Transconjunctival blepharoplasty.
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Conjunctiva↗
Biomedical subjects
R Ellenbogen
Publications and source records attributed to R Ellenbogen.
Alar rim raising.
The relationship of the alar rim to columella visibility and nostril proportion is crucial to a good aesthetic result. The alar rim has been a neglected part of the nose in primary and secondary rhinoplasty procedures for want of a natural contouring operation. Results of directly excising the alar rim and its indications are presented with adequate follow-up. Indications for the procedure include (1) recontouring of the cleft lip nose with anterior webbing, (2) equalizing asymmetrical nostrils, (3) enlarging small nostrils, (4) correcting a hanging (sigmoid) ala, and (5) converting round to oval nostrils.
Adult↗
Avoiding visual tipoffs to face lift surgery. A troubleshooting guide.
As aesthetic surgeons we should look more closely at our finished products. A visible scar, distorted ear lobe or tragus, or unnatural hairline says "face lift" to a patient's friends and creates a self-conscious, unhappy patient. The modifications I have adopted of accepted techniques give a more natural look and less conspicuous scarring. They avoid the most dreaded question a patient's associates may ask: "Have you had a face lift?" The text outlines the areas where tipoffs are most prevalent and makes suggestions to minimize them. It is impossible to do inconspicuous surgery all the time, but it is possible by careful observation to minimize visual tipoffs. An unnatural tragus or bad scar should be considered as severe a complication as nerve damage. We should use as proficient avoidance techniques for one as for the other.
Humans↗
Curette fat sculpture in rhytidectomy: improving the nasolabial and labiomandibular folds.
The nasolabial and labiomandibular folds develop with facial aging by an anterior caudal descent of the fat prominences of the same name. Young patients with minimal folding can be corrected by substances inserted in the fold; however, this and other techniques have failed satisfactorily to improve the folds naturally and permanently. Identification of the prominences and removal of the fat superficial to the skin by curettes have proven safe and effective and superior to fat suction. Complications include small hematomas and visible depressions in the sculpted areas. There was no nerve or skin injury. Follow-up of this technique (an improvement of a previous technique) is 3 1/2 years.
Adipose Tissue↗
Autologous fat injection.
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Adipose Tissue↗
myc gene amplification and expression in primary human neuroblastoma.
Although N-myc amplification in neuroblastomas correlates with poor prognosis, not all neuroblastomas which fail to respond to therapy have N-myc amplification. To determine whether other modes of myc gene activation underlie progression of some neuroblastomas, 45 were analyzed for amplification of N-myc, c-myc and L-myc and 26 were studied for transcription of these oncogenes. N-myc amplification was found in 6 of 45 tumors; no tumor had amplification of c-myc or L-myc. Transcription of both N-myc and c-myc occurred in 21 of 26 neuroblastomas. No tumor without N-myc amplification had a level of N-myc expression near that of a tumor or cell line with amplification. One tumor with N-myc amplification was the only specimen with N-myc but not c-myc expression. Five samples had c-myc but not N-myc expression; all had histological features of ganglioneuroma. DNA index did not correlate with myc gene amplification or expression. It is concluded that N-myc and c-myc are commonly expressed in primary untreated neuroblastomas, but in the absence of N-myc amplification, expression of these genes does not appear to correlate with disease progression.
Adolescent↗
Tissue expansion for rhytidectomy.
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Humans↗
Achieving standardized photographs in aesthetic surgery.
The plastic surgeon who wishes to share clinical experience with colleagues is obligated to produce accurate data in the form of photographs. Moreover, accurate photographs are essential to enable an objective critical appraisal of one's own surgical skill and to display postoperative results to patients in an unbiased fashion. Change should not be a function of either the photograph or the photographer. The use of an acetate screen grid in conjunction with anatomic boundaries is described as a means to achieve accurate, reproducible standard photographs of the face and body in aesthetic surgical patients.
Acetates↗
Kluver-Bucy syndrome following recovery from transtentorial herniation.
Kluver-Bucy syndrome is an uncommon constellation of behavioral abnormalities resulting from bilateral temporal lobe damage. The syndrome is rare in humans. In this paper we present a patient who developed the Kluver-Bucy syndrome following recovery from an intracerebral haemorrhage and transtentorial herniation.
Adult↗
Stereotactic craniotomy: methods and results using the Brown-Roberts-Wells stereotactic frame.
Combining the power of stereotactic precision with open craniotomy in a stereotactic craniotomy technique decreases surgical time, morbidity, and postoperative hospitalization. Indications for its use are deep intrinsic masses 3.5 cm or less in diameter; small, superficial lesions otherwise difficult to localize; and lesions associated with motor, visual, or speech areas. Using the standard Brown-Roberts-Wells system allows a) precisely planned cortical entries, b) gross total lesion excisions under direct vision, c) use of probe-guided resection margins, d) small craniotomies through linear incisions, and e) use of local anesthetic alone for resections. The method and results of this universally available and relatively inexpensive technique are discussed in reference to 20 patients.
Adolescent↗
Studies on experimentally induced hyperphenylalaninemia.
The administration of several compounds that can increase plasma phenylalanine levels and/or inhibit phenylalanine hydroxylase in rats was studied in order to determine their usefulness in inducing a phenylketonuria-like state. The results of this investigation revealed that 4.5 microns/10 g p-chlorophenylalanine is more effective than L-phenylalanine, alpha-methylphenylalanine, trimethoprim, Bactrim and Septra, since the former compound produced both adequate hyperphenylalaninemia and marked inhibition of hepatic phenylalanine hydroxylase activity. In addition, a 24-h study provided important insights into the changing diurnal patterns of specified biochemical parameters.
Animals↗
Alar rim lowering.
A technique for the lowering of the alar rim is presented. The indications for this technique, originally presented by Meyer and Kesselring, have been expanded to other related nasal deformities, including the high-arched nostril, the asymmetrical nostril, the Mestizo nose, and the hanging columella, in which the surgeon feels that total nasal length should not be sacrificed. The technique consists of an incision parallel to the alar rim and an unfurling of the vestibular mucosa caudally. A cartilage graft from the septum, lowering lateral cartilage, or other source is placed between the two layers at the newly proposed alar height. Through-and-through sutures hold the graft and alar rim in place.
Female↗
Free autogenous pearl fat grafts in the face--a preliminary report of a rediscovered technique.
Free autogenous fat grafts between 4 and 6 mm (the size of a pearl) have been used successfully to correct pitting acne, nasolabial folds, eyelid depressions, facial atrophy, facial wrinkles, depressed scars, and in chin augmentation. Theoretical measures taken to ensure the maximum amount of survival of donor fat include exogenous vitamin E, treatment with insulin, small size of grafts, and atraumatic antiseptic technique. Numerous supportive clinical, historical, and laboratory references are cited, dating from 1893. Considering the abundance of fat tissue available and the prolific amounts discarded during blepharoplasty, liposuction, lipectomy, and platysma cervical lift, fat should be reconsidered as the soft tissue substitute. This is a preliminary report and further study is needed.
Adipose Tissue↗
Breast implant encapsulation in association with dental work.
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Breast↗
Male baldness: immediate single-stage rotation of very long arterialized temporo-parieto-occipital flaps.
Over a period of 5 years we have performed 62 rotations of long temporo-parieto-occipital flaps in a single stage without delay for both frontal and occipital male baldness. The technique and indications are reported and discussed. The good results obtained permit us to affirm that this surgical technique is safe, simple to perform, and rapidly effective. It has clear advantages over techniques involving delay, including guaranteed survival and vitality of the rotated flap, speedier execution, and few, if not minimal, complications.
Alopecia↗
The improvement of the gummy smile using the implant spacer technique.
A simple technique for correction of a gummy smile by partially transecting the levator labii superioris, the major lip elevator, and decreasing its cephalic excursion using an implant spacer is presented. Results are given for 21 patients, and 3 representative patients are discussed, in whom a silicone implant with maxillary augmentation with concomitant rhinoplasty; cartilage from the nasal septum with concomitant rhinoplasty; and a silicone implant independent of rhinoplasty without maxillary augmentation were utilized.
Adult↗
A technique for the closure of small septal perforations.
The small septal perforation has been a particular problem with regard to its symptoms. One author even recommended its conversion into a large septal perforation to decrease the symptoms. A simple technique using autologous nasal cartilage is presented in 4 cases with follow-up for one year.
Cartilage↗