberrations from expected surgical outcomes and to assist in surgical audit.

  17. Surgical innovation: the ethical agenda

    PubMed Central

    Broekman, Marike L.; Carrière, Michelle E.; Bredenoord, Annelien L.

    2016-01-01

    Abstract The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges. To answer the question “What are the main ethical aspects of surgical innovation?”, we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers. We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure. We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health

  18. Aesthetic comparison between synthetic glue and subcuticular sutures in thyroid and parathyroid surgery: a single-blinded randomised clinical trial.

    PubMed

    Alicandri-Ciufelli, M; Piccinini, A; Grammatica, A; Molteni, G; Spaggiari, A; DI Matteo, S; Tassi, S; Ghidini, A; Izzo, L; Gioacchini, F M; Marchioni, D; DI Saverio, S; Presutti, L

    2014-12-01

    The aim of our study was to compare, in terms of aesthetic results, the use of synthetic glue to intradermal absorbable sutures in postthyroidectomy and parathyroidectomy wound closure in a single blinded, randomised, per protocol equivalence study. From September 2008 to May 2010, patients undergoing thyroid or parathyroid surgery (with an external approach) at the Otolaryngology Department of the University Hospital of Modena were assessed for eligibility. In total, 42 patients who had had synthetic glue application on surgical incisions (A) and 47 patients who had subcuticular sutures on their surgical incisions (B) were enrolled. The mean of the endpoint (based on the Wound Registry Scale) of group A at 10 days was 1.4, while that in group B (based on the Stony Brook Scar Evaluation Scale) was 2.9. Statistically significant (p = 0.002) and clinically significant (difference of the means = 1.5) differences in the aesthetic results were found between groups A and B at 10 days, with better results in group B. On the other hand, at 3 months, the mean of the endpoint in group A was 3.1 while that in group B was 2.8; no statistically significant (p = 0.62) or clinically significant (difference in means = 0.3) differences were found between groups A and B. In conclusion, synthetic glue differs from subcuticular suture in post-thyroidectomy or post-parathyroidectomy incision for early aesthetic results, with better outcomes for subcuticular sutures. At 3 months, there were no differences in aesthetic outcomes between groups. Moreover, sex, incision length, age, cold/hot blade and correspondence of the incision with a wrinkle in the skin did not seem to influence aesthetic outcomes with this type of incision.

  19. Loop Electrosurgical Excision Procedure (LEEP)

    MedlinePlus

    ... that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away ... A procedure in which an instrument works with electric current to destroy tissue. Local Anesthesia: The use of ...

  20. [Stomata--surgical standards].

    PubMed

    Wagner, M; Malayeri, V; Seiler, C A; Candinas, D

    2003-01-01

    The placement of an intestinal stoma is still a common procedure despite the recent advantages in intestinal surgery. It is mandatory to apply meticulously sound surgical principles in order to achieve good results. Nevertheless, intestinal stomas are envisioned with a high perioperative morbidity which is mostly caused by surgical inadequacy. This can lead to considerable problems in management of the stoma in the long term and ultimately will affect quality of life of the patient. The cumulative morbidity can be given by 50% with prolaps, hernia, stenosis and necrosis as well as stoma retraction being the most relevant. In contrast, an adequate intestinal stoma will positively affect the quality of life of the patient. The availability of devices developed by the industry and the inauguration of a professional service in certain hospitals simplified the management of patients with a stoma. This significantly improved the standards of care especially regarding preoperative preparation and postoperative management. Thus, most patients are able to maintain an active and socially integrated life with minimal physical and psychical limitations.