WorldWideScience
 
 
1

The Tutopatch graft for transcanal myringoplasty.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This article describes the technique and the preliminary results of transcanal myringoplasty for small or midsized tympanic membrane perforations with the Tutopatch (Tutogen Medical, Inc., Alachua, FL, USA), a xenograft derived from bovine pericardium. METHODS: All procedures started with a Rosen incision. The meatal skin was loosened from the bone up to the fibrous annulus, which was dislocated out of the sulcus, and the tympanic membrane was elevated from the malleus handle. The Tutopatch was placed over the malleus handle, the annulus, and the denuded bone. RESULTS: Eleven patients were included, and follow-up ranged from 3 to 14 months. Ten of the eleven eardrums were successfully closed. One patient developed myringitis 2 months after the procedure. The average air-bone gap at 0.5, 1, 2, and 4 kHz, of all but one patient was less than 10 dB. CONCLUSION: When anatomically feasible, a transcanal myringoplasty with a Tutopatch graft yields similar audiological results compared to fascia temporalis, perichondrium or tragal perichondrium-cartilage, but reduces the surgical trauma, the complications of the autograft harvesting, and the negative cosmetic and psychological impact of this procedure.

Gérard JM; Gersdorff M

2006-01-01

2

Utilization of CO(2) laser for temporal fascia graft welding in myringoplasty: an experimental study on guinea pigs.  

UK PubMed Central (United Kingdom)

UNLABELLED: An experimental study was undertaken to investigate the use of a CO(2) laser welding technique in myringoplasty. Albumin solder was used to fix a temporal fascia graft via an overlay transcanal approach. The results of the operative procedure were assessed by microscopic and histopathologic examination over an interval of 1, 2, 3 and 4 weeks postoperatively. MATERIALS AND METHODS: Forty-eight adult guinea pigs were divided into two groups after permanent perforation of the tympanic membrane was created: laser-assisted myringoplasty group and surgical myringoplasty group. Laser beam power was 0.4 W, pulse duration 0.75 s, pulse interval 0.1 s and spot size 250 microm. Each experimental group was further subdivided into four subgroups of 6 animals each. Histological and microscopic findings of the tympanic membrane for both groups after 1, 2, 3, and 4 weeks were compared. RESULTS: Microscopic examination of the tympanic membrane showed high success rate in the laser-assisted myringoplasty group compared to the control group. Histological evaluation for the tympanic membrane showed complete repair of the tympanic membrane in the laser-assisted myringoplasty group. CONCLUSION: Laser-assisted myringoplasty using CO(2) might be a promising new method in surgical myringoplasty.

Youssef TF; Ahmed MR; Kassab AN

2010-01-01

3

Myringoplasties in children: our results.  

UK PubMed Central (United Kingdom)

INTRODUCTION AND OBJECTIVES: Myringoplasty, one of the most frequent surgical techniques in otology, is the repair of tympanic membrane when the ear has only a perforation without any ossicular damage. The main objective of our work was to study the outcome of myringoplasty in patients less than 15 years of age. We also reviewed the existence of prognostic factors, such as Eustachian tube functionality, surgical technique and the hearing outcome after surgery. METHOD: We present a retrospective study (1994-2010) with a total of 81 children (under 15 years of age) who had undergone myringoplasty during that period of time. For these children, we analysed age, sex, technique, approach, type of graft, type of perforation, anaesthesia, hearing gain and perforation closure. We correlated these variables with the success of the surgery. RESULTS: The percentage of closure was 84% (n=68). The techniques used were underlay in 79.01% (n=64), overlay in 11.11% (n=9) and sandwich in 9.87% (n=8). The percentage of patients with hearing improvement was 88.40% (n=61). CONCLUSION: Myringoplasty is a surgical technique that offers good anatomical and functional results in children. We did not find prognostic factors in our study. We found postoperative improvement of hearing but it was not statistically significant.

Castro O; Pérez-Carro AM; Ibarra I; Hamdan M; Meléndez JM; Araujo A; Espiña G

2013-03-01

4

Cyanoacrylate in myringoplasty - an office based procedure  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Graft failure continues to be a problem for surgery of the perforated eardrum. We present our experience of six cases managed using commercially available superglue (cyanoacrylate) for myringoplasty. This method is simple, office based, less time consuming and cost effective. An insulin syringe was ...

Albert, R. R. A.; Job, A.

5

Success rate of myringoplasty at Groote Schuur Hospital  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVES: The aim of this study was to determine the success rate of myringoplasty surgery performed at Groote Schuur Hospital and to evaluate some of the presumed prognostic factors. DESIGN: The study design was a retrospective analytical cohort. SETTING: Groote Schuur Hospital (tertiary medical centre), Cape Town. SUBJECTS: This study assessed the success rate of 341 myringoplasty operations performed by surgeons in the Department of Otolaryngology from January 2005 t (more) o December 2009. OUTCOME MEASURES: An unsuccessful operation was classified as a residual perforation seen at the 3-month follow-up visit that remained present at all subsequent visits. Presumed prognostic factors such as the rank of the surgeon, size of the perforation, location of the perforation, graft used and whether it was a revision procedure, were also evaluated. Where possible, the audiometric gain following surgery was calculated. RESULTS: The overall success rate in terms of an intact tympanic membrane following myringoplasty was 71%. The average improvement in pure tone average following myringoplasty was 12.4 dB. In 64% of patients, socially acceptable hearing levels were present postoperatively (air-conduction of less than 30 dB). None of the presumed prognostic factors was a statistically significant determinant (p>0.05). CONCLUSION: The success rate for myringoplasty (in terms of perforation closure) of 71% at Groote Schuur Hospital compares well with that quoted in the literature. There is no ethical dilemma from a surgical outcomes perspective of registrars performing myringoplasties.

Becker, Juanita; Lubbe, Darlene

2011-10-01

6

Success rate of myringoplasty at Groote Schuur Hospital.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The aim of this study was to determine the success rate of myringoplasty surgery performed at Groote Schuur Hospital and to evaluate some of the presumed prognostic factors. DESIGN: The study design was a retrospective analytical cohort. Setting. Groote Schuur Hospital (tertiary medical centre), Cape Town. Subjects. This study assessed the success rate of 341 myringoplasty operations performed by surgeons in the Department of Otolaryngology from January 2005 to December 2009. OUTCOME MEASURES: An unsuccessful operation was classified as a residual perforation seen at the 3-month follow-up visit that remained present at all subsequent visits. Presumed prognostic factors such as the rank of the surgeon, size of the perforation, location of the perforation, graft used and whether it was a revision procedure, were also evaluated. Where possible, the audiometric gain following surgery was calculated. RESULTS: The overall success rate in terms of an intact tympanic membrane following myringoplasty was 71%. The average improvement in pure tone average following myringoplasty was 12.4 dB. In 64% of patients, socially acceptable hearing levels were present postoperatively (air-conduction of less than 30 dB). None of the presumed prognostic factors was a statistically significant determinant (p>0.05). CONCLUSION: The success rate for myringoplasty (in terms of perforation closure) of 71% at Groote Schuur Hospital compares well with that quoted in the literature. There is no ethical dilemma from a surgical outcomes perspective of registrars performing myringoplasties.

Becker J; Lubbe D

2011-10-01

7

Sepsis after autologous fat grafting.  

UK PubMed Central (United Kingdom)

Autologous fat grafting is an increasingly popular technique, with numerous examples of excellent results. Adherence to key principles, including sterile technique and low-volume injection throughout layers of tissue, appears to be critical to obtaining good results. Reports of adverse outcomes are infrequent, but several case reports document both infectious and aesthetic complications. This case report represents an extreme complication, including abscess formation, life-threatening sepsis, and residual deformity. It serves as yet another reminder that early adoption of surgical procedures by those without a sound understanding of the underlying principles and techniques can have disastrous consequences. Furthermore, physicians operating on any patient must understand the potential for complications and be able to manage these appropriately when they occur.

Talbot SG; Parrett BM; Yaremchuk MJ

2010-10-01

8

[Integrated autologous fat graft in face recontouring].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To discuss the integrated autologous fat graft technique in face recontouring. METHODS: In this study we treated 83 cases of face recontouring with 3L3M technique (low pressure suction, low speed centrifugation, low volume, multi-plane, multi-tunnel, multi-point injection). Each case was treated 1-3 times and the interval period is 3-6 months. The result was based on comparing the photos taken from pre-operation and post operation, observing the expression recovery, cysts, local absorption, and patients self evaluation. RESULTS: Long time follow up showed that fat graft can be alive in the recipient site for long time after 1-3 times autologous fat injection. More than 73.5% patients were satisfactory with the curative effect while less than 4.8% patients were unsatisfactory. CONCLUSION: 3L3M integrated fat graft technique is an effective and safe treatment in face recontouring.

Xie Y; Zheng DN; Liu K; Gu B; Li QF

2010-05-01

9

[Aesthetic gluteal remodeling by fat grafting].  

UK PubMed Central (United Kingdom)

INTRODUCTION: The most common surgical techniques performed for gluteal augmentation employ gluteal implants. Gluteal augmentation is today a consultation request for many patients. The results can be interesting, but this surgical procedure can provide some complications. Fat grafting is reliable technique to remodel the buttocks. The aim of this study is to describe our experience for buttocks remodeling with fat grafting. METHODS AND TECHNIQUE: A prospective study has been performed, including patients that have been operated for buttocks remodeling with fat grafting in our department during one year. We have recorded the average age and body mass index of each patient, the total volume transferred for each patient, and the postoperator complications (infection, hemorrhage, seroma, fat embolism). The end result was evaluated by the patient and the surgical team using four criteria: very satisfying, satisfying, fair and poor. RESULTS: A prospective study including 24 cases of buttocks remodeling corrected with fat grafting. The average age was 43 years (30 to 65 years) and the average body mass index was 20.4 (18 to 24,2). The average volume transferred for each patient was 280cm(3) (from 140 to 440cm(3)). The patients and the surgical team were very satisfied or satisfied in 87,5% of cases. In this series we had no complications (infection, hemorrhage, fat embolism). We only had one seroma. CONCLUSION: Fat grafting is a reliable technique, simple and safe procedure. Fat grafting is an excellent indication for moderate buttocks remodeling. Surgery for correction of the buttocks may involve more than projection and volume. However, these must be in a balanced proportion with the rest of the body.

Ho Quoc C; Mojallal A; Delay E

2013-06-01

10

Autologous fat grafting viability: lower third of the face.  

UK PubMed Central (United Kingdom)

The process of aging is the result of subcutaneous loss of volume, in addition to vertical tissue descent. Surgeons are therefore emphasizing soft tissue augmentation to achieve a natural, rejuvenated appearance in patients. Autologous fat grafting is now a commonly performed aesthetic procedure. Autologous fat grafting is a challenging procedure, due to the fragile characteristic of adipose tissue. Viability of transplanted fat is a main consideration when fat grafting is performed. Poor fat viability produces an inadequate result and thus can be considered as a complication of this procedure. Many studies have demonstrated that fat longevity is dependent upon handling and preparation of fat. This article outlines the history of autologous fat grafting. The technique of fat grafting is described, along with review of the evidence of fat viability according to the technique used. The specific technique for autologous fat grafting in the lower third of the face is described including augmentation of the labiomandibular fold, lips, chin, and the jaw.

Sykes JM; Tapias V; Pu LL

2010-10-01

11

The effect of hyaluronan hydrogel on fat graft survival.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat transplantation is a common technique for soft tissue augmentation in aesthetic and reconstructive surgery; however, the degree of fat graft take can be unpredictable. Hyaluronan has been shown to be a promising cell carrier in adipose tissue engineering. OBJECTIVES: The authors investigate the effect of a hyaluronan hydrogel on fat graft survival, angiogenesis, and volume maintenance in a rat model. METHODS: Fat was harvested from the groins of 27 rats, processed, and injected beneath the animals' dorsums to form 2 grafts: 1 containing fat alone and 1 containing fat and hyaluronan hydrogel in a 1:1 mix (fat-HA). The grafts were scanned in vivo under high-resolution computed tomography at baseline and prior to euthanasia at 4, 12, and 20 weeks to measure total fat-HA graft volume as well as the volume of the fat component alone. Histological studies were performed after sacrifice to evaluate fat necrosis and blood vessel density. RESULTS: All grafts were clinically viable. Overall, fat necrosis was significantly reduced in the fat-HA grafts compared with the grafts containing fat alone (P < .001). This difference was most profound at 4 weeks (P = .008) but did not reach statistical significance at 12 and 20 weeks. At 12 weeks, blood vessel density in the fat-HA grafts was significantly greater than in the grafts containing fat alone (P = .016), but this did not reach statistical significance at 4 or 20 weeks. At 20 weeks, the fat component of the fat-HA graft had significantly less volume loss than the fat-alone graft (P = .008). CONCLUSIONS: When mixed with fat, hyaluronan hydrogel can improve early fat graft survival and may enhance vascularity and prolong volume maintenance.

Alghoul M; Mendiola A; Seth R; Rubin BP; Zins JE; Calabro A; Siemionow M; Kusuma S

2012-07-01

12

A STUDY ON EFFICACY OF AUTOLOGOUS PLATELET RICH PLASMA IN MYRINGOPLASTY  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To study the efficacy and advantage in using autologus platelet rich plasma during myringoplasty in closure of tympanic membrane perforation preventing the graft displacement, promoting quicker healing & improving overall outcome.Methods : Platelet rich plasma(PRP) is an autologus platelet rich concentrate prepared from patients own blood with growth factors up to 8 times that of normal serum and its efficacy when used during myringoplasty is studied.50 patients with chronic otitis media inactive mucosal disease were randomly chosen and 25 of them was the study group and other 25 were the control group. Both group patients underwent myringoplasty and PRP was used in the study group and the results were evaluated.Results: In our study among 25 cases that underwent myringoplasty with use of platelet rich fibrin, 24 had complete tympanic membrane closure and only one failure has been noticed. In controls 5 out of 25 cases had failure. The graft take up rate in our study is comparable with the reference studies. Use of PRP accelerates graft uptake.Conclusion: Platelet rich plasma is a cheap and cost effective platelet concentrate with enriched growth factors. It accelerates the tympanic membrane closure following myringoplasty.

Sankaranarayanan Gopalakrishnan; Prithviraj Venkatasamy; Kumar Vivekanandamurthy

2013-01-01

13

Autologous fat grafting in secondary breast reconstruction.  

UK PubMed Central (United Kingdom)

Autologous fat grafting has become a common technique for revisional breast surgery. The purpose of this series is to review our experience with fat grafting for the correction of acquired breast deformities. A retrospective review was performed on 107 patients with a history of breast cancer between 1996 and 2010, who had autologous fat grafting at the time of secondary breast reconstruction. The indications were for improvement in contour, shape, and volume of the breast following transverse rectus abdominis myocutaneous (TRAM) flap reconstruction (n = 55), latissimus dorsi with or without implant (n = 20), implant reconstruction (n = 20), and breast conservation therapy deformity (n = 12). The average volume of injection was 40 mL (range, 5-150 mL), the most common location being upper and medial quadrants. Fat was harvested mainly from the abdomen, thighs, and flanks. Complications occurred in 11% of the patients, and included fat necrosis, erythema, keloid scarring, and pain. Complications were higher when performed with implant reconstructions. Repeat fat injection was performed in 25% (n = 27/107), which increased with the length of follow-up. Patients with a history of radiation therapy had an increased incidence of repeat injections (36% vs. 18%). Patients with >6 months follow-up reported an improvement of about 83%. Autologous fat grafting is a safe and effective tool for secondary breast reconstruction. It is helpful in all types of reconstructions to improve contour, volume, and overall breast shape and symmetry. Repeat injections are often required and this is more common in patients with longer follow-up and in those with a history of radiation therapy. The popularity of this approach in reconstructive breast surgery will likely continue to increase.

Losken A; Pinell XA; Sikoro K; Yezhelyev MV; Anderson E; Carlson GW

2011-05-01

14

Intrasellar fat graft gains weight with the patient: imaging features.  

UK PubMed Central (United Kingdom)

We describe a 56-year-old man with an intrasellar craniopharyngioma who underwent transphenoidal resection and abdominal fat grafting of the dural opening. Follow-up MRI showed hypertrophy of the sellar fat graft concurrent with the patient's weight gain. To our best of knowledge sellar fat graft hypertrophy has not been reported before.

Anis KH; Sossa DE; Sossa DG; Castillo M

2013-06-01

15

Autologous fat grafting and facial reconstruction.  

Science.gov (United States)

There is tremendous interest in autologous fat grafting for the management of soft tissue volume deficiencies, treatment of cutaneous injuries, and regeneration of missing parts. Given its relative abundance and proximity to the surface of the skin, adipose tissue seems an excellent choice for the treatment of both congenital and acquired soft tissue defects, but the mesenchymal stem cells contained within the fat may provide unexpected opportunities for tissue replacement and repair. Although adipose transfer has been successfully used for reconstructive purposes since the end of the 19th century, numerous controversies about adipose harvesting, processing, delivery, survival, and efficacy still persist today. The purpose of this article was to highlight current practices, areas of controversy, and near-term future applications of fat grafting for reconstruction of the face. PMID:22337433

Wetterau, Meredith; Szpalski, Caroline; Hazen, Alexes; Warren, Stephen M

2012-01-01

16

Autologous fat grafting and facial reconstruction.  

UK PubMed Central (United Kingdom)

There is tremendous interest in autologous fat grafting for the management of soft tissue volume deficiencies, treatment of cutaneous injuries, and regeneration of missing parts. Given its relative abundance and proximity to the surface of the skin, adipose tissue seems an excellent choice for the treatment of both congenital and acquired soft tissue defects, but the mesenchymal stem cells contained within the fat may provide unexpected opportunities for tissue replacement and repair. Although adipose transfer has been successfully used for reconstructive purposes since the end of the 19th century, numerous controversies about adipose harvesting, processing, delivery, survival, and efficacy still persist today. The purpose of this article was to highlight current practices, areas of controversy, and near-term future applications of fat grafting for reconstruction of the face.

Wetterau M; Szpalski C; Hazen A; Warren SM

2012-01-01

17

Autologous fat graft in postmastectomy pain syndrome.  

UK PubMed Central (United Kingdom)

BACKGROUND: Mastectomy with axillary dissection is still one of the most common procedures in oncologic surgery. Unfortunately, a condition of neuropathic pain, termed postmastectomy pain syndrome, can appear after mastectomy. Although evidence regarding the epidemiology of postmastectomy pain syndrome is well researched, an effective therapy is still unknown. The aim of this study was to assess the clinical effectiveness of lipoaspirate graft in the treatment of postmastectomy pain syndrome. METHODS: From February of 2006 to August of 2008, a total of 113 patients affected by postmastectomy pain syndrome and severe scar retractions were enrolled for this clinical study. Seventy-two patients were treated with autologous fat grafted in painful scars, and 41 patients did not undergo any further surgical procedure. Pain assessment was performed using a visual analogue scale before and after treatment, with a mean follow-up of 13 months. In addition, antalgic drug intake was recorded in the 34 patients who received a surgical treatment. Results were analyzed using the Wilcoxon rank sum test. RESULTS: A significant decrease in pain according to the visual analogue scale was detected in patients treated with autologous fat graft (3.23-point reduction, p = 0.0005). Twenty-eight of 34 patients stopped their analgesic therapy with a significant follow-up (13 months). CONCLUSIONS: Autologous fat grafting is a safe, relatively noninvasive, and rapid surgical procedure. The authors' results suggest its effectiveness for treatment of postmastectomy pain syndrome. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Caviggioli F; Maione L; Forcellini D; Klinger F; Klinger M

2011-08-01

18

Adipose-derived regenerative cell (ADRC)-enriched fat grafting: optimal cell concentration and effects on grafted fat characteristics.  

UK PubMed Central (United Kingdom)

BACKGROUND: To overcome the absorption of traditional fat grafting, techniques for adipose-derived regenerative cell (ADRC)-enriched fat grafting are currently being adapted for practical application. The Celution(R)800/CRS (Cytori Therapeutics, San Diego, CA) has enabled rapid grafting of the patient's own freshly harvested ADRCs without requiring a culturing step. However, the optimal cell concentration and the effects of ADRCs on the characteristics of grafted fat after free fat grafting remain unclear. METHODS: ADRCs were isolated and purified from human fat tissue using the Celution(R)800/CRS. Animals that received fat grafting without the addition of ADRCs were designated the control group (group A). The number of ADRCs per grafted fat volume (mL) was adjusted to 3 x 105, 1.5 x 106, and 3 x 106 cells/mL (groups B, C, and D, respectively), mixed with free fat, and transplanted as ADRC-enriched fat grafting. These mixtures were transplanted subcutaneously into BALB/C Jcl-nu/nu mice. The volume of grafted fat was determined 5 months after transplantation, and histological assessments were performed. RESULTS: ADRC-enriched fat grafting resulted in decreased fat absorption and the formation of greater numbers of new blood vessels in the grafted fat. The optimal ADRC concentration in this study was found to be 3 x 105 cells/mL (group B), with higher concentrations resulting in increased cyst and fibril formation in the grafted fat. CONCLUSIONS: This study used the Celution(R)800/CRS for free fat grafting and demonstrated that the concentration of transplanted ADRCs affected the engraftment and quality of the grafted fat.

Kakudo N; Tanaka Y; Morimoto N; Ogawa T; Kushida S; Hara T; Kusumoto K

2013-10-01

19

Towards more rationalized approach to autologous fat grafting.  

UK PubMed Central (United Kingdom)

BACKGROUND: Even though fat grafting has become widely used by plastic surgeons, most surgeons choose their method of fat grafting based almost entirely on anecdotal evidence. As more and more scientific studies appear in the literature, we now may have more objective, scientific evidence to support the use of specific techniques. METHODS: The author critically reviewed all studies related to fat grafting research in the last 20 years in the English literature. To better summarize the findings of the studies, the fat grafting procedure was arbitrarily divided into 4 essential parts to determine the best donor sites and how the fat grafts should be harvested, processed, and placed. RESULTS: While most studies show no difference in the viability of fat grafts harvested from different donor sites, one study shows that more adipose-derived stem cells (ADSCs) are found within the fat grafts harvested from the lower abdomen or inner thigh. Fat grafts harvested with syringe aspiration and processed with centrifugation at 1200 g for 3 min clearly have better viability. In addition, viable adipocytes and ADSCs as well as growth factors can be concentrated within the fat grafts after proper centrifugation. The studies also reinforce the principle that fat grafts, once placed, should have a maximal amount of contact with the vascularized tissue in the recipient site for better survival. CONCLUSIONS: Most scientific studies in fat grafting research support a more rationalized technique that should be selected by surgeons for fat grafting. The technique includes proper selection of donor sites, proper harvest and process of fat grafts, and proper placement of fat grafts.

Pu LL

2012-04-01

20

Autologous fat graft in scar treatment.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Regenerative medicine is an emerging and rapidly evolving field of research and therapy, thanks to new discoveries on stem cells. Adipose tissue is a connective tissue which contains a reserve of mesenchymal stem cells. Clinical improvements in trophic characteristics of teguments after autologous fat graft are well described in literature. In this paper, we present our observation after 6 years of autologous fat graft experience in scar remodeling. MATERIALS AND METHODS: All patients recruited had retractile and painful scars compromising the normal daily activity/mobility of the joint involved. We performed surgical procedure with Coleman technique. In 20 patients, we performed a clinical assessment using Patient and Observer Scar Assessment Scale (POSAS) and Durometer measurements. RESULTS: In all treated scars, a qualitative improvement was shown both from an aesthetic and functional point of view. Most importantly, reduction or complete resolution of pain and increases in scar elasticity were objectively assessable in all cases. In patients studied using Durometer and POSAS score, areas treated with autologous fat graft showed statistically significant reduction in hardness measurements in comparison with areas infiltrated with saline solution. POSAS scores showed a statistically significant reduction of a great deal of POSAS parameters as a result of an improvement of both clinical evaluation and patient perception. CONCLUSIONS: Injection of processed autologous fat seems to be a promising and effective therapeutic approach for scars with different origin such as burns and other trauma scars, and post-surgery and radiotherapy outcomes. In general, we can affirm that treated areas regain characteristics similar to normal skin, which are clinically objectivable, leading not only to aesthetic but also functional results.

Klinger M; Caviggioli F; Klinger FM; Giannasi S; Bandi V; Banzatti B; Forcellini D; Maione L; Catania B; Vinci V

2013-09-01

 
 
 
 
21

Tuberous breast correction by fat grafting.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Tuberous breast is a rare malformation that has negative physical and psychological impacts during puberty. A range of surgical techniques has been used to correct breast shape and volume in this context, including a combination of skin plasty and mammary gland remodeling, as well as prostheses and locoregional flaps. The authors have used fat grafting as a complementary technique to correct tuberous breasts since 1998. OBJECTIVES: The authors discuss application of their lipomodeling technique for correction of tuberous breast deformity. METHODS: The charts of tuberous breast patients treated consecutively over an 11-year period (n = 31) solely with fat grafting (ie, without using an implant) were retrospectively reviewed. Each breast deformation was graded according to the Grolleau classification. The number of sessions and the mean transfer of fat volume by lipomodeling session were recorded. Patient and surgeon satisfaction were evaluated. RESULTS: Of the 31 patients in this series, 18 had bilateral formations and 13 had unilateral malformations. The mean patient age was 23 years, and the mean body mass index was 21.9. A single session (mean transfer volume, 158 mL; range, 90-253 mL) was required in 14 (45%) cases. A second session (mean transfer volume, 226 mL; range, 100-316 mL) was necessary in the remaining 55% of cases. Mean follow-up period after the last fat transfer session was 6.5 years (range, 1.5-11 years). Patients were very satisfied in 94% of cases (n = 29) and satisfied in 6% (n = 2). The surgical team rated 94% of cases as being successful or very successful. No complications were observed. One patient developed hypertrophy of the treated breast following weight gain and thus required breast reduction. Imaging performed preoperatively and 1 year postoperatively did not reveal any anomalies other than oil cysts. CONCLUSION: Fat grafting is a reliable technique that produces excellent results and high levels of patient satisfaction for the treatment of tuberous breast. The aesthetic outcome is natural, implant free, and long lasting. Level of Evidence: 4.

Delay E; Sinna R; Ho Quoc C

2013-05-01

22

Facial fat grafting: the search for predictable results.  

Science.gov (United States)

Since the majority of volume loss to the face is due to fat atrophy, autologous fat grafting with living fat cells represents the ideal tissue replacement. Recent technical improvements have led to excellent results utilizing fat grafting for cosmetic and reconstructive indications. The purpose of this article is to describe our clinical and laboratory experience with successful facial fat grafting for volume augmentation. Our laboratory experience with facial fat grafting centers around the results of multiple studies utilizing a nude mouse model of facial fat transplantation. Armed with the knowledge gained from our laboratory experience we present modified techniques to optimize fat grafting in the clinical setting. Furthermore, we present the results of several clinical studies examining a variety of recipient sites including nasolabial folds, glabella, lips, and lower eyelids. Lastly we describe our experience utilizing fat grafting to treat patients with hemifacial atrophy. When utilized in the appropriate areas, facial fat grafting can provide long-lasting aesthetically superior replacement for the soft tissues lost through aging or disease. PMID:12739189

Kanchwala, Suhail K; Bucky, Louis P

2003-02-01

23

Sequelae of Fat Grafting Postmastectomy: An Algorithm for Management of Fat Necrosis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: Fat grafting is used to improve the reconstructed breast. Local recurrences following mastectomy present as palpable subcutaneous nodules; fat necrosis/oil cysts, a sequelae of fat grafting, also present as subcutaneous nodules. Our objective was to examine the frequency and factors assoc...

Doren, Erin L.; Parikh, Rajiv P.; Laronga, Christine; Hiro, Matthew E.; Sun, Weihong; Lee, Marie Catherine; Smith, Paul D.

24

Utilising silk fibroin membranes as scaffolds for the growth of tympanic membrane keratinocytes, and application to myringoplasty surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Chronic tympanic membrane perforations can cause significant morbidity. The term myringoplasty describes the operation used to close such perforations. A variety of graft materials are available for use in myringoplasty, but all have limitations and few studies report post-operative hearing outcomes. Recently, the biomedical applications of silk fibroin protein have been studied. This material's biocompatibility, biodegradability and ability to act as a scaffold to support cell growth prompted an investigation of its interaction with human tympanic membrane keratinocytes. METHODS AND MATERIALS: Silk fibroin membranes were prepared and human tympanic membrane keratinocytes cultured. Keratinocytes were seeded onto the membranes and immunostained for a number of relevant protein markers relating to cell proliferation, adhesion and specific epithelial differentiation. RESULTS: The silk fibroin scaffolds successfully supported the growth and adhesion of keratinocytes, whilst also maintaining their cell lineage. CONCLUSION: The properties of silk fibroin make it an attractive option for further research, as a potential alternative graft in myringoplasty.

Levin B; Redmond SL; Rajkhowa R; Eikelboom RH; Atlas MD; Marano RJ

2013-01-01

25

Fat grafting and stem cell enhanced fat grafting to the breast under oncological aspects - Recommendations for patient selection.  

UK PubMed Central (United Kingdom)

Reconstructive and aesthetic fat grafting has been introduced to the breast level over the last years. The safety of such procedures has so far not been completely clarified. The concept has now been refined to stem cell enhanced fat grafting. However beside the promise of using adult stem cells in terms of tissue rejuvenation and augmentation, scar treatment and reconstruction, the variance of adipose stem cell function - including angiogenetic, antiapoptotic, immunomodulatory, chemotactic and anti-scarring potential - raises new scepsis about oncological safety. Herein we reviewed experimental and clinical data on fat grafting and stem cell enhanced fat grafting addressing surgical promise and oncological concerns. Based on these data we suggest clinical criteria for patient selection undergoing fat grafting for aesthetic or reconstructive reasons based on their individual breast cancer risk.

Krumboeck A; Giovanoli P; Plock JA

2013-10-01

26

Adjunctive fat grafting to the upper lid and brow.  

UK PubMed Central (United Kingdom)

This discussion focuses primarily on lipoatrophy and periorbital deflation in relation to adjunctive fat grafting of the brow and upper eyelid. Like with all clinical information for cosmetic and reconstructive surgeons in this multidisciplinary review of rejuvenation of the brow and upper lid, the authors present anatomy, evaluation, patient expectations, technique, and complications - here, specifically in terms of fat grafting and its associated aspects of fat transfer and relocation and autologous fat, along with hyaluronic acid fillers. Fat harvest and preparation are also described in detail.

Collar RM; Boahene KD; Byrne PJ

2013-01-01

27

Adjunctive fat grafting to the upper lid and brow.  

Science.gov (United States)

This discussion focuses primarily on lipoatrophy and periorbital deflation in relation to adjunctive fat grafting of the brow and upper eyelid. Like with all clinical information for cosmetic and reconstructive surgeons in this multidisciplinary review of rejuvenation of the brow and upper lid, the authors present anatomy, evaluation, patient expectations, technique, and complications - here, specifically in terms of fat grafting and its associated aspects of fat transfer and relocation and autologous fat, along with hyaluronic acid fillers. Fat harvest and preparation are also described in detail. PMID:23186769

Collar, Ryan M; Boahene, Kofi D; Byrne, Patrick J

2012-09-13

28

[Autologous fat grafting in the breast: oncological implications].  

UK PubMed Central (United Kingdom)

Autologous fat grafting for breast is increasing dramatically. This fat injection needs accurate technical conditions, and shows very good and long-lasting clinical results. Nevertheless, in breast conservative treatment sequellae, fat injection could lead to difficulties in breast imaging, but also there is some concerns about the potential oncologic risks of these procedures.

Nizet JL; Gonzalez A; Peulen O; Castronovo V

2011-05-01

29

Cryopreservation of autologous fat grafts harvested with the Coleman technique.  

UK PubMed Central (United Kingdom)

The viability of fat grafts harvested with an established technique after cryopreservation remains unknown. This study was conducted in vitro to evaluate the viability of autologous fat grafts harvested with the Coleman technique and subsequently preserved with our preferred cryopreservation method. Eight adult females were enrolled in this study. In each patient, 10 mL of fat grafts were harvested with the Coleman technique by a single surgeon from the lower abdomen. In group 1, 5 mL of fresh fat grafts were mixed with cryoprotective agents and underwent cryopreservation with controlled slow cooling and fast rewarming. In group 2, 5 mL of fresh fat grafts without cryopreservation from the same patient served as a control. The fat graft samples from both groups were evaluated with trypan blue vital staining, glycerol-3-phophatase dehydrogenase assay, and routine histology. Viable adipocyte counts were found similar in both group 1 and group 2 (3.46 +/- 0.91 vs. 4.12 +/- 1.11 x 10/mL, P = 0.22). However, glycerol-3-phophatase dehydrogenase activity was significantly lower in group 1 compared with group 2 (0.47 +/- 0.09 vs. 0.66 +/- 0.09 u/mL, P < 0.001). Histologically, the normal structure of fragmented fatty tissues was found primarily in both groups. Our results indicate that autologous fat grafts harvested with the Coleman technique and preserved with our preferred cryopreservation method have a normal histology with near the same number of viable adipocytes as compared with the fresh fat grafts. However, those cryopreserved fat grafts appear to have a less optimal level of adipocyte specific enzyme activity compared with the fresh ones and thus may not survive well after they are transplanted without being optimized.

Pu LL; Coleman SR; Cui X; Ferguson RE Jr; Vasconez HC

2010-03-01

30

Treatment of chronic posttraumatic leg injury using autologous fat graft.  

UK PubMed Central (United Kingdom)

We present the results obtained in a case of a 20-year-old Caucasian woman with a posttraumatic injury "hard-to-heal" of the left leg treated using autologous fat graft. Considering our experience in treatment of chronic posttraumatic ulcers by autologous fat graft, we decided to use this surgical technique to induce a regenerative effect in this young patient. We have had complete wound closure with only a single surgical procedure after 1 month; after the second intervention of autologous fat graft we observed an improvement in the quality of the scar tissue. The patient satisfaction was excellent. The results were long lasting and remained virtually unchanged after 1 year.

Caviggioli F; Klinger FM; Vinci V; Cornegliani G; Klinger M

2012-01-01

31

Fat grafting: evidence-based review on autologous fat harvesting, processing, reinjection, and storage.  

UK PubMed Central (United Kingdom)

BACKGROUND: Over the past 20 years, there has been a dramatic increase in the use of autologous fat grafting to treat volume and contour defects in aesthetic and reconstructive surgery. It is generally accepted that fat grafting is safe, with good patient satisfaction. However, there are many procedural variations, and in terms of objective clinical effectiveness, the major disadvantage of this technique remains the unpredictable fat resorption rates and subsequent adverse events. Because of the rapidly evolving nature of this procedure, this review article provides an update on previous reviews by looking at the current evidence base regarding fat graft techniques and their effect on clinical outcome. METHODS: A systematic review of the scientific literature listed on PubMed was performed using 20 search terms focused on harvesting, processing, reinjection, and conservation of fat grafting. An evidence-based system was used to determine eligibility for clinical and preclinical studies. RESULTS: Thirty-seven articles were selected based on inclusion and exclusion criteria: five articles were clinical trials and 32 were experimental comparative studies examining human fat grafting. CONCLUSIONS: This systematic review revealed a lack of high-quality data despite the increase in fat grafting over the past 20 years. At present, there is no evidence that supports specific procedural standardization. Evidence-based studies that incorporate randomized controlled, prospective, multicenter trials are required to understand which factors influence positive fat grafting clinical outcomes.

Gir P; Brown SA; Oni G; Kashefi N; Mojallal A; Rohrich RJ

2012-07-01

32

Magnetic resonance imaging of autologous fat grafting  

International Nuclear Information System (INIS)

A 30-year-old female patient with isolated facial lipodystrophy underwent two sessions of fat injection. MR signals of injected fat at different injection ages were compared to native fat. Native T1 signal was smaller for transplant fat, probably due to a slightly lower fat content and/or fibrosis or due to higher perfusion. T2 signal of transplants was significantly higher than that of native fat. T1 post-contrast was also higher, and contrast uptake of transplanted fat increased slightly with transplant age, which could be explained by an increasing perfusion. This study demonstrates the differences and MR signal time changes of native and transplanted fat. (orig.)

2005-01-01

33

Magnetic resonance imaging of autologous fat grafting  

Energy Technology Data Exchange (ETDEWEB)

A 30-year-old female patient with isolated facial lipodystrophy underwent two sessions of fat injection. MR signals of injected fat at different injection ages were compared to native fat. Native T1 signal was smaller for transplant fat, probably due to a slightly lower fat content and/or fibrosis or due to higher perfusion. T2 signal of transplants was significantly higher than that of native fat. T1 post-contrast was also higher, and contrast uptake of transplanted fat increased slightly with transplant age, which could be explained by an increasing perfusion. This study demonstrates the differences and MR signal time changes of native and transplanted fat. (orig.)

Goehde, Susanne C.; Kuehl, Hilmar; Ladd, Mark E. [University Hospital Essen, Department of Diagnostic and Interventional Radiology, Essen (Germany)

2005-12-01

34

Correction of nasojugal groove with tunnelled fat graft.  

UK PubMed Central (United Kingdom)

BACKGROUND: Pronounced nasojugal sulcus (tear trough deformity) is a frequent and distressing symptom in aesthetic palpebral surgery. The sliding fat technique using the transcutaneous or transconjunctival approach has proven to be considerably useful in patients with clinically evident fat bags. In the absence of fat bags, commonly used techniques can lead to unpredictable (and frequently less than optimal) results. OBJECTIVE: The authors report their experience with correcting the nasojugal groove in the absence of palpebral fat bags by use of a one-piece, free fat graft as an alternative to autologous fat injections or the placement of alloplastic materials. METHODS: The authors conducted a retrospective study of a consecutive series of 34 patients (33 women and one man) between 42 and 57 years of age. In all cases, small, free fat grafts harvested from the medial fat compartment of the upper eyelid were placed precisely under the depression through two stab incisions in the suborbicularis plane, filling in the groove. RESULTS: Results were considered excellent in 24 out of the 34 patients. Results in the remaining 10 patients were rated as good, in most cases because of mild undercorrection. All patients expressed a high degree of satisfaction. Recovery time was very short and no eye or eyelid complications were observed. CONCLUSIONS: Correction of the nasojugal groove with a tunnelled fat graft causes minimal tissue trauma and allows exact placement of the graft. The upper palpebral fat has unique characteristics that render it an ideal graft material for correction of the nasojugal groove in patients with no concomitant lower fat bags. This procedure offers more predictable results and a lower incidence of adverse effects than more commonly used techniques.

de la Cruz L; Berenguer B; García T

2009-05-01

35

The effect of pressure and shear on autologous fat grafting.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fat grafting has become routine in plastic surgery because of low donor-site morbidity, a low complication rate, and fast recovery time. The optimal technique, however, has yet to be defined. Two critical variables are pressure and shear, both defined as force divided by area. In this study, the authors examined the effect of pressure and shear on human fat grafts in a nude mouse model. METHODS: For negative pressure, tumescent liposuction was performed on fresh panniculectomy specimens. Suction pressure was either -15 inHg or -25 inHg. Lipoaspirate was centrifuged at 1200 g and injected into the flanks of nude mice. For positive pressure, positive pressure was applied to lipoaspirate up to 6 atm for up to 3 minutes and then injected into nude mice. For shear stress, lipoaspirate was centrifuged at 1200 g for 3 minutes and then injected with a fast flow rate (3 to 5 cc/second) or slow flow rate (0.5 to 1 cc/second). After 4 weeks, the fat grafts were analyzed for weight and histology. RESULTS: For negative pressure, there were no differences in weight or histology with high versus low suction pressures. For positive pressure, application of positive pressures up to 6 atm for up to 3 minutes did not create a significant difference in graft weight or histology at 4 weeks. For shear stress, in vivo, a slow injection pressure yielded a 38 percent increase in weight (p < 0.001) compared with fast injection. Histology was similarly affected. CONCLUSIONS: Higher aspiration pressures up to -0.83 atm did not affect fat graft viability in vivo. Positive pressure up to 6 atm also did not affect fat graft viability. The degree of shear stress, which is a function of flow rate, did significantly affect fat graft viability. Fat grafts injected slowly with low shear stress significantly outperformed fat injected with high shear stress. These data suggest that shear stress is a more important variable regarding fat graft viability than pressure.

Lee JH; Kirkham JC; McCormack MC; Nicholls AM; Randolph MA; Austen WG Jr

2013-05-01

36

CASE REPORT Pharyngocutaneous Fistula Closure Using Autologous Fat Grafting.  

Science.gov (United States)

Objective: Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive treatment approaches designed to reverse tissue damage or promote spontaneous healing would represent an important medical advance. Autologous fat grafts have been previously shown to promote healing of persistent wounds and improve the quality of radiation-damaged tissue. In this report, successful closure of a persistent pharyngocutaneous fistula with use of autologous fat grafting is described. Method: The history and details of pharyngocutaneous fistula closure in a patient with recurrent head and neck cancer are reported. Result: A 67-year-old patient with recurrent head and neck cancer and prior radiotherapy underwent reresection including partial pharyngectomy with pectoralis major myocutaneous flap closure. Postoperatively, he developed an enterocutaneous fistula, which failed to close with conservative measures including 8 months of nothing per os. Two rounds of autologous fat grafting were performed with successful fistula healing. Conclusion: Autologous fat grafting is a useful treatment for closure of persistent pharyngocutaneous fistulas. Autologous fat grafting should be considered in poor surgical candidates, particularly in the setting of extensive radiation-induced tissue damage. PMID:23691260

Hespe, Geoffrey E; Albornoz, Claudia R; Mehrara, Babak J; Kraus, Dennis; Matros, Evan

2013-05-09

37

CASE REPORT Pharyngocutaneous Fistula Closure Using Autologous Fat Grafting.  

UK PubMed Central (United Kingdom)

Objective: Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive treatment approaches designed to reverse tissue damage or promote spontaneous healing would represent an important medical advance. Autologous fat grafts have been previously shown to promote healing of persistent wounds and improve the quality of radiation-damaged tissue. In this report, successful closure of a persistent pharyngocutaneous fistula with use of autologous fat grafting is described. Method: The history and details of pharyngocutaneous fistula closure in a patient with recurrent head and neck cancer are reported. Result: A 67-year-old patient with recurrent head and neck cancer and prior radiotherapy underwent reresection including partial pharyngectomy with pectoralis major myocutaneous flap closure. Postoperatively, he developed an enterocutaneous fistula, which failed to close with conservative measures including 8 months of nothing per os. Two rounds of autologous fat grafting were performed with successful fistula healing. Conclusion: Autologous fat grafting is a useful treatment for closure of persistent pharyngocutaneous fistulas. Autologous fat grafting should be considered in poor surgical candidates, particularly in the setting of extensive radiation-induced tissue damage.

Hespe GE; Albornoz CR; Mehrara BJ; Kraus D; Matros E

2013-01-01

38

CASE REPORT Pharyngocutaneous Fistula Closure Using Autologous Fat Grafting  

Science.gov (United States)

Objective: Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive treatment approaches designed to reverse tissue damage or promote spontaneous healing would represent an important medical advance. Autologous fat grafts have been previously shown to promote healing of persistent wounds and improve the quality of radiation-damaged tissue. In this report, successful closure of a persistent pharyngocutaneous fistula with use of autologous fat grafting is described. Method: The history and details of pharyngocutaneous fistula closure in a patient with recurrent head and neck cancer are reported. Result: A 67-year-old patient with recurrent head and neck cancer and prior radiotherapy underwent reresection including partial pharyngectomy with pectoralis major myocutaneous flap closure. Postoperatively, he developed an enterocutaneous fistula, which failed to close with conservative measures including 8 months of nothing per os. Two rounds of autologous fat grafting were performed with successful fistula healing. Conclusion: Autologous fat grafting is a useful treatment for closure of persistent pharyngocutaneous fistulas. Autologous fat grafting should be considered in poor surgical candidates, particularly in the setting of extensive radiation-induced tissue damage.

Hespe, Geoffrey E.; Albornoz, Claudia R.; Mehrara, Babak J.; Kraus, Dennis; Matros, Evan

2013-01-01

39

Applicability of buccal fat pad grafting for oral reconstruction.  

UK PubMed Central (United Kingdom)

This study evaluated the applicability of pedicled buccal fat pad grafting for the reconstruction of defects surgically created during oral surgery. A buccal fat pad graft was applied in 23 patients (5 males, 18 females; mean age 68.3 years) between 2003 and 2011. The graft was used to cover surgical defects of the palate, maxilla, upper gingiva, buccal mucosa, lower gingiva, oral floor, and temporomandibular joint region. Size of the surgical defects ranged from 15mm×12mm to 30mm×40mm; size of the buccal fat pad ranged from 15mm×12mm to 43mm×38mm. A pedicled buccal fat pad was prepared by incising the maxillary vestibule following primary surgery, and the surrounding connective tissue was preserved to supply nutrition to the pedicle during surgery. The buccal fat pad was placed on the raw surface of soft tissue or bone surface and sutured to the surrounding tissue of the defect. Complete epithelialization was observed within 4 weeks postoperatively. There were no complications or functional disorders during follow-up. Buccal fat pad grafting appears to be feasible for the reconstruction of surgically induced defects, and can be extended to the palate, mandible, mouth angle, and temporomandibular joint region.

Toshihiro Y; Nariai Y; Takamura Y; Yoshimura H; Tobita T; Yoshino A; Tatsumi H; Tsunematsu K; Ohba S; Kondo S; Yanai C; Ishibashi H; Sekine J

2013-05-01

40

Applicability of buccal fat pad grafting for oral reconstruction.  

Science.gov (United States)

This study evaluated the applicability of pedicled buccal fat pad grafting for the reconstruction of defects surgically created during oral surgery. A buccal fat pad graft was applied in 23 patients (5 males, 18 females; mean age 68.3 years) between 2003 and 2011. The graft was used to cover surgical defects of the palate, maxilla, upper gingiva, buccal mucosa, lower gingiva, oral floor, and temporomandibular joint region. Size of the surgical defects ranged from 15mm×12mm to 30mm×40mm; size of the buccal fat pad ranged from 15mm×12mm to 43mm×38mm. A pedicled buccal fat pad was prepared by incising the maxillary vestibule following primary surgery, and the surrounding connective tissue was preserved to supply nutrition to the pedicle during surgery. The buccal fat pad was placed on the raw surface of soft tissue or bone surface and sutured to the surrounding tissue of the defect. Complete epithelialization was observed within 4 weeks postoperatively. There were no complications or functional disorders during follow-up. Buccal fat pad grafting appears to be feasible for the reconstruction of surgically induced defects, and can be extended to the palate, mandible, mouth angle, and temporomandibular joint region. PMID:22902877

Toshihiro, Y; Nariai, Y; Takamura, Y; Yoshimura, H; Tobita, T; Yoshino, A; Tatsumi, H; Tsunematsu, K; Ohba, S; Kondo, S; Yanai, C; Ishibashi, H; Sekine, J

2012-08-16

 
 
 
 
41

Oncologic risks of autologous fat grafting to the breast.  

UK PubMed Central (United Kingdom)

As the frequency of fat grafting to the breast has increased, some investigators have raised the possibility that this procedure may potentially increase the risks associated with breast cancer. Their concerns included not only interference with cancer detection, but also promotion of tumor formation or recurrence mediated by mechanisms such as aromatase expression, angiogenesis, and tumor stromal cells. However, published clinical studies describing outcomes of fat grafting to the breast in more than 2000 patients have not reported any increase in new or recurrent cancers. The reason for this apparent disconnect may lie in the small sample sizes and relatively short follow-up, but it may also reside in the considerable gap between laboratory studies or theoretical considerations suggesting potential risks and the actual clinical practice. This review discusses potential risks of current and novel approaches to autologous fat grafting to the breast within the context of both the underlying science and clinical practice.

Fraser JK; Hedrick MH; Cohen SR

2011-01-01

42

Autologous fat grafting for primary breast augmentation: a systematic review.  

UK PubMed Central (United Kingdom)

As the technique of autologous fat grafting is being refined and perfected, its clinical applications are expanding. The use of autologous fat grafting for primary breast augmentation is controversial due to a lack of clarity regarding its safety and efficacy. Most notably, concerns about interference with the detection of breast cancer have been raised, but these have not been clearly addressed in the literature. To help surgeons gain further insight, the authors conducted a systematic review of the literature, carefully comparing technique, clinical outcome, radiologic impact, and complications in all available data on this subject. Although an optimal method of autologous fat grafting for primary breast augmentation is yet to be standardized, further strong evidence-based studies are necessary to confirm the findings of this approach.

Rosing JH; Wong G; Wong MS; Sahar D; Stevenson TR; Pu LL

2011-10-01

43

Treatment of chronic posttraumatic leg injury using autologous fat graft.  

Science.gov (United States)

We present the results obtained in a case of a 20-year-old Caucasian woman with a posttraumatic injury "hard-to-heal" of the left leg treated using autologous fat graft. Considering our experience in treatment of chronic posttraumatic ulcers by autologous fat graft, we decided to use this surgical technique to induce a regenerative effect in this young patient. We have had complete wound closure with only a single surgical procedure after 1 month; after the second intervention of autologous fat graft we observed an improvement in the quality of the scar tissue. The patient satisfaction was excellent. The results were long lasting and remained virtually unchanged after 1 year. PMID:23319957

Caviggioli, Fabio; Klinger, Francesco Maria; Vinci, Valeriano; Cornegliani, Guido; Klinger, Marco

2012-12-19

44

Autologous fat grafting for primary breast augmentation: a systematic review.  

Science.gov (United States)

As the technique of autologous fat grafting is being refined and perfected, its clinical applications are expanding. The use of autologous fat grafting for primary breast augmentation is controversial due to a lack of clarity regarding its safety and efficacy. Most notably, concerns about interference with the detection of breast cancer have been raised, but these have not been clearly addressed in the literature. To help surgeons gain further insight, the authors conducted a systematic review of the literature, carefully comparing technique, clinical outcome, radiologic impact, and complications in all available data on this subject. Although an optimal method of autologous fat grafting for primary breast augmentation is yet to be standardized, further strong evidence-based studies are necessary to confirm the findings of this approach. PMID:21455825

Rosing, James H; Wong, Granger; Wong, Michael S; Sahar, David; Stevenson, Thomas R; Pu, Lee L Q

2011-04-01

45

Using an external soft tissue expander before autologous fat grafting for non-irradiated breast reconstruction.  

UK PubMed Central (United Kingdom)

Abstract Autologous fat grafting is a method that has been used for breast augmentation since last century. This case report presents a woman with non-irradiated breast requested autologous fat grafting after modified radical mastectomy for breast cancer. An external soft tissue expander was used before fat grafting. This innovative technique showed benefits for the patient, with tight skin after the operation.

Cheng YC; Chen TM; Chen SG; Teng SC

2013-10-01

46

Fat grafting of the buttocks and lower limbs.  

Science.gov (United States)

This article presents the senior author's experience in fat grafting for the treatment of contour deformities of the buttocks and lower limbs. This method has been termed liposculpture and consists in removal of adipose tissue by cannula and syringe and cleaning of the aspirated material with saline. All external contact is thus carefully avoided, preventing contamination. Fat grafting is done in multiple tunnels in a deep plane. Total of 140 patients were treated over the last 5 years and results were considered uniformly satisfactory. Fat absorption was estimated by clinical evaluation to be less than 20% volume. A low rate of complications (less than 3%) supports the authors' opinion that this is an efficient and safe procedure to correct or enhance contour deformities of the lower limbs. PMID:8849433

Pereira, L H; Radwanski, H N

47

Chorda tympani nerve function after myringoplasty.  

Science.gov (United States)

This is a cross-sectional study design aimed to determine the prevalence of Chorda Tympani Nerve (CTN) injury and related symptoms following myringoplasty. Thirty patients were included in this study. The methods used were measuring taste thresholds using electrogustometer to map taste threshold on the anterior two-third of the tongue on the operated side with the non operated side as the control. Reading is taken when the subject experiences sour/metallic taste. All corresponding threshold values and findings were recorded and compared to control. Results showed 50% of patients had elevated threshold levels suggestive of CTN injury. However, none of the patients reported subjective taste loss. This study concludes that the prevelance rate of CTN injury in post myringoplasty patients is about 50% but this is not associated with altered taste sensation. PMID:18705465

Sham, E H; Prepageran, N; Raman, R; Quek, K F

2007-12-01

48

Autologous fat grafting for correction of unaesthetic scars.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting has many clinical applications, and its use in Plastic Surgery is increasing. Currently, autologous fat grafts are used in breast surgery, facial rejuvenation, and facial lipoatrophy secondary to antiretroviral therapy and as a treatment for liposuction sequelae, buttock augmentation, and congenital facial hemiatrophy. Their use is expanding rapidly, and their applications in other fields are an ever growing interest within the Plastic Surgery community. OBJECTIVE: To introduce a new application of lipoinjection for the correction of unaesthetic, retracted, or sunken scars. METHODOLOGY: The study consisted of a total of 8 patients (6 women and 2 men), with a mean age of 47 years old, all of whom presented retractile and dystrophic scars in the abdomen (n = 3), arm (n = 1), male breast (n = 1), and face (n = 3). They all received treatment with a fat injection using Coleman technique. General anesthesia was used in 3 patients; deep intravenous sedation plus local anesthesia was used in the remaining 5 patients. A COL-ASP15 cannula was used to harvest the fat and a blunt-tipped COL-19 cannula (Byron Medical) to release the fibrosis and retraction, and for the fat grafting injection. A 4-grade visual scale was use to evaluate the results. RESULTS: An improvement in the scar was achieved in all patients. One operation was required in 5 cases, and 2 operations in 3 cases. There were no complications in any patient and the results were lasting in all cases (the mean follow-up period was of 18 months). CONCLUSIONS: Autologous fat grafting is a good method for correction of retracted or sunken scars instead of the traditional scar surgical excision.

Guisantes E; Fontdevila J; Rodríguez G

2012-11-01

49

Grading lipoaspirate: is there an optimal density for fat grafting?  

UK PubMed Central (United Kingdom)

BACKGROUND: Clinical results of fat grafting have been unpredictable. In this article, the authors hypothesize that centrifugation creates "graded densities" of fat with varying characteristics that influence lipoaspirate persistence and quality. METHODS: Aliquots of human female lipoaspirate (10 cc) were centrifuged for 3 minutes at 1200 g. The bloody and oil fractions were discarded. Subsequently, 1.0 cc of the highest density and lowest density fat was separated for lipoinfiltration or analysis. Highest density or lowest density fat grafted into adult FVB mice was harvested at 2 and 10 weeks to quantify short- and long-term persistence, respectively. Progenitor cell number and expression of vascular endothelial growth factor, stromal cell-derived factor-1?, platelet-derived growth factor, and adiponectin were analyzed by flow cytometry and enzyme-linked immunosorbent assay, respectively. RESULTS: Greater percentages of highest density fat grafts remain at 2 and 10 weeks after injection compared with lowest density fat grafts (85.4 ± 1.9 percent versus 62.3 ± 0.1 percent, p = 0.05; and 60.8 ± 4.9 versus 42.2 ± 3.9, p < 0.05, respectively). Highest density fractions contain more progenitor cells per gram than lowest density fractions (2.0 ± 0.2-fold increase, p < 0.01). Furthermore, concentrations of vascular endothelial growth factor, stromal vascular fraction, platelet-derived growth factor, and adiponectin are all elevated in highest density compared with lowest density fractions (34.4 percent, p < 0.01; 34.6 percent, p < 0.05; 52.2 percent, p < 0.01; and 45.7 percent, p < 0.05, respectively). CONCLUSIONS: Greater percentages of highest density fractions of lipoaspirate persist over time compared with lowest density fractions. A vasculogenic mechanism appears to contribute significantly, as highest density fractions contain more progenitor cells and increased concentrations of several vasculogenic mediators than lowest density fractions.

Allen RJ Jr; Canizares O Jr; Scharf C; Nguyen PD; Thanik V; Saadeh PB; Coleman SR; Hazen A

2013-01-01

50

Autologous fat grafting in lip reconstruction following hemangioma treatment.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Autologous fat grafting has been successfully used in lip cosmetic surgery. However, little supportive evidence exists for its use in lip reconstruction following hemangioma treatment. METHODS: Patients with lip deformity following hemangioma treatment at the Plastic Surgery Hospital in Beijing between September 2010 and July 2012 were retrospectively investigated. Twelve patients underwent autologous fat grafting. Aesthetic appearance and texture and volume persistence of the graft were measured preoperatively and postoperatively, and the presence of infection and hematoma was recorded. RESULTS: After a series of 3 to 4 injections and a mean 24 months of follow-up, all 12 patients were satisfied with their aesthetic appearance and the texture and volume persistence of the graft. There were no complications such as infection or hematoma. CONCLUSIONS: The current study demonstrates that autologous fat transplantation is a viable option for correction of lip deformities. It is beneficial not only for correction of the tissue defect themselves, but also in terms of its effect on surrounding tissues and its long-lasting results without major complications in the management of this difficult problem.

Yin J; Li H; Yin N; Wu D; Wang Y; Tong H; Li Y; Yan W; Fang L; Zhao Z

2013-03-01

51

Long-term outcomes following fat grafting in prosthetic breast reconstruction: a comparative analysis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting has become a common technique for optimizing aesthetic outcomes following breast reconstruction. Its long-term oncologic implications, however, remain unclear. The authors evaluated long-term outcomes following tissue expander breast reconstruction with and without fat grafting. METHODS: A retrospective review was performed of consecutive patients undergoing mastectomy with immediate tissue expander reconstruction from April of 1998 to August of 2008. Demographic, operative, oncologic, and postoperative factors were recorded, including the use of fat grafting. Mean follow-up was 42.1 ± 28.8 and 43.6 ± 27.2 months for non-fat-grafting and fat-grafting patients, respectively (p = 0.63), including 24.8 ± 5.9 months after the first fat-grafting procedure. Fisher's exact test, t test, and regression analysis were used for statistics. RESULTS: A review of 886 patients (n = 1202 breasts) revealed no significant differences in demographics, operative characteristics, tumor staging, or radiation therapy exposure between fat-grafting (n = 90 breasts) and non-fat-grafting (n = 1112 breasts) patients. Ninety-nine fat-grafting procedures were performed an average of 18.3 months after reconstruction, with one complication (fat necrosis). Grafting did not affect local tumor recurrence or survival when compared with non-fat-grafted breasts. Complication following reconstruction, including a poor cosmetic result, was an independent predictor of undergoing subsequent fat grafting (p < 0.0001). CONCLUSIONS: The analysis suggests that fat grafting after breast reconstruction does not adversely affect local tumor recurrence or survival on long-term follow-up. Autologous fat grafting can be used as an aesthetic adjunct to prosthetic reconstruction with minimal complications. These results also indicate the need for multi-institutional, prospective studies to definitively establish its oncologic safety. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Seth AK; Hirsch EM; Kim JY; Fine NA

2012-11-01

52

Does platelet-rich plasma enhance the survival of grafted fat? An update review.  

UK PubMed Central (United Kingdom)

Autologous fat grafting enables repair and augmentation of soft tissues and is increasingly used in plastic and reconstructive surgery. The main limitation of fat grafting is unpredictable graft resorption. To obviate this disadvantage, several studies have searched for new ways of increasing the viability of the transplanted tissue. One promising approach has been to mix the fat graft with Platelet-Rich Plasma (PRP) before transplantation. The purpose of this article is to review systematically the available comparative evidence about PRP-assisted fat grafting.

Jin R; Zhang L; Zhang YG

2013-01-01

53

Supplementing fat grafts with adipose stromal cells for cosmetic facial contouring.  

UK PubMed Central (United Kingdom)

BACKGROUND: Numerous methods have been proposed to enhance the survival of fat grafts, but no definitive treatment is available. Stromal vascular fraction (SVF)-assisted cell therapy offers new perspectives for improving fat graft survival. OBJECTIVES: To determine whether SVF supplementation could improve graft retention in patients undergoing autologous fat grafting for cosmetic improvement of facial contour. METHODS: We retrospectively analyzed data from 38 women who underwent fat transplantation with SVF (n = 26) or fat grafting alone (n = 12) between October 2010 and January 2012. Each patient underwent computed tomography, and photographs were taken before and 6 months after surgery. The Philips Extended Brilliance Workspace was used for analysis of volume augmentation. RESULTS: All patients showed cosmetic improvements, but the degree varied. No complications were evidenced during follow-up. Fat survival was higher with SVF (64.8 ± 10.2%) than fat grafting alone (46.4 ± 9.3%) (p < .01). SVF supplementation resulted in better clinical improvement than fat grafting alone. CONCLUSION: Supplementing fat grafts with SVF for cosmetic facial contouring can improve the survival of fat grafts over fat grafting alone and provides satisfactory outcomes without major complications. Autologous fat grafting has been used for various cosmetic treatments and difficult reconstructive indications such as temporal depression, wrinkles of nasolabial folds, and hemifacial atrophy, with no incisional scar or complications associated with foreign materials, although problems such as a low rate of graft survival because of early resorption remain. (Aesthet Plast Surg, 14, 1990 and 127) Despite many innovations to overcome these problems, (Dermatol Surg, 26, 2000 and 1159); (Ann Plast Surg, 60, 2008 and 594); (Dermatol Surg, 27, 2001 and 819); (Dermatol Surg, 28, 2002 and 987) we lack a definitive method of fat processing that ensures maximal graft take and viability. (Plast Reconstr Surg, 115, 2005 and 197); (Dermatol Surg, 37, 2011 and 619).

Li J; Gao J; Cha P; Chang Q; Liao Y; Liu C; Li K; Lu F

2013-03-01

54

Cryopreservation of fat tissue and application in autologous fat graft: in vitro and in vivo study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Absorption of the autologous fat graft results in repeated harvesting procedures. The cost and complications increase with repeated procedures, but cryopreservation is one way to solve the problem. The aim of this study was to find an optimal temperature at which to store fat tissue with or without cryoprotective agents for long-term use. METHODS: Fat tissues harvested by liposuction were stored in normal saline, frozen in the freezer following the preset program, and cryopreserved at -20, -80, and -196°C. The other group of fat tissues was stored in hydroxyethyl starch using the same frozen procedure. Two and 7 days after cryopreservation, viability tests were conducted. The fat tissues were injected into nude mice 2 and 4 weeks after cryopreservation. Three months later the fat grafts were harvested for histologic examination. RESULTS: No significant differences in cell viability were found in either in vitro or in vivo experiments for the three preserving temperatures. The cryoprotective agent HES did not influence cell viability. CONCLUSION: There were no differences in cell viability among the three temperatures and with the use of a cryoprotective agent. Cryopreservation for salvage management is a clinically practical method.

Li BW; Liao WC; Wu SH; Ma H

2012-06-01

55

Particle size, temperature, and released amount of fat for safe periorbital fat grafts.  

UK PubMed Central (United Kingdom)

The aim of this study was to determine the particle size, temperature, and amount of released fat for safe periorbital fat grafts. From 28 patients, fat was suctioned from the abdomen (large particles [LPs]) and from the inner thigh (small particles [SPs]) using a 2.1-mm harvesting cannula with a diameter 3.2 × 1.4-mm hole and a 1-mm hole, respectively. The 10-mL syringes full of fat were then put into a centrifuge for 3 minutes (LP) and 1 minute (SP) at 3000 revolutions/min. Fat was then transferred to a 1-mL syringe with Luer-Lock adapters and a blunt cannula of 0.9-mm diameter. The force needed to push the fat out of the cannula was measured with a force gauge. The force was measured within the different groups according to particle size of the fat, temperature of the fat, and released amount of fat. The force needed to push the SP fat out of the cannula into the air with minimal amount (MA) (0.01-0.02 mL) injected at room temperature (25°C) (1.75 ± 0.82 N) was significantly greater (P = 0.000 [t test]) than at body temperature (BT, 33°C) (1.27 ± 0.38 N). At BT, the force needed to push the SP fat into subcutaneous pig tissue (2.30 ± 1.46 N) was significantly lesser (P = 0.000 [t test]) than LP fat (6.54 ± 2.39 N). At BT, the force needed to push the MA of SP fat into pig subcutaneous tissue (1.38 ± 0.26 N) was significantly lesser (P = 0.000 [t test]) than the force needed to push the usual amount (0.03-0.04 mL) of SP fat (3.83 ± 1.78 N). The force needed to push the fat into human lower eyelids at room temperature (4.06 ± 2.26 N) was significantly greater (P = 0.000 [t test]) than at BT (2.11 ± 0.96 N). At BT, the force needed to inject an MA of SP fat into human lower eyelids (1.55 ± 0.83 N) was significantly lesser (P = 0.000 [t test]) than the force needed to inject a usual amount of fat (2.78 ± 1.03 N). We suggest injections of the SP (1-mm hole diameter harvesting cannula) fat with MAs (0.01-0.02 mL) by means of fragmented incremental injections stored at BT (33°C) to reduce the injection pressure.

Kim SK; Hwang K; Huan F; Hwang SH

2013-09-01

56

Computer assisted planning of autologous fat grafting in breast.  

Science.gov (United States)

Autologous fat grafting is an emerging and promising surgical technique in regenerative medicine, and its application is quickly spreading in plastic and reconstructive surgery of the breast. However, despite the advantages of the technique, surgical complications may occur, such as implanted tissue necrosis and resorption and onset of microcalcifications. In view of the hypothesis that the uniformity of the lipoaspirate transplantation is related to graft survival and a lower probability of complications, we developed an interactive lipomodeling planning software application based on a genetic algorithm that allows automatic optimization of the uniformity of fat tissue distribution. The input dataset consists of a 3D model of the patient's thorax, created from MRI scans, on which relevant structures are segmented. The developed software was tested starting from either an automatically generated plan or an initial guess of the optimal surgical plan, and in both cases the application yielded a consistent improvement in the planned fat tissue distribution by optimizing the position of the insertion points and the direction of the insertion pathways. On the basis of the simulations performed, the use of genetic algorithms for optimization of the geometry of autologous fat transfer in the breast proved to be effective. These results will foster further activities focused on the comparison of predicted optimized geometries and those obtained in real surgical cases as a means of obtaining a deeper knowledge of the potential influence of a uniform fat tissue distribution on the quality of the surgical outcome. The presented application is also put forward as representing a noteworthy step towards the clinical application of computer assisted planning tools in breast surgery. PMID:23253184

Patete, Paolo; Rigotti, Gino; Marchi, Alessandra; Baroni, Guido

2012-12-20

57

Breast Fistula Repair after Autologous Fat Graft: A Case Report  

Science.gov (United States)

We report the case of a 55-year-old female patient who attended our clinic for the presence of a scar retraction in the upper pole of the left breast as a complication of breast augmentation. In the scar area, we observed an orifice that probing revealed to be a fistula. The patient was referred to surgical intervention under general anesthesia to obtain scar contracture release using autologous fat graft; one month after autologous fat injection, following healing of the fistula, the patient underwent a second surgical procedure to replace the left breast implant. Unexpectedly, two weeks after the surgical procedure, complete healing of the breast fistula within the scar area was observed; this observation was confirmed during the second surgical step for left breast implant repositioning, when we observed the absence of the fistula orifice in the breast implant cavity. Upon clinical examination at 1-year followup, tissue integrity was preserved. The patient's satisfaction was excellent. We have observed a possible additional effect of fat graft.

Klinger, Francesco Maria; Caviggioli, Fabio; Forcellini, Davide; Vinci, Valeriano; Maione, Luca; Pajardi, Giorgio; Klinger, Marco

2011-01-01

58

Breast fistula repair after autologous fat graft: a case report.  

UK PubMed Central (United Kingdom)

We report the case of a 55-year-old female patient who attended our clinic for the presence of a scar retraction in the upper pole of the left breast as a complication of breast augmentation. In the scar area, we observed an orifice that probing revealed to be a fistula. The patient was referred to surgical intervention under general anesthesia to obtain scar contracture release using autologous fat graft; one month after autologous fat injection, following healing of the fistula, the patient underwent a second surgical procedure to replace the left breast implant. Unexpectedly, two weeks after the surgical procedure, complete healing of the breast fistula within the scar area was observed; this observation was confirmed during the second surgical step for left breast implant repositioning, when we observed the absence of the fistula orifice in the breast implant cavity. Upon clinical examination at 1-year followup, tissue integrity was preserved. The patient's satisfaction was excellent. We have observed a possible additional effect of fat graft.

Klinger FM; Caviggioli F; Forcellini D; Vinci V; Maione L; Pajardi G; Klinger M

2011-01-01

59

Liver Fat Accumulation after Islet Transplantation and Graft Survival.  

UK PubMed Central (United Kingdom)

OBJECTIVE: to evaluate if there is an association between liver fat accumulation after islet transplantation (ITx) and graft survival.RESEARCH DESIGN AND METHODS: a cohort study was conducted in 34 subjects with type 1 diabetes post-allogeneic ITx. Liver fat content was evaluated by MRI (change in liver signal intensity on in-phase and opposed-phase images). Kaplan-Meier curves and Cox-regression analysis were performed with islet dysfunction duration as the dependent variable and fat liver content as an independent one. P values of <0.05 were significant (SSPS ©18.0 and MedCalc ©12.5).RESULTS: Patients' mean age was 40±8 years (diabetes duration: 31±12 years; male: 41%). Islet survival did not differ in patients without (51 months, 95%CI 40-62 months) or with steatosis (48 months, 95%CI 38-58 months; P=0.55) during islet dysfunction period. Nevertheless, survival curves appear to separate late in the follow-up, and after 40 months steatosis was associated with shorter graft survival (P LogRank=0.049). This association remained (RR 23.5, CI95% 1.1-516.0; P=0.045) after adjustments for possible confounding factors.CONCLUSIONS: In this sample of subjects with type 1 diabetes submitted to ITx, steatosis was not associated with islet failure in the whole cohort. However in subjects with functional islets after 40 months, a shorter graft survival was observed in those with steatosis during islet dysfunction period, even after adjustments to variables known to be associated withislet failure.

Leitao C; Peixoto E; Westphalen A; Mireles-Zavala L; Lauriola V; Bernetti K; Corrales A; Ricordi C; Alejandro R

2013-06-01

60

Facial fat grafting with a prototype injection control device  

Directory of Open Access Journals (Sweden)

Full Text Available Hugh E Hetherington,1 Jon E Block2 1Bozeman Deaconess Health Group, Bozeman, MT, USA; 2The Jon Block Group, San Francisco, CA, USA Objective: To evaluate the initial clinical performance of a prototype injection control device (ICD) to facilitate fat grafting by injection. Methods: An ICD, which mechanically couples the act of withdrawing the cannula with the act of depressing the plunger, was fabricated for the purpose of facial fat grafting. The action of the device results in deposition of consistent threads of fat having a volume of approximately 33 uL per cm that the cannula is withdrawn, which is slightly less than the internal volume of a 12-gauge cannula. A total of 26 patients underwent 30 procedures, and the results were subjectively evaluated using pre- and postoperative photographs, with a minimum follow-up of 4 months. Results: The desired degree of correction was more consistent, recovery was faster, and procedural efficiency was improved when performing the procedure with the ICD compared to historical use of the manual method of injection. Minor irregularities were the only complications encountered. Conclusion: The ICD optimally distributes fat as a uniform thread along the withdrawal tract of the cannula, thereby eliminating clumping and minimizing tissue trauma, resulting in reduced recovery time as well as more consistent and predictable clinical results. Since the ICD automates the injection process, it provides a notable and easily attainable efficiency in procedural time and minimal learning curve for the user. Keywords: dermal fillers, liposuction, facial rejuvenation, threading

Hetherington HE; Block JE

2013-01-01

 
 
 
 
61

Breast reconstruction with autologous fat graft mixed with platelet-rich plasma.  

UK PubMed Central (United Kingdom)

BACKGROUND: The purpose of this study was to review the authors' experience of fat grafting, evaluating the effects related to the use of fat grafting with platelet-rich plasma (PRP) in the improvement of fat volume in breast reconstruction and comparing the results with a control group (only centrifuged fat grafting). METHODS: A total of 50 patients aged between 19 and 60 years affected by breast soft-tissue defects were analyzed at the Plastic and Reconstructive Department of the University of Tor Vergata. They were treated with fat grafting + PRP. The control group (50 patients with breast soft-tissue defects) were treated with centrifuged fat grafting injection according to Coleman's procedure. RESULTS: The patients treated with PRP added to the autologous fat grafts showed a 69% maintenance of the contour restoring and of 3-dimensional volume after 1 year, whereas the patients of the control group treated with centrifuged fat grafting showed a 39% maintenance. CONCLUSION: PRP mixed with fat grafting leads to an improvement in maintaining breast volume in patients affected by breast soft-tissue defects.

Gentile P; Di Pasquali C; Bocchini I; Floris M; Eleonora T; Fiaschetti V; Floris R; Cervelli V

2013-08-01

62

Autologous fat grafting for the treatment of velopharyngeal insufficiency: State of the art.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting to the velopharynx has been described for treatment of velopharyngeal insufficiency for over a decade. The aim of this review was to evaluate outcomes of autologous fat grafting for velopharyngeal insufficiency. METHODS: A computerized search was performed across multiple databases. Studies involving patients undergoing autologous fat grafting for velopharyngeal insufficiency treatment that reported at least one pre- and post-intervention outcome measure were included. RESULTS: A systematic search revealed eleven studies that satisfied inclusion criteria. All were case series or noncomparative observational studies. Three reported on isolated posterior pharyngeal wall augmentation, while eight involved augmentation of the pharyngeal arches, velum and/or posterior pharyngeal wall. In general, selected patients had plateaued with regards to speech therapy and had small-to-moderate velopharyngeal closure defects. Although most patients had a cleft palate diagnosis, the proportion that had previous velopharyngoplasty, or other related diagnoses was highly variable. In all but one report outcome measures included perceptual speech assessment. Objective measures such as nasalance and fat graft take were inconsistently reported. Overall, results of fat grafting for velopharyngeal insufficiency were variable and depended on assessment modality. One case of obstructive sleep apnea was reported. CONCLUSIONS: Despite potential benefits of autologous fat grafting for velopharyngeal insufficiency, questions remain as to patient selection, safety, and optimal graft volume and injection sites. This review underscores the need for standardized assessment methods and prospective comparative studies or randomized controlled trials to compare fat grafting with established velopharyngoplasty techniques to better define indications for its use.

Bishop A; Hong P; Bezuhly M

2013-09-01

63

Craniofacial microsomia soft-tissue reconstruction comparison: inframammary extended circumflex scapular flap versus serial fat grafting.  

UK PubMed Central (United Kingdom)

BACKGROUND: The authors investigated the use of serial autologous fat grafting to restore soft-tissue contour in craniofacial microsomia patients. METHODS: Patients with moderate to severe craniofacial microsomia were divided into two groups. Microvascular free flap patients had reconstruction with inframammary extended circumflex scapular flaps at skeletal maturity (n = 10). Alternatively, patients had fat grafting during multiple staged operations for mandible and ear reconstruction (n = 21). Sex, age, severity of deformity [determined by OMENS (orbital deformity, mandibular hypoplasia, ear deformity, nerve involvement, and soft-tissue deficiency) classification], number of procedures, operative times, and augmentation volumes were recorded. A digital three-dimensional photogrammetry system was used to determine "final fat take" and symmetry (affected side versus unaffected side). Physician and patient satisfaction were elicited. RESULTS: Microvascular free flap and fat grafting groups had similar OMENS scores, 2.4 and 2.3, and similar mean prereconstruction symmetry scores, 74 percent and 75 percent, respectively. Although the mean number of procedures was less for the microvascular free flap group versus the fat grafting group (2.2 versus 4.3), the combined surgical time was greater for the microvascular free flap group. The complication rate for the microvascular free flap group was 12 percent and that for the fat grafting group was 5 percent. The mean microvascular free flap volume implanted was 131 cc, with a final measured volume of 106 cc. Mean fat grafting volume injected per case was 33 cc, with total fat injections of 146 cc and a final measured volume of 121 cc. There was a mean fat loss of 25 cc and 83 percent fat take. Symmetry score was 121 percent for the microvascular free flap group and 99 percent for the fat grafting group. No statistically significant difference in patient or physician satisfaction was noted. CONCLUSION: Serial fat grafting provided a useful alternative to microvascular free tissue transfer after skeletal reconstruction.

Tanna N; Wan DC; Kawamoto HK; Bradley JP

2011-02-01

64

Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF) for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG) with use of disposable, microcannula systems. DESIGN: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. RESULTS: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. CONCLUSION: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are available as safe, sterile, disposable, compact systems for acquiring high-quality AFG. Presented is a detailed, step-by-step, proven protocol for performing quality autologous structural adipose transplantation.

Alexander RW; Harrell DB

2013-01-01

65

Effects of lidocaine plus epinephrine and prilocaine on autologous fat graft survival.  

UK PubMed Central (United Kingdom)

Although fat grafting is frequently used in plastic surgery practice, debate about the viability of the graft still persists owing to its questionable long-term success. The ultimate aim is to obtain long-term graft viability. Vascularization of the graft is essential for this purpose. The effects of 2 different local anesthetic preparations frequently used during harvesting of fat grafts on long-term graft survival were compared with angiogenesis and volumetric measurements. Twenty-four male Wistar rats were divided into 3 groups. The inguinal region was selected as the fat graft donor site. The first group was injected with isotonic saline, the second was injected with lidocaine plus epinephrine, and the third was injected with prilocaine. Fat grafts were implanted into the dorsal regions of rats, and volumetric measurements were performed initially and on days 30 and 180 at which microvascular angiogenesis were also analyzed. Microvascular angiogenesis was assessed both with the reverse transcription-polymerase chain reaction and immunohistochemistry through determination of vessels stained with factor VIII. No significant difference was obtained between the 3 groups in graft volume or microvascular angiogenesis at any stage of the study. Results from this experimental study indicate that there is no negative effect of lidocaine plus epinephrine or prilocaine on microangiogenesis and the survival of fat grafts.

Livao?lu M; Buruk CK; Uralo?lu M; Ersöz S; Livaog?lu A; Sözen E; Agdo?an Ö

2012-07-01

66

Effects of lidocaine plus epinephrine and prilocaine on autologous fat graft survival.  

Science.gov (United States)

Although fat grafting is frequently used in plastic surgery practice, debate about the viability of the graft still persists owing to its questionable long-term success. The ultimate aim is to obtain long-term graft viability. Vascularization of the graft is essential for this purpose. The effects of 2 different local anesthetic preparations frequently used during harvesting of fat grafts on long-term graft survival were compared with angiogenesis and volumetric measurements. Twenty-four male Wistar rats were divided into 3 groups. The inguinal region was selected as the fat graft donor site. The first group was injected with isotonic saline, the second was injected with lidocaine plus epinephrine, and the third was injected with prilocaine. Fat grafts were implanted into the dorsal regions of rats, and volumetric measurements were performed initially and on days 30 and 180 at which microvascular angiogenesis were also analyzed. Microvascular angiogenesis was assessed both with the reverse transcription-polymerase chain reaction and immunohistochemistry through determination of vessels stained with factor VIII. No significant difference was obtained between the 3 groups in graft volume or microvascular angiogenesis at any stage of the study. Results from this experimental study indicate that there is no negative effect of lidocaine plus epinephrine or prilocaine on microangiogenesis and the survival of fat grafts. PMID:22777468

Livao?lu, Murat; Buruk, Celal K; Uralo?lu, Muhammet; Ersöz, Safak; Livaog?lu, Ayten; Sözen, Emrah; Agdo?an, Özgür

2012-07-01

67

Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF) for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG) with use of disposable, microcannula systems. Design: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. Results: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. Conclusion: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are available as safe, sterile, disposable, compact systems for acquiring high-quality AFG. Presented is a detailed, step-by-step, proven protocol for performing quality autologous structural adipose transplantation. Keywords: autologous fat grafting, closed syringe lipoaspiration, adipose-derived adult stem-stromal cell, bioscaffolds, lipoaspiration/liposuction, stromal vascular fraction (SVF)

Alexander RW; Harrell DB

2013-01-01

68

Fat graft transfer in children's facial malformations: a prospective three-dimensional evaluation.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Autologous fat grafting for volume augmentation in soft tissues has grown in popularity in the paediatric plastic surgery community, despite a lack of quantifiable evidence of graft survival and predictable outcomes for child patients. The objective of this study is to quantify, through an objective method, the rate of survival of fat grafting in children's reconstructive surgery. METHODS: Clinical evaluation of all children was performed under standardised conditions in a prospective fashion with a 1-year follow-up. All patients, under 18 years of age, were photographed with a three-dimensional imaging system. Data were analysed with three-dimensional analysing software to quantify the volume improvements postoperatively and during the follow-up. RESULTS: Eleven children were included and followed up for 12 months. The mean age was 7.4 years. The mean amount of fat grafted was 13 cm3. At the end of the follow-up, the mean survival rate of the fat grafted was 40%. Complementary fat grafts were needed in 27% of the cases. No significant complications occurred. CONCLUSION: Until now, the literature has failed to provide objective evidence of fat survival in children. This study, using three-dimensional data, showed a 40% survival of grafted fat. The use of three-dimensional photographs and analysis has great clinical potential for surgical planning and follow-up.

Guibert M; Franchi G; Ansari E; Billotet B; Diner PA; Cassier S; Vazquez MP; Picard A; Kadlub N

2013-06-01

69

CT image of a free fat graft (FFG) within hemilaminectomy space  

International Nuclear Information System (INIS)

To prevent scarformation after hemilaminectomy many authors use free autologous fat grafts. CT scanning reveals vitality or death of the transplant. CT enables to control intra vitam whether FFG diminishes postnucleotomy syndrom caused by scar formation. (orig.).

1982-01-01

70

CT image of a free fat graft (FFG) within hemilaminectomy space  

Energy Technology Data Exchange (ETDEWEB)

To prevent scarformation after hemilaminectomy many authors use free autologous fat grafts. CT scanning reveals vitality or death of the transplant. CT enables to control intra vitam whether FFG diminishes postnucleotomy syndrome caused by scar formation.

Schroeder, S.; Lackner, K.; Koester, O.; Anders, G.

1982-02-01

71

Correction of cicatricial ectropion by autologous fat graft.  

UK PubMed Central (United Kingdom)

BACKGROUND: Over the past few years, treatment of burn scars with lipofilling has shown encouraging clinical results in terms of texture, color, softness, and quality of skin patterns. This clinical application has been widened to include treatment for scars resulting from surgical correction of cicatricial ectropion. In fact, although standard surgery with flaps and skin grafts can grant significant functional and cosmetic improvements, these often are not complete because of secondary surgical scars. METHODS: The case of a 43-year-old man with cicatricial outcomes from chemical burns and subsequent surgical repair of medial ectropion in the lower eyelid is reported. The scar area was treated with injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. RESULTS: At the 1-year follow-up assessment after lipostructure, the patient no longer reported xeroftalmia and epiphora. He had experienced complete functional recovery with excellent cosmetic results. CONCLUSIONS: Lipostructure of cicatricial ectropion seems to complete and improve the results of the standard surgical approach, and its long-lasting benefits are in keeping with the theoretical basis of this procedure.

Caviggioli F; Klinger F; Villani F; Fossati C; Vinci V; Klinger M

2008-05-01

72

Evaluation of superficial musculoaponeurotic system flap and fat graft outcomes for benign and malignant parotid disease.  

UK PubMed Central (United Kingdom)

OBJECTIVE: (1) To evaluate the effectiveness of the superficial musculoaponeurotic system (SMAS) flap and free fat graft in reconstructing the parotidectomy defect. (2) To evaluate the long-term viability of the free fat graft following parotidectomy for benign and malignant disease, including in the postradiation setting. STUDY DESIGN: Prospective study of consecutive patients. SETTING: Academic tertiary care medical center. Subjects and Methods Thirty-one consecutive patients underwent parotidectomy with SMAS flap and free fat graft reconstruction from 2006 to 2012. Data were compiled through a manual chart review. RESULTS: Twenty-three of the 31 total patients had benign disease, including pleomorphic adenoma, oncocytoma, and Warthin tumor. The 8 remaining patients (9 parotidectomies) underwent surgery for malignant disease, followed by postoperative radiation. The average age was 56 years (range, 16-84 years). The mean follow-up was 22.5 months. Satisfactory volumetric symmetry was achieved in all procedures for benign and malignant disease. Magnetic resonance imaging confirmed long-term fat graft viability in the postradiation setting. There was 1 case of Frey syndrome and no cases of unexpected, permanent facial nerve weakness among the patients. CONCLUSION: The combined technique of SMAS flap and free fat graft is effective for immediate reconstruction of the parotidectomy defect with minimal morbidity and low complication rates. This study demonstrates long-term viability of the free fat graft even in the setting of postoperative radiation.

Ambro BT; Goodstein LA; Morales RE; Taylor RJ

2013-06-01

73

Soft Tissue Augmentation with Autologous Fat Graft: The Dissected Pouch Technique  

Science.gov (United States)

Background: Soft tissue augmentation with autologous fat graft has been increasingly used by plastic surgeons despite unpredictable results. Several techniques have been described to prevent the main setback of this technique, fat graft resorption. However, there is no ideal technique described for this purpose. Materials and Methods: Twenty patients with subcutaneous tissue loss, atrophy or hypoplasia were treated with lipofilling. A subcutaneous pouch is dissected at the deformed area and later it is filled with autologous fat graft. Results: Graft maintenance during the postoperative period was satisfactory. Overcorrection was not performed except for the first three cases. Patient, surgeon and layman satisfaction was surveyed. Satisfaction was rated between 0 and 10. The mean score was 7.67 ± 1.22. Conclusion: The authors describe a technique for soft tissue augmentation which effectively corrects contour deformities, provides a low resorption rate and a relatively non-visible scar without causing irregularities.

Livaoglu, Murat; Yavuz, Ercan

2009-01-01

74

Soft tissue augmentation with autologous fat graft: The dissected pouch technique  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Soft tissue augmentation with autologous fat graft has been increasingly used by plastic surgeons despite unpredictable results. Several techniques have been described to prevent the main setback of this technique, fat graft resorption. However, there is no ideal technique described for this purpose. Materials and Methods: Twenty patients with subcutaneous tissue loss, atrophy or hypoplasia were treated with lipofilling. A subcutaneous pouch is dissected at the deformed area and later it is filled with autologous fat graft. Results: Graft maintenance during the postoperative period was satisfactory. Overcorrection was not performed except for the first three cases. Patient, surgeon and layman satisfaction was surveyed. Satisfaction was rated between 0 and 10. The mean score was 7.67 ± 1.22. Conclusion: The authors describe a technique for soft tissue augmentation which effectively corrects contour deformities, provides a low resorption rate and a relatively non-visible scar without causing irregularities.

Livaoglu Murat; Yavuz Ercan

2009-01-01

75

[Progress of autologous fat grafting in clinical applications of the face].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review the progress of autologous fat grafting of the face and outline different arguments in this field. METHODS: Recent literature concerning autologous fat grafting of the face was reviewed and analyzed. RESULTS: The applications and techniques for autologous fat grafting have been matured increasingly. It not only can adjust the proportion of facial contours, restore tissue volume, but also can improve the local skin texture. Reliable clinical results have achieved in facial augmentation and rejuvenation. Although there are arguments about donor site, harvesting technique, processing technique, and grafting technique, the basic principle is the same. CONCLUSION: From the perspective of evidence-based medicine, clinicians are rich in clinical experience, but objective evidence is insufficient. So further researches should be carried to look for scientific evidences.

Han C; Liu L; Liao H; Wen H

2012-01-01

76

Complications of fat grafts growth after weight gain: report of a severe diplopia.  

UK PubMed Central (United Kingdom)

A 47 years old woman underwent autologous fat grafting to treat a 5×4 cm depression of the lower lid and the upper cheek secondary resection of squamous cell carcinoma and subsequent coverage by full thickness skin graft. 20 mL of autologous fat were harvested from lower abdomen, centrifuged and injected subcutaneously. The patient then gained a total of 15 kg over a period of 24 months. Eye dystopia developed while the grafted area became convex. MRI confirmed subcutaneous fat mass going to the orbital floor through the inferior septal defect. The fat excess was removed through a trans-conjonctival approach allowing for a progressive regression of diplopia after 2 months while the oedema reduced. The overall follow up from the resection-coverage and last examination was 5 years. In this case with a context of noticeable weight gain, the growth of a fat graft trapped between a sclerous plane and the eye, that penetrated the orbital cavity through a septal defect led have led to exophthalmos, ocular dystopia and diplopia. Systematic overcorrection in autologous fat grafting should be prevented, especially in functional areas and on low body mass index patient that might gain weight.

Duhoux A; Chennoufi M; Lantieri L; Hivelin M

2013-07-01

77

Complications of fat grafts growth after weight gain: report of a severe diplopia.  

Science.gov (United States)

A 47 years old woman underwent autologous fat grafting to treat a 5×4 cm depression of the lower lid and the upper cheek secondary resection of squamous cell carcinoma and subsequent coverage by full thickness skin graft. 20 mL of autologous fat were harvested from lower abdomen, centrifuged and injected subcutaneously. The patient then gained a total of 15 kg over a period of 24 months. Eye dystopia developed while the grafted area became convex. MRI confirmed subcutaneous fat mass going to the orbital floor through the inferior septal defect. The fat excess was removed through a trans-conjonctival approach allowing for a progressive regression of diplopia after 2 months while the oedema reduced. The overall follow up from the resection-coverage and last examination was 5 years. In this case with a context of noticeable weight gain, the growth of a fat graft trapped between a sclerous plane and the eye, that penetrated the orbital cavity through a septal defect led have led to exophthalmos, ocular dystopia and diplopia. Systematic overcorrection in autologous fat grafting should be prevented, especially in functional areas and on low body mass index patient that might gain weight. PMID:23270665

Duhoux, Alexandre; Chennoufi, Mehdi; Lantieri, Laurent; Hivelin, Mikael

2012-12-24

78

Safety Concern between Autologous Fat Graft, Mesenchymal Stem Cell and Osteosarcoma Recurrence  

Science.gov (United States)

Background Osteosarcoma is the most common malignant primary bone tumour in young adult treated by neo adjuvant chemotherapy, surgical tumor removal and adjuvant multidrug chemotherapy. For correction of soft tissue defect consecutive to surgery and/or tumor treatment, autologous fat graft has been proposed in plastic and reconstructive surgery. Principal Findings We report here a case of a late local recurrence of osteosarcoma which occurred 13 years after the initial pathology and 18 months after a lipofilling procedure. Because such recurrence was highly unexpected, we investigated the possible relationship of tumor growth with fat injections and with mesenchymal stem/stromal cell like cells which are largely found in fatty tissue. Results obtained in osteosarcoma pre-clinical models show that fat grafts or progenitor cells promoted tumor growth. Significance These observations and results raise the question of whether autologous fat grafting is a safe reconstructive procedure in a known post neoplasic context.

Perrot, Pierre; Rousseau, Julie; Bouffaut, Anne-Laure; Redini, Francoise; Cassagnau, Elisabeth; Deschaseaux, Frederic; Heymann, Marie-Francoise; Heymann, Dominique; Duteille, Franck; Trichet, Valerie; Gouin, Francois

2010-01-01

79

The History of Autologous Fat Graft Use for Prevention of Cerebrospinal Fluid Rhinorrhea After Transsphenoidal Approaches.  

UK PubMed Central (United Kingdom)

Presented herein is a review of the history of fat graft use in preventing iatrogenic cerebrospinal fluid (CSF) rhinorrhea after transsphenoidal surgery. Since the first transsphenoidal surgeries were described in the early 1900s, the techniques of sellar packing to prevent CSF leak have evolved. Kanavel, Halstead, and Cushing used bismuth- or iodine-soaked gauze. Under Dandy's influence, fascia lata was the first autologous material used for repair and prevention of CSF rhinorrhea. The use of autologous fat graft for this purpose has only been reported in recent decades. Montgomery was the first to use abdominal fat to obliterate the middle ear cavity in 1964, and Collins reported the first transsphenoidal application of fat graft in 1973. Other reports by Kirchner, Tindall, and Wilson followed.

Ziu M; Jimenez DF

2012-08-01

80

[Autologous fat grafts and supportive enrichment with adipose tissue stromal cells].  

UK PubMed Central (United Kingdom)

Liposuction is a most common surgical procedure in aesthetic surgery that aims at the local fat reduction. The obtained adipose tissue is currently used as a biocompatible filler. Autologous fat transplantation, also known as lipofilling, has become an attractive treatment method in the field of aesthetic facial surgery and scar tissue reconstruction. Lipofilling may also offer an alternative method to prosthetic breast surgery. Nevertheless, postoperative fat tissue resorption is still a limitiation to lipofilling in breast reconstruction leading to multiple revisions in order to reach the requested clinical outcome. The therapeutic effect of autologous fat grafts does not solely lie in its role as a filler material, but also in its wound healing and angiogenetic properties. The latter is not attributed to the mature adipocytes, but rather to the undifferentiated adipose derived stromal cells (ASC). Thus enrichment of the fat graft with autologous ASC, known as cell-assisted lipotransfer (CAL) may lead to further optimisation of lipofilling concerning fat graft survival. Still aiming to establish the application of autologous fat grafts and ASC in breast reconstruction, there is a necessity for systematic analyses in order to resolve questions regarding the operational technique and qualitative aspects of the ASC manufacturing in accordance with pharmaceutical guidelines and regulations in Germany. Besides, some open questions need to be addressed regarding the ASC differentiation potential in vivo.

Karagianni M; Kraneburg U; Klüter H; Machens HG; Bieback K; Schantz JT; Papadopulos N

2013-04-01

 
 
 
 
81

[Autologous fat grafts and supportive enrichment with adipose tissue stromal cells].  

Science.gov (United States)

Liposuction is a most common surgical procedure in aesthetic surgery that aims at the local fat reduction. The obtained adipose tissue is currently used as a biocompatible filler. Autologous fat transplantation, also known as lipofilling, has become an attractive treatment method in the field of aesthetic facial surgery and scar tissue reconstruction. Lipofilling may also offer an alternative method to prosthetic breast surgery. Nevertheless, postoperative fat tissue resorption is still a limitiation to lipofilling in breast reconstruction leading to multiple revisions in order to reach the requested clinical outcome. The therapeutic effect of autologous fat grafts does not solely lie in its role as a filler material, but also in its wound healing and angiogenetic properties. The latter is not attributed to the mature adipocytes, but rather to the undifferentiated adipose derived stromal cells (ASC). Thus enrichment of the fat graft with autologous ASC, known as cell-assisted lipotransfer (CAL) may lead to further optimisation of lipofilling concerning fat graft survival. Still aiming to establish the application of autologous fat grafts and ASC in breast reconstruction, there is a necessity for systematic analyses in order to resolve questions regarding the operational technique and qualitative aspects of the ASC manufacturing in accordance with pharmaceutical guidelines and regulations in Germany. Besides, some open questions need to be addressed regarding the ASC differentiation potential in vivo. PMID:23629684

Karagianni, M; Kraneburg, U; Klüter, H; Machens, H-G; Bieback, K; Schantz, J-T; Papadopulos, N

2013-04-29

82

[Autologous fat grafting in radiated tissue prior to breast prosthetic reconstruction: is the technique reliable?].  

UK PubMed Central (United Kingdom)

BACKGROUND: Prosthetic breast reconstruction is critical in the radiated breast. The main purpose of this study was to determine whether fat grafting prior to breast reconstruction could improve thoracic tissue trophicity enough to perform a simple prosthetic reconstruction, avoiding a flap procedure. PATIENTS AND METHODS: A total of 25 patients who had undergone a modified radical mastectomy followed by radiotherapy were retrieved. Fat was injected according to Coleman's technique. Prosthetic reconstruction was performed three to six months after the fat grafting procedure. Reconstruction of the nipple-areola complex was performed 3 months after implant positioning. Median follow-up interval was two years. Patient satisfaction was ascertained with a self-assessment questionnaire. Three independent blinded physician observers judged preoperative and postoperative photographs to determine the quality of reconstruction. RESULTS: The mean refined fat injected volume was 160ml. In all cases except two, a unique fat grafting procedure was necessary. Prosthetic reconstruction was achieved in 23 cases. The technique failed in two cases and breast reconstruction was achieved by a latissimus dorsi flap with implant. During the follow-up interval, two complications occurred in two patients presenting with fat necrosis and oil cysts. The mean number of total surgical procedures was 2.5 per patient. Quality of reconstruction was judged as good by both physicians and patients. CONCLUSIONS: Autologous fat grafting in radiated tissue prior to breast reconstruction is a safe and reliable technique. In selected cases, a simple prosthetic reconstruction can be achieved avoiding a flap procedure.

Irani Y; Casanova D; Amar E

2012-02-01

83

Lip augmentation with AlloDerm acellular allogenic dermal graft and fat autograft: A comparison with autologous fat injection alone.  

UK PubMed Central (United Kingdom)

Many surgical options exist for lip augmentation, none of which consistently provide safe, lasting, and predictable volume gains. We describe and evaluate the use of AlloDerm acellular allogenic dermal graft in combination with fat autograft and compare the postoperative results with those of autologous fat injection alone. Analysis of the preoperative and 1- and 3-month postoperative photographs was done using digital imaging software. Outcome measures included vermilion show and horizontal lip projection from the soft tissue pogonion-subnasale plane. A 61% mean increase in vermilion show was observed in lips augmented with AlloDerm/fat injection, in comparison to a mean increase of 13% in lips augmented with fat injection alone. Lip projection demonstrated a mean increase of 1 mm in AlloDerm/fat lips at 3 months. Postoperatively, no evidence of resorption was seen in lips augmented with AlloDerm/fat between the 1- and the 3-month follow-ups, however, a 9% decrease in vermilion show occurred in lips augmented with fat injection over the same period. No complications occurred in either group. We conclude that AlloDerm in conjunction with autologous fat injection constitutes a safe, reliable, and lasting method of lip augmentation providing increased vermilion show compared to that with autologous fat injection alone.

Castor SA; To WC; Papay FA

1999-05-01

84

Quantitative Volumetric Analysis of Progressive Hemifacial Atrophy Corrected Using Stromal Vascular Fraction-Supplemented Autologous Fat Grafts.  

UK PubMed Central (United Kingdom)

BACKGROUND: Progressive hemifacial atrophy (Parry-Romberg disease) is rare and involves all skin layers and subcutaneous soft and hard tissue. Autologous fat grafting has revolutionized the field of soft-tissue reconstruction and augmentation, but long-term maintenance is unpredictable. Stromal vascular fraction (SVF)-supplemented cell therapy offers new hope for improving fat graft survival, with good long-term results, but efficacy and long-term outcome in the clinic are rarely studied using objective data. OBJECTIVE: To compare the long-term viability of SVF-supplemented fat grafts and fat grafts alone for contour reconstruction of progressive hemifacial atrophy using quantitative volume analysis. METHODS: We treated 20 patients with stable hemifacial atrophy for at least 2 years with SVF-supplemented autologous fat grafting (n = 10) or fat grafting alone (n = 10). All patients were followed up every 3 months. Hemifacial volume was measured using computed tomography and the Philips Extended Brilliance Workspace. RESULTS: All patients had successful outcomes without complications, but fat survival and clinical improvement was greater with SVF-supplemented grafting than fat grafting alone after 6 months. CONCLUSION: SVF-supplemented autologous fat transplantation is effective and safe for treating progressive hemifacial atrophy and can enhance the survival of grafts in the face without major complications.

Chang Q; Li J; Dong Z; Liu L; Lu F

2013-10-01

85

The role of autologous fat grafting in secondary microsurgical breast reconstruction.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous breast reconstruction offers higher rates of patient satisfaction, but not all patients are ideal candidates, often due to inadequate volume of donor sites. Although autologous fat grafting is frequently used to augment volume and contour abnormalities in implant-based breast reconstruction, its clear utility in microsurgical breast reconstruction has yet to be defined. Here, we examined patients undergoing autologous microsurgical breast reconstruction with and without the adjunct of autologous fat grafting to clearly define utility and indications for use. METHODS: A retrospective review of all patients undergoing autologous breast reconstruction with microvascular free flaps at a single institution between November 2007 and October 2011 was conducted. Patients were divided into 2 groups as follows: those requiring postoperative fat grafting and those not requiring fat grafting. Patient demographics, indications for surgery, history of radiation therapy, patient body mass index, mastectomy specimen weight, need for rib resection, flap weight, and complications were analyzed in comparison. RESULTS: Two hundred twenty-eight patients underwent 374 microvascular free flaps for breast reconstruction. One hundred (26.7%) reconstructed breasts underwent postoperative fat grafting, with an average of 1.12 operative sessions. Fat was most commonly injected in the medial and superior medial poles of the breast and the average volume injected was 147.8 mL per breast (22-564 mL). The average ratio of fat injected to initial flap weight was 0.59 (0.07-1.39). Patients undergoing fat grafting were more likely to have had deep inferior epigastric perforator and profunda artery perforator flaps as compared to muscle-sparing transverse rectus abdominis myocutaneous. Patients additionally were more likely to have a prophylactic indication 58% (n = 58) versus 42% (n = 117) (P = 0.0087), rib resection 68% (n = 68) versus 54% (n = 148) (P < 0.0153), and acute postoperative complications requiring operative intervention 7% (n = 7) versus 2.1% (n = 8) (P < 0.0480). Additionally, patients undergoing autologous fat grafting had smaller body mass index, mastectomy weight, and flap weight. CONCLUSIONS: Fat grafting is most commonly used in those breasts with rib harvest, deep inferior epigastric perforator flap reconstructions, and those with acute postoperative complications. It should be considered a powerful adjunct to improve aesthetic outcomes in volume-deficient autologous breast reconstructions and additionally optimize contour in volume-adequate breast reconstructions.

Weichman KE; Broer PN; Tanna N; Wilson SC; Allan A; Levine JP; Ahn C; Choi M; Karp NS; Allen R

2013-07-01

86

[Tolerance of pre-expansion BRAVA and fat grafting into the breast].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Fat grafting is very interesting for breast reconstruction and for breast deformities. Fat grafting can improve results with a long-standing follow-up. Pre-expansion with BRAVA® can be a powerful tool for recipient site improvement. The aim of this study is to evaluate tolerance of BRAVA by the patient. MATERIAL AND METHODS: We do realize a prospective study with fat grafting into the breast surgery. Recipient site was prepared with BRAVA®: 4 weeks before surgical procedure, and 2 weeks after surgical procedure. Fat was harvested, centrifugated, and injected into breast reconstructions or breast augmentation. Following items were noticed by the patient after they wear BRAVA: pain, noise, sleep, infection, skin redness, motivation, skin bubbles. We have noticed if the patient has stopped BRAVA. RESULTS: Twenty-three breasts were treated with BRAVA and fat grafting. Main indications were four mastectomies with radiation, five mastectomies without radiation, three breast cancer conservative surgeries, six breast reconstructions with flap improvements, one breast implant reconstruction failure, one deformity due to a surgical cardiac procedure and three contralateral breast augmentations. Only twenty-one patients succeed to wear BRAVA during one cycle. We have noticed no pain, no motivation loss, no infection. We have noticed 86% of skin redness, and 9,5% sleep troubles and noise troubles. No patient had stop BRAVA during the cycle. CONCLUSION: Tolerance of BRAVA is very good for the patient. Main troubles are skin redness. We have noticed any infection, any pain and any motivation loss. If patient can understand how to wear BRAVA, it's important to explain every item of complications. It's a reliable and safe pre-expansion. Another prospective study would evaluate efficiency of BRAVA with fat grafting versus fat grafting alone.

Ho Quoc C; Delay E

2013-06-01

87

Sepsis with multiple abscesses after massive autologous fat grafting for augmentation mammoplasty: a case report.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting to the breast for breast reconstruction and cosmetic breast augmentation has gained much attention recently. However, its efficacy and the severities of its associated complications are of concern. The authors experienced one case of multiple breast abscesses after augmentation mammoplasty by autologous fat grafting. METHODS: A 42-year-old woman presented to the authors' emergency department reporting tenderness, swelling, and a sensation of heat in both breasts. The patient had undergone augmentation mammoplasty by autologous fat grafting 7 days previously. Abscess formation was suspected based on the patient's history, physical examination, laboratory findings, and image study. RESULTS: Incision and drainage were performed immediately with the patient under general anesthesia, and 500 ml of a foul, brown, turbid, purulent fluid containing necrotic fat debris was drained from each breast. Empiric antibiotics were started on the first hospital day, and betadine and saline-irrigation were administered daily for 2 weeks. Incisions were closed on hospital day 19 when laboratory data and local infection signs had improved. At the patient's 9-month follow-up assessment, breast contours were found to be well preserved, and scarring was minimal. CONCLUSION: Immediate complications such as edema, hematoma, and infection require serious consideration after autologous fat grafting in the breast. In particular, infection probably is the most serious complication because the volume of the fat injected is large and can induce systemic infections such as sepsis and distort the contours of the breast. To avoid such infections, systemic and multicenter studies are required to determine how fat grafting should be performed to minimize the risks of fat necrosis and infection.

Lee KS; Seo SJ; Park MC; Park DH; Kim CS; Yoo YM; Lee IJ

2011-08-01

88

Development of micro-injection as an innovative autologous fat graft technique: The use of adipose tissue as dermal filler.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat graft, by virtue of its volumetric qualities and its action on skin trophicity, can be considered as a gold standard implant. Current techniques do not allow very superficial or subdermal injections of adipose tissue. The authors report technical modifications that enable fat transfer through a 25-gauge cannula. The viability of grafted fat was assessed after subcutaneous injection on a murine model. METHODS: Micro-fat grafting consists of harvesting fat tissue using a multiperforated cannula with holes of 1 mm. Fat tissue is refined as described by SR Coleman and transferred through a micro-cannula. Initially, human fat was first harvested using two different procedures: Coleman's technique and the modified harvesting technique. Preliminary comparative histologic analyses were performed. Sixteen nude mice received human fat tissue: one side was filled with 0.7 cc through a 17-G cannula using Coleman's technique, and the opposite side was grafted using smaller cannulae (20G, 23G and 25G) following the modified harvesting technique. Mice were euthanised at 12 weeks and skin biopsies were performed. RESULTS: Experimental fat grafts on mice were observed and analysed: macroscopically, the fat tissue of each side showed the same healthy aspect. Haematoxylin-eosin-saffron staining revealed intact adipocytes and anti-CD31 antibody immunohistochemical staining highlighted an abundant neo-vessel network. CONCLUSION: Fat graft obtained by the modified technique maintains a normal histologic structure. Fat injection with micro-cannulae extends the application of lipostructure to the superficial layers of the skin.

Nguyen PS; Desouches C; Gay AM; Hautier A; Magalon G

2012-12-01

89

Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival: a randomised placebo-controlled trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting is increasingly used in reconstructive surgery. However, resorption rates ranging from 25% to 80% have been reported. Therefore, methods to increase graft viability are needed. Here, we report the results of a triple-blind, placebo-controlled trial to compare the survival of fat grafts enriched with autologous adipose-derived stem cells (ASCs) versus non-enriched fat grafts. METHODS: Healthy participants underwent two liposuctions taken 14 days apart: one for ASC isolation and ex-vivo expansion, and another for the preparation of fat grafts. Two purified fat grafts (30 mL each) taken from the second liposuction were prepared for each participant. One graft was enriched with ASCs (20?×?10(6) cells per mL fat), and another graft without ASC enrichment served as a control. The fat grafts were injected subcutaneously as a bolus to the posterior part of the right and left upper arm according to the randomisation sequence. The volumes of injected fat grafts were measured by MRI immediately after injection and after 121 days before surgical removal. The primary goal was to compare the residual graft volumes of ASC-enriched grafts with those of control grafts. This study is registered at www.clinicaltrialsregister.eu, number 2010-023006-12. FINDINGS: 13 participants were enrolled, three of whom were excluded. Compared with the control grafts, the ASC-enriched fat grafts had significantly higher residual volumes: 23·00 (95% CI 20·57-25·43) cm(3) versus 4·66 (3·16-6·16) cm(3) for the controls, corresponding to 80·9% (76·6-85·2) versus 16·3% (11·1-21·4) of the initial volumes, respectively (p<0·0001). The difference between the groups was 18·34 (95% CI 15·70-20·98) cm(3), equivalent to 64·6% (57·1-72·1; p<0·0001). No serious adverse events were noted. INTERPRETATION: The procedure of ASC-enriched fat grafting had excellent feasibility and safety. These promising results add significantly to the prospect of stem cell use in clinical settings, and indicate that ASC graft enrichment could render lipofilling a reliable alternative to major tissue augmentation, such as breast surgery, with allogeneic material or major flap surgery. FUNDING: Danish Cancer Society, Centre of Head and Orthopaedics Rigshospitalet, and Moalem Weitemeyer Bendtsen.

Kølle SF; Fischer-Nielsen A; Mathiasen AB; Elberg JJ; Oliveri RS; Glovinski PV; Kastrup J; Kirchhoff M; Rasmussen BS; Talman ML; Thomsen C; Dickmeiss E; Drzewiecki KT

2013-09-01

90

"Mucosal pocket" myringoplasty: a modification of underlay technique for anterior or subtotal perforations.  

UK PubMed Central (United Kingdom)

PURPOSE: Chronic otitis media surgery is the most common procedure in otology in developing countries. Subtotal and total tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rate of graft failure. It was the goal of this study to test the anatomical and functional outcomes of a modified underlay myringoplasty technique. MATERIALS AND METHODS: In a prospective clinical study, 45 patients with subtotal or total TM perforation and inadequate anterior remnant underwent tympanoplasty (+/-mastoidectomy). The anterior tip of the temporalis fascia was secured in a mucosal pocket on the lateral wall of eustachian tube orifice. Data on graft take rate, preoperative and postoperative hearing status, and intraoperative findings were analyzed. RESULTS: We achieved the graft success rate of 91.1%, without lateralization, blunting, atelectasia, or epithelial pearls. Approximately 24% patients had air-bone gap within 25 dB before intervention, which increased to 71% postoperatively (P < .001). CONCLUSION: We believe that this technique could be a convenient and suitable method for cases with subtotal or total TM perforation and inadequate anterior remnant.

Faramarzi A; Hashemi SB; Rajaee A

2012-11-01

91

Importance of mesenchymal stem cells in autologous fat grafting: a systematic review of existing studies.  

Science.gov (United States)

Autologous fat grafting (lipofilling) enables repair and augmentation of soft tissues and is increasingly used both in aesthetic and reconstructive surgery. Autologous fat has several advantages, including biocompatibility, versatility, natural appearance, and low donor site morbidity. The main limitation is unpredictable graft resorption, which ranges from 25%-80%, probably as a result of ischaemia and lack of neoangiogenesis. To obviate these disadvantages, several studies have searched for new ways of increasing the viability of the transplanted tissue. One promising approach has been to enrich the fat graft with adipose tissue-derived mesenchymal stem cells (ASC) before transplantation. We have reviewed original studies published on fat transplantation enriched with ASC. We found four murine and three human studies that investigated the subject after a sensitive search of publications. In the human studies, so-called cell assisted lipotransfer (CAL) increased the ASC concentration 2-5 times compared with non-manipulated fat grafts, which caused a questionable improvement in survival of fat grafts, compared with that of traditional lipofilling. In contrast, in two of the murine studies ASC-concentrations were increased 1250 and 6250 times, respectively, by ASC ex vivo expansion, which resulted in considerably improved fat transplant survival as well as quality. This effect of high-level enrichment with ASC is thought to have been caused by paracrine signalling, cellular differentiation, or both. The surgical and tissue handling techniques used in lipofilling are well proved, but the added effect of high-level enrichment with ex vivo expanded ASC still needs to be investigated properly in human lipofilling studies, combined with a thorough follow up and matched control groups. In conclusion, ASC-enriched lipofilling theoretically has the potential for transforming lipofilling from a relatively unpredictable intervention into one in which the resorption rate, quality of tissue, and safety can be predicted, and possibly superior to prosthetic implantation. PMID:22471250

Trojahn Kølle, Stig-Frederik; Oliveri, Roberto S; Glovinski, Peter Viktor; Elberg, Jens Jørgen; Fischer-Nielsen, Anne; Drzewiecki, Krzysztof Tadeusz

2012-04-01

92

Importance of mesenchymal stem cells in autologous fat grafting: a systematic review of existing studies.  

UK PubMed Central (United Kingdom)

Autologous fat grafting (lipofilling) enables repair and augmentation of soft tissues and is increasingly used both in aesthetic and reconstructive surgery. Autologous fat has several advantages, including biocompatibility, versatility, natural appearance, and low donor site morbidity. The main limitation is unpredictable graft resorption, which ranges from 25%-80%, probably as a result of ischaemia and lack of neoangiogenesis. To obviate these disadvantages, several studies have searched for new ways of increasing the viability of the transplanted tissue. One promising approach has been to enrich the fat graft with adipose tissue-derived mesenchymal stem cells (ASC) before transplantation. We have reviewed original studies published on fat transplantation enriched with ASC. We found four murine and three human studies that investigated the subject after a sensitive search of publications. In the human studies, so-called cell assisted lipotransfer (CAL) increased the ASC concentration 2-5 times compared with non-manipulated fat grafts, which caused a questionable improvement in survival of fat grafts, compared with that of traditional lipofilling. In contrast, in two of the murine studies ASC-concentrations were increased 1250 and 6250 times, respectively, by ASC ex vivo expansion, which resulted in considerably improved fat transplant survival as well as quality. This effect of high-level enrichment with ASC is thought to have been caused by paracrine signalling, cellular differentiation, or both. The surgical and tissue handling techniques used in lipofilling are well proved, but the added effect of high-level enrichment with ex vivo expanded ASC still needs to be investigated properly in human lipofilling studies, combined with a thorough follow up and matched control groups. In conclusion, ASC-enriched lipofilling theoretically has the potential for transforming lipofilling from a relatively unpredictable intervention into one in which the resorption rate, quality of tissue, and safety can be predicted, and possibly superior to prosthetic implantation.

Trojahn Kølle SF; Oliveri RS; Glovinski PV; Elberg JJ; Fischer-Nielsen A; Drzewiecki KT

2012-04-01

93

Effect of ASCs on the graft survival rates of fat particles in rabbits.  

UK PubMed Central (United Kingdom)

This study was conducted to explore the effect of adipose-derived stem cells (ASCs) on the graft survival rates of fat particles in rabbits. Six domestic rabbits were used for a 3-month study; 1.4 grams of fat tissues were harvested from the bilateral inguinal regions of each animal. They were cut into granules and divided into three parts (A = 0.4 g, B = 0.4 g, and C = 0.6 g). Part A was centrifuged after 0.075% collagenase digestion for isolation of the stromal vascular fraction (SVF). About 0.2 grams of SVF containing ASCs was obtained, and then incorporated with part B to create a treated group, whereas part C was treated as a control group. The tissues in both groups were randomly transplanted into a subcutaneous space that had been created on each side of the dorsal midline of the rabbit. The grafts were taken out after 3 months for calculation of the survival rates. The graft survival rate in the treated group was 23.56 ± 2.49%, while that in the control group was 11.06 ± 2.10%. The graft survival rate in the treated group increased significantly, compared with in the control group (p < 0.01). Improved transplantation effects may be obtained by implanting the fat particles mixed with ASCs. It is suggested that this approach has the potential for becoming a new method of fat graft in clinical practice.

He X; Zhong X; Ni Y; Liu M; Liu S; Lan X

2013-02-01

94

Effect of ASCs on the graft survival rates of fat particles in rabbits.  

Science.gov (United States)

This study was conducted to explore the effect of adipose-derived stem cells (ASCs) on the graft survival rates of fat particles in rabbits. Six domestic rabbits were used for a 3-month study; 1.4 grams of fat tissues were harvested from the bilateral inguinal regions of each animal. They were cut into granules and divided into three parts (A = 0.4 g, B = 0.4 g, and C = 0.6 g). Part A was centrifuged after 0.075% collagenase digestion for isolation of the stromal vascular fraction (SVF). About 0.2 grams of SVF containing ASCs was obtained, and then incorporated with part B to create a treated group, whereas part C was treated as a control group. The tissues in both groups were randomly transplanted into a subcutaneous space that had been created on each side of the dorsal midline of the rabbit. The grafts were taken out after 3 months for calculation of the survival rates. The graft survival rate in the treated group was 23.56 ± 2.49%, while that in the control group was 11.06 ± 2.10%. The graft survival rate in the treated group increased significantly, compared with in the control group (p < 0.01). Improved transplantation effects may be obtained by implanting the fat particles mixed with ASCs. It is suggested that this approach has the potential for becoming a new method of fat graft in clinical practice. PMID:23210496

He, Xiaosheng; Zhong, Xiaochun; Ni, Youdi; Liu, Maolin; Liu, Suhang; Lan, Xiaoling

2012-12-04

95

Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes.  

UK PubMed Central (United Kingdom)

With adipose-derived stem cells (ASCs) at the forefront of research and potential clinical applications, it is important that clinicians be able to distinguish them from the fat grafting currently used clinically and to understand how the two approaches relate to one another. At times, there has been confusion in clinically considering the two therapies to be the same. This report is aimed at distinguishing clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, application techniques, outcomes, and complications. Findings have shown that autologous fat transfer, a widely used procedure for soft tissue augmentation, is beneficial for reconstructive and cosmetic procedures used to treat patients with volume loss due to disease, trauma, congenital defects, or the natural process of aging. On the other hand, ASCs have been identified as an ideal source of cells for regenerative medicine, with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. Recent advances in tissue engineering suggest that the supplementation of fat grafts with ASCs isolated in the stromal vascular fraction may increase the longevity and quality of the fat graft. Research suggests that ASC supplementation may be a great clinical tool in the future, but more data should be acquired before clinical applications.

Tabit CJ; Slack GC; Fan K; Wan DC; Bradley JP

2012-06-01

96

Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes.  

Science.gov (United States)

With adipose-derived stem cells (ASCs) at the forefront of research and potential clinical applications, it is important that clinicians be able to distinguish them from the fat grafting currently used clinically and to understand how the two approaches relate to one another. At times, there has been confusion in clinically considering the two therapies to be the same. This report is aimed at distinguishing clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, application techniques, outcomes, and complications. Findings have shown that autologous fat transfer, a widely used procedure for soft tissue augmentation, is beneficial for reconstructive and cosmetic procedures used to treat patients with volume loss due to disease, trauma, congenital defects, or the natural process of aging. On the other hand, ASCs have been identified as an ideal source of cells for regenerative medicine, with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. Recent advances in tissue engineering suggest that the supplementation of fat grafts with ASCs isolated in the stromal vascular fraction may increase the longevity and quality of the fat graft. Research suggests that ASC supplementation may be a great clinical tool in the future, but more data should be acquired before clinical applications. PMID:22069062

Tabit, Christina J; Slack, Ginger C; Fan, Kenneth; Wan, Derrick C; Bradley, James P

2011-11-09

97

[Viability of autologous fat grafts harvested with the Coleman technique and the tissu trans system (shippert method): a comparative study].  

Science.gov (United States)

Various methods for harvesting and refining autologous fat grafts have been described. One of the standard procedures, the Coleman technique, is based on manual aspiration to reduce the negative presssure and the centrifugation of the grafts. The Shippert technique uses automatic liposuction with reduced negative pressure and abstains from centifugation in order not to reduce viability of the graft by exposing it to centrifugal forces. This study intends to compare the viability of fat grafts processed with the above-mentioned methods.Fat grafts were obtained in 9 patients by using both the Tissu Trans system (Shippert technique) and the Coleman technique. To evaluate the impact of centrifugation forces, the grafts harvested with the Coleman technique were treated with standard adjustment of the centrifuge and also with doubled g-force. Viability of fat grafts was analysed with the WST-8 test and with annexin V/PI assay FACS analysis.The viability of fat grafts processed by the Coleman technique was significantly higher compared to the Shippert technique on applying the WST-8 test. Applying the annexin V/PI analysis, the viability of fat grafts was almost equal with both techniques. Whereas the fat grafts processed with the Tissu Trans system are injected without condensation, the grafts refined with the Coleman technique were concentrated 3 times by centrifugation compared to the primary liposuctioned graft volumes.The Coleman technique allows the preparation of a fat graft containing more viable cells than the Shippert technique. This is in part due to the condensation of the graft by centrifugation using the Coleman technique. The factor of condensation of the grafts harvested and refined with the Coleman technique exceeds the factor of increased fat graft viability in comparison to the Shippert technique. The Tissu Trans system is more than twice as fast and easier to use with a preferential use for large volume grafts like in breast augmentation, whereas the Coleman technique produces a more condensed graft, favouring it for fat grafting to the face where less volume is needed. PMID:22241519

Herold, C; Pflaum, M; Utz, P; Wilhelmi, M; Rennekampff, H-O; Vogt, P M

2012-01-12

98

Trends in autologous fat grafting to the breast: a national survey of the american society of plastic surgeons.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting has been gaining popularity in recent years, although there remains concern regarding the safety and efficacy of the practice for breast surgery. The purpose of this study was to determine national trends for fat grafting to the breast and to establish the frequency and specific techniques of the procedure to provide more supportive data. METHODS: A questionnaire was e-mailed to 2584 members of the American Society of Plastic Surgeons. Variables included prevalence and applications of fat grafting to the breast. Components of the fat graft protocol were also assessed. RESULTS: Four hundred fifty-six of the 2584 questionnaires were completed. Sixty-two percent of all respondents reported currently using fat grafting for reconstructive breast surgery and 28% of all respondents reported currently using the practice for aesthetic breast surgery. The most common reason cited by respondents for using fat grafting to the breast was as an adjunctive therapy to implant or flap surgery. CONCLUSIONS: Fat grafting to the breast is a common procedure most often used in reconstructive operations. The increasing prevalence of fat grafting to the breast indicates a need for collection of clinical data and supports the establishment of a national prospective registry to track outcomes after aesthetic and reconstructive applications.

Kling RE; Mehrara BJ; Pusic AL; Young VL; Hume KM; Crotty CA; Rubin JP

2013-07-01

99

Free dermal fat graft for restoration of soft tissue defects in maxillofacial surgery.  

Science.gov (United States)

Various local flaps have been used for reconstruction of developmental and post surgical soft tissue defects of maxillofacial region. They include nasolabial flap, palatal pedicled flap, buccal fat pad, temporalis muscle and fascia flap. An ideal flap for all indications is yet to be found. Our experience with free dermal fat graft in the correction of deformities associated with Parry Romberg syndrome and oral submucous fibrosis is presented. PMID:23997484

Kumar, N Girish; Thapliyal, G K

2012-04-25

100

Free dermal fat graft for restoration of soft tissue defects in maxillofacial surgery.  

UK PubMed Central (United Kingdom)

Various local flaps have been used for reconstruction of developmental and post surgical soft tissue defects of maxillofacial region. They include nasolabial flap, palatal pedicled flap, buccal fat pad, temporalis muscle and fascia flap. An ideal flap for all indications is yet to be found. Our experience with free dermal fat graft in the correction of deformities associated with Parry Romberg syndrome and oral submucous fibrosis is presented.

Kumar NG; Thapliyal GK

2012-09-01

 
 
 
 
101

Sequelae of autologous fat graft used for reconstruction in skull base surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: The use of an autologous free fat graft is a widely applied technique to obliterate dead space and reinforce dural closure during skull base reconstructions. The associated complications and outcomes of this practice have not been studied. Dissemination of fat in the subarachnoid space resulting in lipoid meningitis has been reported after translabyrinthine approaches, and leakage of liquefied fat is seldom reported in the literature. This study aims to evaluate the morbidity associated with the usage of autologous fat graft in reconstruction of skull base defects based on an extensive experience. METHODS: This study is a retrospective review of 1581 cases in which the senior author (O.A.) used a skull base approach for the resection of tumor. Autologous fat grafts were used for reconstruction in 974 cases and 10 cases (male to female ratio, 4:6) in which there were associated complications were analyzed. RESULTS: Complications included leakage of sterile liquefied fat from fistula (patients 1, 2, 3), delayed cerebrospinal fluid leak after radiation (Patients 5, 6, 9), and postoperative lipoid meningitis (Patients 4, 7, 8, 10). The onset ranged from 11 days to 10 years. Four patients were managed conservatively, and the other six required surgical intervention. All patients had good outcomes after treatment. CONCLUSIONS: The use of autologous fat is associated with a 1% complication rate and should be considered a safe and effective method for skull base reconstruction. However, neurosurgeons should be aware of early and late complications of fat necrosis, including sterile liquefied fat fistula, cerebrospinal fluid leakage, and lipoid meningitis.

Taha AN; Almefty R; Pravdenkova S; Al-Mefty O

2011-05-01

102

[Adipocyte microinfiltration in the face or tissue restructuration with fat tissue graft].  

Science.gov (United States)

The author presents his experience of the autologous fatty tissue transplantation. He calls his method microinfiltration of adipocytes (MIA). The fat of the body is harvested with the technique of syringe liposuccion without trauma and is refined and placed in an intricate layering of autologous fatty tissue with anatomic patented microcanulaes. This procedure named Lipostructure by Coleman is not a lipofilling or "liposculpture" as described by P. Fournier in 1989. By focusing on the procedure as autotransplantation fat grafting technique and fully respecting the delicate nature of the fat cell, the author has been able to document a high rate of success with 3 years follow-up. PMID:10675959

Amar, R E

1999-12-01

103

[Adipocyte microinfiltration in the face or tissue restructuration with fat tissue graft  

UK PubMed Central (United Kingdom)

The author presents his experience of the autologous fatty tissue transplantation. He calls his method microinfiltration of adipocytes (MIA). The fat of the body is harvested with the technique of syringe liposuccion without trauma and is refined and placed in an intricate layering of autologous fatty tissue with anatomic patented microcanulaes. This procedure named Lipostructure by Coleman is not a lipofilling or "liposculpture" as described by P. Fournier in 1989. By focusing on the procedure as autotransplantation fat grafting technique and fully respecting the delicate nature of the fat cell, the author has been able to document a high rate of success with 3 years follow-up.

Amar RE

1999-12-01

104

[Clinical analysis of bilateral same-day myringoplasty for 22 cases with bilateral tympanic membrane perforation].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the feasibility of bilateral same-day myringoplasty and the indications for myringoplasty for patients with bilateral tympanic membrane perforation, and to summarize relevant experience. METHODS: Twenty-two patients underwent bilateral same-day underlay myringoplasty, and all cases were consistent with the indications for myringoplasty. The preoperative hearing and postoperative hearing at three months were compared, and the postoperative symptoms and complications were observed. Forty patients underwent monaural myringoplasty as the control group over the same period. All cases were followed up for 1 - 3 years. RESULTS: The postoperative hearing was increased by an average of 18 dB, and the rate of closure of tympanic membrane perforation was 93.2% (41/44). There were seven patients with ear fullness after operation in the bilateral myringoplasty group and two patients in the control group (?(2) = 4.5374, P = 0.0332). There were no differences in the postoperative hearing improvement, the rate of closure and the rates of other discomfort symptoms except for ear fullness between the two groups (P > 0.05). CONCLUSION: It was feasible and safe to perform bilateral same-day myringoplasty for bilateral tympanic membrane perforation, but the postoperative temporary discomfort of bilateral ear fullness should be informed the patients in advance.

Wang HB; Yu F; Shan XZ; Zhang F; Zhao LZ; Long SB; Ma LT; Han DY

2013-04-01

105

Effect of Fat Particle-to-SVF Ratio on Graft Survival Rates in Rabbits.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study aimed to compare the graft survival rates of various ratios of fat particles to stromal vascular fraction (SVF) in rabbits. METHODS: Fifteen purebred white rabbits of the same brood were used. In the study, the grafts of equal weight (0.8 g) were mixtures of fat particles with various proportions of SVF (1/3, 1/4, 1/5, and 1/6) to form 4 treated groups (I, II, III, and IV), whereas merely fat particles formed 1 control group. They were randomly autoimplanted into subcutaneous pockets on both sides of the dorsal midlines of the rabbits. Animals were killed 3 months after surgery. The grafts were harvested and weighed. Comparisons were performed between the groups for survival rates. RESULTS: The treated group II (fat particle-to-SVF ratio was 3:1) revealed the greatest weight maintenance in all of the groups, showing the greatest survival rate [87.94% (1.30%), P < 0.01 or P < 0.05]. CONCLUSIONS: It was suggested that the optimal fat particle-to-SVF ratio might be 3:1, with a low resorption rate.

Ni Y; He X; Yuan Z; Liu M; Du H; Zhong X

2013-07-01

106

Liposuction fat grafts in face wrinkles and hemifacial atrophy.  

UK PubMed Central (United Kingdom)

We present the idea of correcting soft tissue defects with an injection of fat obtained by liposuction. Our method has great advantages, with few serious complications. The technique is described and the results are demonstrated in several patients treated over a period of one year.

Chajchir A; Benzaquen I

1986-01-01

107

Evaluation of the histologic changes in the fat-grafted facial skin: clinical trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fat grafting is increasingly common in plastic surgery procedures. The discovery of stem cells in fat tissue has given a new direction to the use of fat as a therapeutic tool for other patient conditions. Only one experimental study in rats shows dermal changes after application of lipofilling. For this reason, the authors conducted this study to evaluate skin changes in patients after application of the technique. This study aimed to observe histologic changes in the skin of patients undergoing fat grafting. METHODS: Fat grafting was performed in the preauricular region on one side of patients undergoing face-lifts at the Jalisco Reconstructive Surgery Institute, Guadalajara, Mexico. Preauricular skin was used in this procedure as a withdrawal study and control condition. Hematoxylin-eosin and Masson staining was performed to assess dermal and epidermal thickness, vascularity, and collagen behavior. No inferential statistics were registered with the Wilcoxon test. RESULTS: The study investigated 16 patients to observe statistically significant differences in dermal thickness, the presence of immature collagen (neoformation), and arteries. No difference in epidermal thickness was observed. CONCLUSIONS: The study showed a regenerative effect with fat grafting that included an increased thickness of the dermis, collagen neoformation, and the presence of increased vascularity in local skin subjected to treatment. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Covarrubias P; Cárdenas-Camarena L; Guerrerosantos J; Valenzuela L; Espejo I; Robles JA; Gioia S

2013-08-01

108

Comparison of three different fat graft preparation methods: gravity separation, centrifugation, and simultaneous washing with filtration in a closed system.  

UK PubMed Central (United Kingdom)

BACKGROUND: Successful long-term volume retention of an autologous fat graft is problematic. The presence of contaminating cells, tumescent fluid, and free lipid in the graft contributes to disparate outcomes. Better preparation methods for the fat graft before transplantation may significantly improve results. METHODS: Subcutaneous fat from 22 donors was divided and processed using various graft preparation methods: (1) no manipulation control, (2) gravity separation, (3) Coleman centrifugation, and (4) simultaneous washing with filtration using a commercially available system (Puregraft; Cytori Therapeutics, Inc., San Diego, Calif.). Fat grafts from various preparation methods were examined for free lipid, aqueous liquid, viable tissue, and blood cell content. Adipose tissue viability was determined by measuring glycerol release after agonist induction of lipolysis. RESULTS: All test graft preparation methods exhibited significantly less aqueous fluid and blood cell content compared with the control. Grafts prepared by washing with filtration exhibited significantly reduced blood cell and free lipid content, with significantly greater adipose tissue viability than other methods. CONCLUSION: Washing with filtration within a closed system produces a fat graft with higher tissue viability and lower presence of contaminants compared with grafts prepared by alternate methods.

Zhu M; Cohen SR; Hicok KC; Shanahan RK; Strem BM; Yu JC; Arm DM; Fraser JK

2013-04-01

109

Contemporary techniques for the correction of temporal hollowing: augmentation temporoplasty with the classic dermal fat graft.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Temporal hollowing is a depression within the soft tissues overlying the temporal fossa, sometimes seen after surgical dissection for access to the facial skeleton. Surgeons have successfully used bone grafts, hydroxyapatite, methyl methacrylate, and autogenous tissue to correct the deformity. A systematic review of the literature demonstrated that the most popular technique for the correction of temporal hollowing seems to be the use of nonbiologic materials. These materials have been used successfully but are associated with some complications. There has been a growing experience with augmentation of the soft tissues of the temporal fossa using dermal fat grafts at our institutions, and this article describes this experience. METHODS: Two senior surgeons' recent experience with the correction of temporal hollowing was reviewed and analyzed. RESULTS: The retrospective review revealed 5 cases of temporal hollowing treated with dermal fat graft placement. Follow-up at 1 year revealed aesthetically pleasing results. CONCLUSIONS: A thorough understanding of temporal anatomy and conscious effort to respect structural integrity during dissection are essential in avoiding temporal hollowing. Sometimes, however, this deformity is impossible to avoid. In these patients, there are a number of options for correction. Open placement of the classic dermal fat graft is a technique that seems to offer good long-term aesthetic results.

McNichols CH; Hatef DA; Cole P; Hollier LH; Thornton JF

2012-05-01

110

Autologous Fat Grafting: Current State of the Art and Critical Review.  

UK PubMed Central (United Kingdom)

BACKGROUND: Despite the widespread use of autologous fat grafting in both reconstructive and cosmetic surgery, volume retention remains a significant problem. We aimed to critically appraise the current body of literature in fat grafting to provide a framework to guide application and comparison. METHOD: Search of scientific databases and gray literature was conducted. Articles examining nonadipogenic applications of adipose tissue and those specific to breast reconstruction were excluded. RESULTS: One hundred three articles were included. These fell under the headings of donor site, effect of infiltration solution, harvest method, effect of centrifugation, reinjection method, supplementation, the role of adipose-derived stem cells, and scaffolding. CONCLUSIONS: Despite the significant research effort in this field, there remains no consensus as to the optimum technique. This stems from the vast array of research methods and short follow-up durations. Further, extrapolation of in vitro results to clinical settings has led to many conflicting practices.

Ross RJ; Shayan R; Mutimer KL; Ashton MW

2013-06-01

111

Coronoidectomy, masticatory myotomy and buccal fat pad graft in management of advanced oral submucous fibrosis.  

Science.gov (United States)

The purpose of this study is to evaluate coronoidectomy, masticatory myotomy and buccal fat pad graft in advanced (Stage III-IV) oral sub mucous fibrosis (OSF). 10 patients with clinically and histologically confirmed advanced OSF underwent surgery entailing bilateral coronoidectomy, masticatory muscle myotomy and closure with a pedicled buccal fat pad graft followed by vigorous mouth opening exercises. The result was evaluated using the interincisal distance at maximum mouth opening as the objective outcome measure over a follow up period of 12 months. Results showed a mean interincisal opening of 14.7 mm preoperatively and 32.5 mm at 12 months postoperatively. Relapse was encountered in one patient who did not cooperate with the postoperative exercise regime. Results suggest this regime is effective. PMID:22551649

Kothari, M C; Hallur, N; Sikkerimath, B; Gudi, S; Kothari, C R

2012-04-30

112

Coronoidectomy, masticatory myotomy and buccal fat pad graft in management of advanced oral submucous fibrosis.  

UK PubMed Central (United Kingdom)

The purpose of this study is to evaluate coronoidectomy, masticatory myotomy and buccal fat pad graft in advanced (Stage III-IV) oral sub mucous fibrosis (OSF). 10 patients with clinically and histologically confirmed advanced OSF underwent surgery entailing bilateral coronoidectomy, masticatory muscle myotomy and closure with a pedicled buccal fat pad graft followed by vigorous mouth opening exercises. The result was evaluated using the interincisal distance at maximum mouth opening as the objective outcome measure over a follow up period of 12 months. Results showed a mean interincisal opening of 14.7 mm preoperatively and 32.5 mm at 12 months postoperatively. Relapse was encountered in one patient who did not cooperate with the postoperative exercise regime. Results suggest this regime is effective.

Kothari MC; Hallur N; Sikkerimath B; Gudi S; Kothari CR

2012-11-01

113

Lipoenxertia nas mamas: procedimento consagrado ou experimental?/ Breast fat grafting: experimental or established procedure?  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Atualmente vem ocorrendo aumento da incidência de utilização de enxertia de gordura para correção de defeitos mamários congênitos ou adquiridos e para tratamento mamário estético. Esse aumento é decorrente do surgimento de novas técnicas de lipoenxertia, que produzem resultados mais duradouros e confiáveis, apesar da crença de alguns autores de que o procedimento possa dificultar o rastreamento do câncer mamário. Esta revisão de literatura tem como objetiv (more) o identificar as técnicas de lipoenxertia mamárias mais utilizadas, avaliá-las quanto à eficácia e à segurança, e relatar as principais complicações associadas. A revisão foi realizada nas bases de dados PubMed e LILACS, e os fatores de inclusão foram: artigos em idioma inglês, publicados nos últimos cinco anos. Como resultado observou-se aumento do número de trabalhos abordando o tema nos últimos anos, e predomínio de uma técnica de lipoenxertia específica. A maioria dos trabalhos demonstra que a lipoenxertia mamária não prejudica o rastreamento radiológico para câncer mamário, e alguns sugerem que a gordura enxertada potencializa o desenvolvimento de câncer nas mamas. Apesar do aumento do número de trabalhos, existem ainda poucos com bom nível de evidência científica. Esta revisão permitiu concluir que a lipoenxertia é uma técnica alternativa para reparação de defeitos mamários e discreto aumento estético das mamas, devendo ser utilizada por cirurgiões com treinamento adequado e acompanhada por equipe de radiologia experiente em imagenologia mamária. Mais trabalhos com metodologia científica adequada são necessários para avaliar a lipoenxertia mamária. Abstract in english There has recently been an increase in the use of fat grafting for the correction of congenital or acquired breast deformities and for aesthetic breast treatment. This increase is due to the emergence of novel fat grafting techniques that produce lasting and reliable results despite some authors' beliefs that the procedure might hinder breast cancer screening. This literature review aims to identify the most frequently used breast fat grafting techniques, evaluate their e (more) fficacy and safety, and report their major complications. The review was performed after a search in the PubMed and LILACS databases, and only English-language articles published over the past 5 years were assessed. There have been an increased number of studies on the topic in recent years, and a specific fat grafting technique has been primarily reported. Most studies in this area have shown that breast fat grafting does not affect radiological breast cancer screening, whereas some studies have suggested that the use of grafted fat may enhance the development of breast cancer. Despite the increased number of published studies, few have a good level of scientific evidence. This review concludes that fat grafting is an alternative technique for the correction of breast deformities and moderate aesthetic breast enlargement and should be performed by properly trained surgeons accompanied by a radiology team that is experienced in breast imaging. Further studies with appropriate scientific methodologies are needed to evaluate breast fat grafting.

Blumenschein, Alexandre Roriz; Freitas-Junior, Ruffo; Tuffanin, Andrea Thomazine; Blumenschein, Danielle Isadora

2012-12-01

114

Lipoenxertia nas mamas: procedimento consagrado ou experimental? Breast fat grafting: experimental or established procedure?  

Directory of Open Access Journals (Sweden)

Full Text Available Atualmente vem ocorrendo aumento da incidência de utilização de enxertia de gordura para correção de defeitos mamários congênitos ou adquiridos e para tratamento mamário estético. Esse aumento é decorrente do surgimento de novas técnicas de lipoenxertia, que produzem resultados mais duradouros e confiáveis, apesar da crença de alguns autores de que o procedimento possa dificultar o rastreamento do câncer mamário. Esta revisão de literatura tem como objetivo identificar as técnicas de lipoenxertia mamárias mais utilizadas, avaliá-las quanto à eficácia e à segurança, e relatar as principais complicações associadas. A revisão foi realizada nas bases de dados PubMed e LILACS, e os fatores de inclusão foram: artigos em idioma inglês, publicados nos últimos cinco anos. Como resultado observou-se aumento do número de trabalhos abordando o tema nos últimos anos, e predomínio de uma técnica de lipoenxertia específica. A maioria dos trabalhos demonstra que a lipoenxertia mamária não prejudica o rastreamento radiológico para câncer mamário, e alguns sugerem que a gordura enxertada potencializa o desenvolvimento de câncer nas mamas. Apesar do aumento do número de trabalhos, existem ainda poucos com bom nível de evidência científica. Esta revisão permitiu concluir que a lipoenxertia é uma técnica alternativa para reparação de defeitos mamários e discreto aumento estético das mamas, devendo ser utilizada por cirurgiões com treinamento adequado e acompanhada por equipe de radiologia experiente em imagenologia mamária. Mais trabalhos com metodologia científica adequada são necessários para avaliar a lipoenxertia mamária.There has recently been an increase in the use of fat grafting for the correction of congenital or acquired breast deformities and for aesthetic breast treatment. This increase is due to the emergence of novel fat grafting techniques that produce lasting and reliable results despite some authors' beliefs that the procedure might hinder breast cancer screening. This literature review aims to identify the most frequently used breast fat grafting techniques, evaluate their efficacy and safety, and report their major complications. The review was performed after a search in the PubMed and LILACS databases, and only English-language articles published over the past 5 years were assessed. There have been an increased number of studies on the topic in recent years, and a specific fat grafting technique has been primarily reported. Most studies in this area have shown that breast fat grafting does not affect radiological breast cancer screening, whereas some studies have suggested that the use of grafted fat may enhance the development of breast cancer. Despite the increased number of published studies, few have a good level of scientific evidence. This review concludes that fat grafting is an alternative technique for the correction of breast deformities and moderate aesthetic breast enlargement and should be performed by properly trained surgeons accompanied by a radiology team that is experienced in breast imaging. Further studies with appropriate scientific methodologies are needed to evaluate breast fat grafting.

Alexandre Roriz Blumenschein; Ruffo Freitas-Junior; Andrea Thomazine Tuffanin; Danielle Isadora Blumenschein

2012-01-01

115

Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progen...

Alexander RW; Harrell DB

116

Platelet-rich plasma has no effect on increasing free fat graft survival in the nude mouse.  

UK PubMed Central (United Kingdom)

BACKGROUND: Free fat grafts have an unpredictable survival rate, which may be dependent on host bed vascularity. Therefore, the authors hypothesized that the presence of growth factors in platelet-rich plasma (PRP), may enhance free fat graft survival. METHODS: Free fat grafts and autologous PRP were harvested from a healthy female and processed using the Coleman technique and the Medtronic Magellan system respectively. The experiment comprised two groups of 12 nude mice each with injection of free fat grafts into the scalp. The experimental group comprised the combination of 0.8 ml of free fat graft and 0.2 ml of PRP. The control group comprised the combination of 0.8 ml of free fat graft and 0.2 ml of normal saline. The mice were euthanized after 16 weeks and the fat grafts explanted and measured for weight and volume. Histology was performed with Oil Red O stain. Statistical analysis of the weight and volume in between groups was performed using the independent samples T-test (SPSS v11). The Mann-Whitney test was used to compare the ranking of six histological parameters between the two groups. RESULTS: The mean weight and volume for the experimental arm were 0.503 g and 0.545 ml respectively. The mean weight and volume for the control arm were 0.500 g and 0.541 ml respectively. The weight, volume and histological parameters between the two groups were not statistically significant. A mouse from each group died of unknown causes. CONCLUSION: PRP did not enhance free fat graft survival in the nude mouse.

Por YC; Yeow VK; Louri N; Lim TK; Kee I; Song IC

2009-08-01

117

The fate of adipocytes after nonvascularized fat grafting: evidence of early death and replacement of adipocytes.  

UK PubMed Central (United Kingdom)

BACKGROUND: Clinical outcomes following fat grafting are variable and technique dependent, and it is unknown how the graft is revascularized. The authors recently observed that living and dead adipocytes can be differentiated not with hematoxylin and eosin staining but with immunohistochemistry for perilipin. METHODS: The viability of cellular components (adipocytes, adipose stem/stromal/progenitor cells, vascular endothelial cells, and hematopoietic cells) in human adipose tissue was evaluated using (1) stored lipoaspirates, (2) cultured cells, and (3) organ-cultured adipose tissue. In addition, the groin fat pad (150 to 200 mg) in mice was transplanted under the scalp, and the graft was stained at 0, 1, 2, 3, 5, 7, or 14 days. RESULTS: In vitro studies revealed that adipocytes are most susceptible to death under ischemic conditions, although adipose-derived stromal cells can remain viable for 3 days. The in vivo study indicated that most adipocytes in the graft began to die on day 1, and only some of the adipocytes located within 300 ?m of the tissue edge survived. The number of proliferating cells increased from day 3, and an increase in viable adipocyte area was detected from day 7, suggesting that repair/regeneration of the dead tissue had begun. CONCLUSIONS: The authors show convincing evidence of very dynamic remodeling of adipose tissue after nonvascularized grafting. The authors observed three zones from the periphery to the center of the graft: the surviving area (adipocytes survived), the regenerating area (adipocytes died, adipose-derived stromal cells survived, and dead adipocytes were replaced with new ones), and the necrotic area (both adipocytes and adipose-derived stromal cells died).

Eto H; Kato H; Suga H; Aoi N; Doi K; Kuno S; Yoshimura K

2012-05-01

118

Autologous fat grafts placed around temporomandibular joint total joint prostheses to prevent heterotopic bone formation  

Science.gov (United States)

This study evaluated 1) the efficacy of packing autologous fat grafts around temporomandibular joint (TMJ) total joint prosthetic reconstructions to prevent fibrosis and heterotopic bone formation and 2) the effects on postsurgical joint mobility and jaw function. One hundred fifteen patients (5 males and 110 females) underwent TMJ reconstruction with total joint prostheses and simultaneous fat grafts (88 bilateral and 27 unilateral) for a total of 203 joints. The abdominal fat grafts were packed around the articulating portion of the joint prostheses after the fossa and mandibular components were stabilized. Patients were divided into two groups: group 1 (n = 76 joints) received Christensen total joint prostheses, and group 2 (n = 127 joints) received TMJ Concepts total joint prostheses. Clinical and radiographic assessments were performed before surgery, immediately after surgery, and at long-term follow-up. In group 1, maximal incisal opening (MIO) increased 3.5 mm, lateral excursions (LE) decreased 0.2 mm, and jaw function improved 1.9 levels. In group 2, MIO increased 6.8 mm, LE decreased 1.4 mm, and jaw function improved 2.4 levels. The improvement for MIO and patient perception of jaw function in both groups was statistically significant; no significant difference was found for LE. There was no radiographic or clinical evidence of heterotopic calcifications or limitation of mobility secondary to fibrosis in either group. Twenty-five Christensen prostheses (33%) were removed because of device failure and/or metal hypersensitivity; no fibrosis or heterotopic bone formation was seen at surgical removal. Four TMJ Concepts prostheses (3%) were removed because of metal hypersensitivity. In all instances, removal of the prostheses was unrelated to the autologous fat grafting. Ten patients (8.7%) developed complications involving the fat donor site: two patients (1.8%) developed abdominal cysts requiring surgery, and eight patients (6.9%) developed seroma formation requiring aspiration. Autologous fat transplantation is a useful adjunct to prosthetic TMJ reconstruction to minimize the occurrence of excessive joint fibrosis and heterotopic calcification, consequently providing improved range of motion and jaw function.

Morales-Ryan, Carlos A.; Morales, Patricia Garcia; Cassano, Daniel Serra

2008-01-01

119

Miringoplastia com a utilização de um novo material biossintético Myringoplasty using a new biomaterial allograft  

Directory of Open Access Journals (Sweden)

Full Text Available A miringoplastia é uma cirurgia com a finalidade de controlar a infecção no ouvido médio, reconstruir o mecanismo de transmissão sonora para a janela oval e proteger a janela redonda. São descritos diversos materiais para reconstruir a membrana timpânica, destacando-se a fáscia do músculo temporal, pericôndrio do tragus, cartilagem, dura-máter, tecido placentário, entre outros. OBJETIVO: Este trabalho tem objetivo de demonstrar o efeito de um novo biomaterial, a membrana de látex natural com polilisina, desenvolvida no laboratório de Neuroquímica do Departamento de Bioquímica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo - USP. FORMA DE ESTUDO: Coorte Longitudinal. MATERIAL E MÉTODO: O biomaterial utilizado é estimulante da neovascularização e crescimento tecidual organizado em diferentes órgãos e tecidos, sendo um material inócuo e não rejeitado pelo organismo. Foi usada a biomembrana de látex com polilisina como um implante transitório para o fechamento da perfuração da membrana timpânica. A membrana foi colocada na face externa dos bordos da membrana timpânica e a fáscia temporal na face interna da mesma. Foram estudadas 238 orelhas com perfuração de membrana timpânica por seqüela de otite média crônica, submetidas a miringoplastia com enxerto de fáscia de músculo temporal e a membrana de látex natural, com idades de 7 a 76 anos. Apresentavam uma ou mais miringoplastias anteriores sem sucesso 41 dos casos. RESULTADO: Como ressaltamos preliminarmente, verificamos pega do enxerto em 90,5% das orelhas (181), sendo fechamento de perfuração amplas, 96; médias, 73 e 12 pequenas. Verificamos intensa vascularização em 100% dos enxertos, o que não é habitual quando não se usa a membrana de látex natural. CONCLUSÃO: Conclue-se que o biomaterial usado merece nossa atenção quanto ao seu uso como implante transitório em miringoplastias, melhorando o processo de revascularização da membrana timpânica remanescente.Myringosplaty is a surgery that is performed to control infections in middle ear, to reconstruct the sound conducting mechanism for the oval window and protection of the round window. Some materials are used to reconstruct the tympanic membrane like autologous temporalis fascia, cartilage-perichondium graft taken from the tragus, cartilage only, dura mater human placental graft. It is important the vascular support to the graft with well-vascularized flap in wide perforations. AIM: The main goal of this work is shown the use of a new biomaterial, the natural latex membrane with polylysin. STUDY DESIGN: Longitudinal Cohort. MATERIAL AND METHOD: This material was developed from Department of Biochemistry from Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo. The natural latex membrane is used stimulating neovessels and organized tecidual growing in different parts and tissues of the human body. This material promotes any allergic reaction and is innocuous to the human tissue. The 238 ears with tympanic membrane perforation resulted from chronic middle ear infection and thek was going through myringoplasty with autologous temporalis fascia and natural latex membrane. The ages were 7 to 76 years. RESULTS: The first results show 181 (90,5%) healing tympanic membrane perforation, 96 healing of wide perforation 73 medium perforation and 12 small one. Neovessels could be seen in all grafts and remaining tympanic membrane. This is not a habitual funding when the natural latex membrane is not used. CONCLUSION: According to these results we can conclude that the natural latex membrane can be used as a temporary implant in myringoplasty, improving the well vascularized of remaining tympanic membrane.

José Antonio Apparecido de Oliveira; Miguel Angelo Hyppolito; Joaquim Coutinho Netto; Fátima Mrué

2003-01-01

120

Miringoplastia com a utilização de um novo material biossintético/ Myringoplasty using a new biomaterial allograft  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A miringoplastia é uma cirurgia com a finalidade de controlar a infecção no ouvido médio, reconstruir o mecanismo de transmissão sonora para a janela oval e proteger a janela redonda. São descritos diversos materiais para reconstruir a membrana timpânica, destacando-se a fáscia do músculo temporal, pericôndrio do tragus, cartilagem, dura-máter, tecido placentário, entre outros. OBJETIVO: Este trabalho tem objetivo de demonstrar o efeito de um novo biomaterial, (more) a membrana de látex natural com polilisina, desenvolvida no laboratório de Neuroquímica do Departamento de Bioquímica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo - USP. FORMA DE ESTUDO: Coorte Longitudinal. MATERIAL E MÉTODO: O biomaterial utilizado é estimulante da neovascularização e crescimento tecidual organizado em diferentes órgãos e tecidos, sendo um material inócuo e não rejeitado pelo organismo. Foi usada a biomembrana de látex com polilisina como um implante transitório para o fechamento da perfuração da membrana timpânica. A membrana foi colocada na face externa dos bordos da membrana timpânica e a fáscia temporal na face interna da mesma. Foram estudadas 238 orelhas com perfuração de membrana timpânica por seqüela de otite média crônica, submetidas a miringoplastia com enxerto de fáscia de músculo temporal e a membrana de látex natural, com idades de 7 a 76 anos. Apresentavam uma ou mais miringoplastias anteriores sem sucesso 41 dos casos. RESULTADO: Como ressaltamos preliminarmente, verificamos pega do enxerto em 90,5% das orelhas (181), sendo fechamento de perfuração amplas, 96; médias, 73 e 12 pequenas. Verificamos intensa vascularização em 100% dos enxertos, o que não é habitual quando não se usa a membrana de látex natural. CONCLUSÃO: Conclue-se que o biomaterial usado merece nossa atenção quanto ao seu uso como implante transitório em miringoplastias, melhorando o processo de revascularização da membrana timpânica remanescente. Abstract in english Myringosplaty is a surgery that is performed to control infections in middle ear, to reconstruct the sound conducting mechanism for the oval window and protection of the round window. Some materials are used to reconstruct the tympanic membrane like autologous temporalis fascia, cartilage-perichondium graft taken from the tragus, cartilage only, dura mater human placental graft. It is important the vascular support to the graft with well-vascularized flap in wide perforat (more) ions. AIM: The main goal of this work is shown the use of a new biomaterial, the natural latex membrane with polylysin. STUDY DESIGN: Longitudinal Cohort. MATERIAL AND METHOD: This material was developed from Department of Biochemistry from Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo. The natural latex membrane is used stimulating neovessels and organized tecidual growing in different parts and tissues of the human body. This material promotes any allergic reaction and is innocuous to the human tissue. The 238 ears with tympanic membrane perforation resulted from chronic middle ear infection and thek was going through myringoplasty with autologous temporalis fascia and natural latex membrane. The ages were 7 to 76 years. RESULTS: The first results show 181 (90,5%) healing tympanic membrane perforation, 96 healing of wide perforation 73 medium perforation and 12 small one. Neovessels could be seen in all grafts and remaining tympanic membrane. This is not a habitual funding when the natural latex membrane is not used. CONCLUSION: According to these results we can conclude that the natural latex membrane can be used as a temporary implant in myringoplasty, improving the well vascularized of remaining tympanic membrane.

Oliveira, José Antonio Apparecido de; Hyppolito, Miguel Angelo; Coutinho Netto, Joaquim; Mrué, Fátima

2003-10-01

 
 
 
 
121

Parry-Romberg syndrome: volumetric regeneration by structural fat grafting technique.  

Science.gov (United States)

The use of adipose tissue transfer for correction of maxillo-facial defects was reported for the first time at the end of the 19th century and has since been the subject of numerous studies. Structural Fat Grafting (SFG) differs from other fat grafting techniques in both the harvesting and placement of the fat. The main indications for SFG are for the restoration and rejuvenation of the face. Recent applications include the correction of localised tissue atrophy, loss of substance due to trauma, post-tumour, congenital complex craniofacial deformities, burns, and hemifacial atrophy. The authors describe a case of a 20-year-old woman with right Parry-Romberg syndrome (PRS) treated over many years with many different surgical reconstructive techniques with poor results. After five SFG (three complete procedures and two minor revisions) over three years, the authors obtained a good aesthetic result with complete patient satisfaction. SFG can be an excellent technique for facial reconstruction and re-contouring, with natural and long-lasting results. PMID:20541429

Clauser, Luigi C; Tieghi, Riccardo; Consorti, Giuseppe

2010-06-11

122

Parry-Romberg syndrome: volumetric regeneration by structural fat grafting technique.  

UK PubMed Central (United Kingdom)

The use of adipose tissue transfer for correction of maxillo-facial defects was reported for the first time at the end of the 19th century and has since been the subject of numerous studies. Structural Fat Grafting (SFG) differs from other fat grafting techniques in both the harvesting and placement of the fat. The main indications for SFG are for the restoration and rejuvenation of the face. Recent applications include the correction of localised tissue atrophy, loss of substance due to trauma, post-tumour, congenital complex craniofacial deformities, burns, and hemifacial atrophy. The authors describe a case of a 20-year-old woman with right Parry-Romberg syndrome (PRS) treated over many years with many different surgical reconstructive techniques with poor results. After five SFG (three complete procedures and two minor revisions) over three years, the authors obtained a good aesthetic result with complete patient satisfaction. SFG can be an excellent technique for facial reconstruction and re-contouring, with natural and long-lasting results.

Clauser LC; Tieghi R; Consorti G

2010-12-01

123

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

Science.gov (United States)

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. PMID:23714984

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

2013-05-01

124

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

UK PubMed Central (United Kingdom)

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.

Arcuri F; Stellin L; Gatti A; Benech A

2013-05-01

125

A Multidisciplinary Approach for Management of Postenucleation Socket Syndrome with Dermis-Fat Graft and Ocular Prosthesis: A Clinical Report.  

UK PubMed Central (United Kingdom)

A contracted eye socket is a cosmetic blemish to the patient. It not only renders patients unable to wear an eye prosthesis, but also becomes a source of chronic discharge and irritation. Orbital implants allow for cosmesis and volume replacement of an enucleated or eviscerated eye. Alloplastic orbital implants are associated with potential complications, including exposure and extrusion. A dermis-fat graft offers the advantages of relative availability and an autologous nature. This article reports on a patient suffering from severe postenucleation socket syndrome after enucleation of the bulbus with postoperative irradiation of the orbit due to retinoblastoma and its subsequent management by a dermal-fat graft and ocular prosthesis. The purpose of this article is to emphasize the usefulness of dermal-fat grafting as a safe and stable orbital volume replacement following enucleation.

Aggarwal H; Singh K; Kumar P; Alvi HA

2013-04-01

126

[Correction of progressive hemifacial atrophy using dermis-fat graft and Medpor implant shaped by reverse engineering technique].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the therapeutic effect of dermis-fat graft combined with Medpor implant shaped by reverse engineering technique in the correction of the progressive hemifacial atrophy. METHODS: A skull model was made by rapid prototyping and the bony deficiency model was acquired with reverse engineering technique. The Medpor implant was shaped precisely based on the deficiency model and implanted with dermis-fat graft at the same stage. RESULTS: 11 cases were treated successfully without infection, necrosis and rejection. The patients were followed up for six months to one year with satisfactory cosmetic improvement. The dermis-fat graft survived without obvious absorption. CONCLUSION: The technique can correct both the bony and soft tissue deficiency for progressive hemifacial atrophy. It is very practical and easily performed with reliant results and less morbidity.

Zhang JR; Wei JH; Li YP; Feng XH

2009-01-01

127

Adipose stromal/stem cells assist fat transplantation reducing necrosis and increasing graft performance.  

Science.gov (United States)

Autologous fat transfer (AFT) is a procedure for adipose tissue (AT) repair after trauma, burns, post-tumor resections and lipodystrophies still negatively impacted by the lack of graft persistence. The reasons behind this poor outcome are unclear and seem to involve damages in either harvested/transplanted mature adipocytes or on their mesenchymal progenitors, namely adipose stromal/stem cells (ASC), and due to post-transplant AT apoptosis and involution. A rabbit subcutaneous AT regeneration model was here developed to first evaluate graft quality at different times after implant focusing on related parameters, such as necrosis and vasculogenesis. Standard AFT was compared with a strategy where purified autologous ASC, combined with hyaluronic acid (HA), assisted AFT. Five million of autologous ex vivo isolated CD29+, CD90+, CD49e+ ASC, loaded into HA, enriched 1 ml of AT generating an early significant protective effect in reducing AFT necrosis and increasing vasculogenesis with a preservation of transplanted AT architecture. This beneficial impact of ASC assisted AFT was then confirmed at three months with a robust lipopreservation and no signs of cellular transformation. By a novel ASC assisted AFT approach we ensure a reduction in early cell death favoring an enduring graft performance possibly for a more stable benefit in patients. PMID:23828239

Piccinno, Maria Serena; Veronesi, Elena; Loschi, Pietro; Pignatti, Marco; Murgia, Alba; Grisendi, Giulia; Castelli, Ilaria; Bernabei, Daniela; Candini, Olivia; Conte, Pierfranco; Paolucci, Paolo; Horwitz, Edwin M; De Santis, Giorgio; Iughetti, Lorenzo; Dominici, Massimo

2013-10-01

128

Use of genetically modified muscle and fat grafts to repair defects in bone and cartilage  

Directory of Open Access Journals (Sweden)

Full Text Available We report a novel technology for the rapid healing of large osseous and chondral defects, based upon the genetic modification of autologous skeletal muscle and fat grafts. These tissues were selected because they not only possess mesenchymal progenitor cells and scaffolding properties, but also can be biopsied, genetically modified and returned to the patient in a single operative session. First generation adenovirus vector carrying cDNA encoding human bone morphogenetic protein-2 (Ad.BMP-2) was used for gene transfer to biopsies of muscle and fat. To assess bone healing, the genetically modified (“gene activated”) tissues were implanted into 5mm-long critical size, mid-diaphyseal, stabilized defects in the femora of Fischer rats. Unlike control defects, those receiving gene-activated muscle underwent rapid healing, with evidence of radiologic bridging as early as 10 days after implantation and restoration of full mechanical strength by 8 weeks. Histologic analysis suggests that the grafts rapidly differentiated into cartilage, followed by efficient endochondral ossification. Fluorescence in situ hybridization detection of Y-chromosomes following the transfer of male donor muscle into female rats demonstrated that at least some of the osteoblasts of the healed bone were derived from donor muscle. Gene activated fat also healed critical sized defects, but less quickly than muscle and with more variability. Anti-adenovirus antibodies were not detected. Pilot studies in a rabbit osteochondral defect model demonstrated the promise of this technology for healing cartilage defects. Further development of these methods should provide ways to heal bone and cartilage more expeditiously, and at lower cost, than is presently possible.

CH Evans; F-J Liu; V Glatt; JA Hoyland; C Kirker-Head; A Walsh; O Betz; JW Wells; V Betz; RM Porter; FA Saad; LC Gerstenfeld; TA Einhorn; MB Harris; MS Vrahas

2009-01-01

129

Evaluation of Healing Potential of Autogenous, Macroscopic Fat Deposited or Fat Free, Omental Graft in Experimental Radius Bone Defect in Rabbit: Radiological Study  

Directory of Open Access Journals (Sweden)

Full Text Available This study was designed for evaluation of the difference between the ability of greater omentum graft with or without macroscopic fat deposition in acceleration of bone healing process. Adult female New Zealand white rabbits (n=15) were randomly divided into three equal groups. In groups A and B, the drilled hole on the left radius was filled by the omentum without and with macroscopic fat deposition, respectively while drilled hole on the right radius left intact for consideration as control. In group C, the drilled hole on the left and right radius was filled by the omentum sample with and without macroscopic fat deposition, respectively. Experimental bone defects on the radiuses were secured by the pieces of greater omentum, with or without macroscopic fat deposition, which obtained as an autogenous graft from each rabbit in accompany with control samples. Standardized serial radiography for evaluation of bone healing was performed and the difference in bone healing process in three groups of study was determined. According to the obtained data, the radius bones which filled by omentum without macroscopic fat deposition showed faster healing process than the radius bones which filled by omentum with macroscopic fat deposition (P<0.05).

Mohammad Nasrollahzadeh Masouleh, Iraj Sohrabi Haghdoost, Gholamreza Abedi Cham Heydari, Amirali Raissi* and Soroush Mohitmafi1

2011-01-01

130

Autologous fat grafting for treatment of facial atrophy in Behcet's disease: A case report.  

Science.gov (United States)

Behcet's disease (BD) is an autoimmune & autoinflammatory disease of unclear etiology characterized by recurrent oral & genital ulcers as well as other systemic manifestations. A key pathogenesis is excessive inflammatory wound healing response. While descriptions of the cutaneous manifestations of disease are limited to short-term consequences such as extensive pustule and papule formation in response to minor tissue injury, the long-term consequences are significant fibrosis and scarring of epithelial tissue. We describe the case of a patient with Behcet's disease who presented with unilateral facial atrophy secondary to minor trauma to the oral mucosa. She was treated with autologous fat grafting. Though a rare disease, plastic surgeons should be aware of the entity of Behcet's disease and its complications of tissue atrophy that may require reconstructive surgery. PMID:23642794

Lee, Z-Hye; Khoobehi, Kamran; Chiu, Ernest S

2013-05-01

131

Autologous fat grafting for treatment of facial atrophy in Behcet's disease: A case report.  

UK PubMed Central (United Kingdom)

Behcet's disease (BD) is an autoimmune & autoinflammatory disease of unclear etiology characterized by recurrent oral & genital ulcers as well as other systemic manifestations. A key pathogenesis is excessive inflammatory wound healing response. While descriptions of the cutaneous manifestations of disease are limited to short-term consequences such as extensive pustule and papule formation in response to minor tissue injury, the long-term consequences are significant fibrosis and scarring of epithelial tissue. We describe the case of a patient with Behcet's disease who presented with unilateral facial atrophy secondary to minor trauma to the oral mucosa. She was treated with autologous fat grafting. Though a rare disease, plastic surgeons should be aware of the entity of Behcet's disease and its complications of tissue atrophy that may require reconstructive surgery.

Lee ZH; Khoobehi K; Chiu ES

2013-05-01

132

Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting.  

UK PubMed Central (United Kingdom)

A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction.

Coronado-Malagón M; Tauffer-Carrion LT

2012-01-01

133

Successful treatment of Parry-Romberg syndrome with autologous fat grafting: 14-year follow-up and review.  

UK PubMed Central (United Kingdom)

Parry first described the syndrome of progressive facial atrophy in 1825, followed by Romberg in 1846. The clinical hallmark of the syndrome is atrophy of the facial soft tissues, including fat and muscle as well as underlying bone. Clinicians have classically reserved treatment until the end of the disease process, after the "burn out" stage. Various treatment modalities have been attempted with differing results. In this study, we present a case of Parry-Romberg syndrome treated with autologous fat grafting. This case report reviews the history of the disease, examines the safety and clinical outcomes of fat grafting as a treatment modality, and challenges the classic timing of that treatment. Additionally, long-term follow-up with photos and histological analysis of specimens are included.

Hunstad JP; Shifrin DA; Kortesis BG

2011-10-01

134

Successful treatment of Parry-Romberg syndrome with autologous fat grafting: 14-year follow-up and review.  

Science.gov (United States)

Parry first described the syndrome of progressive facial atrophy in 1825, followed by Romberg in 1846. The clinical hallmark of the syndrome is atrophy of the facial soft tissues, including fat and muscle as well as underlying bone. Clinicians have classically reserved treatment until the end of the disease process, after the "burn out" stage. Various treatment modalities have been attempted with differing results. In this study, we present a case of Parry-Romberg syndrome treated with autologous fat grafting. This case report reviews the history of the disease, examines the safety and clinical outcomes of fat grafting as a treatment modality, and challenges the classic timing of that treatment. Additionally, long-term follow-up with photos and histological analysis of specimens are included. PMID:21587050

Hunstad, Joseph P; Shifrin, David A; Kortesis, Bill G

2011-10-01

135

Supervivencia a largo plazo de los injertos grasos/ Long-term survival with fat grafting  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Presentamos varios casos de pérdida de volumen de diferentes etiologías y en distintas regiones corporales y faciales tratadas mediante injertos de tejido graso autólogo según la técnica de lipoestructura. En ningún caso se realizó sobrecorrección del defecto en ningún caso. La evolución con un seguimiento máximo de 7 años y mínimo de 1 año no mostró disminución del volumen obtenido en el acto quirúrgico en la gran mayoría de los casos. Debido a los resu (more) ltados obtenidos creemos que el injerto de grasa autólogo es el método de elección para restaurar volúmenes con fines estéticos o reconstructivos. Abstract in english Volume loss in several facial and body areas was treated by means of autologous fatty tissue grafts with lipostructure technique. There were no cases of overcorrection. The patients’ course, with a maximum follow-up of 7 years and a minimum of 1 year did not evidence any loss of the surgically restored tissue volume in the majority of cases. The above results suggest that autologous fat grafts are the method of choice to restore volume for both cosmetic and reconstructive purposes.

Planas, J.; Cervelli, V.; Pontón, A.; Planas, G.

2006-03-01

136

Supervivencia a largo plazo de los injertos grasos Long-term survival with fat grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Presentamos varios casos de pérdida de volumen de diferentes etiologías y en distintas regiones corporales y faciales tratadas mediante injertos de tejido graso autólogo según la técnica de lipoestructura. En ningún caso se realizó sobrecorrección del defecto en ningún caso. La evolución con un seguimiento máximo de 7 años y mínimo de 1 año no mostró disminución del volumen obtenido en el acto quirúrgico en la gran mayoría de los casos. Debido a los resultados obtenidos creemos que el injerto de grasa autólogo es el método de elección para restaurar volúmenes con fines estéticos o reconstructivos.Volume loss in several facial and body areas was treated by means of autologous fatty tissue grafts with lipostructure technique. There were no cases of overcorrection. The patients’ course, with a maximum follow-up of 7 years and a minimum of 1 year did not evidence any loss of the surgically restored tissue volume in the majority of cases. The above results suggest that autologous fat grafts are the method of choice to restore volume for both cosmetic and reconstructive purposes.

J. Planas; V. Cervelli; A. Pontón; G. Planas

2006-01-01

137

A tool for computer-controlled lipoaspirate deposition in autologous fat grafting.  

UK PubMed Central (United Kingdom)

BACKGROUND: In autologous fat grafting applied for tissue regeneration and morphologic/volumetric restoration, clinical evidence suggests that the uniformity of tissue distribution in the receiver site may influence regenerative outcomes and rates of complications. METHODS: This technical report describes the prototype of a computer-assisted deposition tool designed to maximize deposition uniformity. This is obtained by modulating the lipoaspirate flow through the cannula of the syringe as a function of the tool withdrawal speed by means of a DC motor that controls the movement of the syringe plunger. Although simpler technologies for speed detection may be applied, the authors' prototype features a wireless connection with an infrared (IR) motion-tracking system for real-time detection of position, orientation, and speed of the surgical tool. The integrated motion-tracking instrumentation grants combined computer-controlled lipoaspirate deposition and real-time surgical navigation to maximize fat tissue uniformity along a planned, patient-specific insertion pattern. CONCLUSIONS: The presented tool ensures the uniformity of tissue deposition through integration of the plunger motion with control of the tool movement, allowing for reduced onset of postintervention complications. EBM level 5 LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Patete P; Baroni G

2013-08-01

138

[Breast reconstruction using muscle sparing latissimus dorsi flap and fat grafting].  

UK PubMed Central (United Kingdom)

INTRODUCTION: The aim of this study is to assess our results of autologous breast reconstruction using a combined muscle sparing latissimus dorsi flap (MSLD) and fat tissue transfer. METHODS: A prospective study was performed on 20 patients over a period of 1 year. Three objective criteria were analyzed: morphometric, surgical procedure and postoperative latissimus dorsi function. A subjective assessment was done using a 4-level scale for patients' and surgeons' satisfaction. RESULTS: Mean age of patients was of 45 ± 1.2 years. The average Body Mass Index (BMI) was 21.9 ± 2.2. The average weight of mastectomy specimen was 348.3 ± 135.6 g. The average duration of the surgical procedure was 149 ± 32.1 minutes. The average length of hospitalization was 4.5 ± 1.4 days. The average quantity of dorsal drainage during the hospitalization was 117.7 ± 41.5 cm(3), and a Visual Analog Scale (VAS) of pain of 2 ± 0.9 over 10. Patients from our series had 0.8 ± 0.9 dorsal punction per patient, with an average volume of seroma of 51.2 ± 70.8 cm(3). Fat grafting was used in every case with an average number of 1.2 ± 0.4 procedures per patient. The mean of injected volume was 250.1 ± 132.8 cm(3). No complications occurred in the postoperative period. There was no difference of latissimus dorsi functional assessment at 3 months and 1 year postoperative. CONCLUSION: Combined MSLD and fat transfer is a reliable and an efficient technique for autologous breast reconstruction. The donor site morbidity is low, the postoperative recovery is fast and functional integrity of latissimus dorsi muscle is preserved in all cases. This technique can be used in immediate or delayed autologous breast reconstruction, and is particularly useful for bilateral breast reconstruction.

Veber M; Guerin AN; Faure C; Delay E; Mojallal A

2012-08-01

139

Effects of Expanded Human Adipose Tissue-Derived Mesenchymal Stem Cells on the Viability of Cryopreserved Fat Grafts in the Nude Mouse  

Directory of Open Access Journals (Sweden)

Full Text Available Adipose-derived mesenchymal stem cells (AdMSCs) augment the ability to contribute to microvascular remodeling in vivo and to modulate vascular stability in fresh fat grafts. Although cryopreserved adipose tissue is frequently used for soft tissue augmentation, the viability of the fat graft is poor. The effects of culture-expanded human adipose tissue-derived mesenchymal stem cells (hAdMSCs) on the survival and quality of the cryopreserved fat graft were determined. hAdMSCs from the same donor were mixed with fat tissues cryopreserved at -70°C for 8 weeks and injected subcutaneously into 6-week-old BALB/c-nu nude mice. Graft volume and weight were measured, and histology was evaluated 4 and 15 weeks post-transplantation. The hAdMSC-treated group showed significantly enhanced graft volume and weight. The histological evaluation demonstrated significantly better fat cell integrity compared with the vehicle-treated control 4 weeks post-transplantation. No significant difference in graft weight, volume, or histological parameters was found among the groups 15 weeks post-transplantation. The hAdMSCs enhanced the survival and quality of transplanted cryopreserved fat tissues. Cultured and expanded hAdMSCs have reconstructive capacity in cryopreserved fat grafting by increasing the number of stem cells.

Myung-Soon Ko, Ji-Youl Jung, Il-Seob Shin, Eun-Wha Choi, Jae-Hoon Kim, Sung Keun Kang, Jeong Chan Ra

2011-01-01

140

[Autologous fat grafting to the postmastectomy irradiated chest wall prior to breast implant reconstruction: a series of 68 patients].  

UK PubMed Central (United Kingdom)

INTRODUCTION: After radiotherapy, breast reconstruction with an implant carries a high risk of failure and complication. Clinical and experimental studies have demonstrated that grafting adipose tissue (lipofilling) in an irradiated area enhances skin trophicity. Thus, we have started performing preliminary fat grafting to the irradiated chest wall prior to implant reconstruction in order to limit complications and failure risk. PATIENTS AND METHODS: Patients were included in this study from 2007 to 2011. All patients had had mastectomy and irradiation for breast cancer. They all had one or more sessions of lipofilling prior to breast implant reconstruction. These patients were prospectively followed up in order to collect the following data: postoperative complications; cosmetic result; local breast cancer recurrences. RESULTS: Sixty-eight patients were included. The mean number of fat grafting sessions was 2.3 (range 1-6). An average volume of 115mL (70-275) was injected each time. The mean volume of breast implants was 300mL (185-400). The mean follow-up was 23months (450). No breast cancer local recurrence was diagnosed during follow-up. Implant explantation was performed in one case (1.47%) The mean cosmetic result was 4.5/5. CONCLUSION: Fat grafting to the irradiated chest wall prior to implant placement might be an alternative to flap reconstruction for patients who are not suitable or who refuse this option.

Sarfati I; Ihrai T; Duvernay A; Nos C; Clough K

2013-02-01

 
 
 
 
141

Closure of oroantral communication using buccal fat pad graft - case report  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: There are many causes of fistulas that involve the nasal and antral cavities or both. They may result from pathological entities or secondary to removal of tumors or maxillary cysts. However, the extraction of a maxillary molar or premolar is the most common cause of oroantral fistula. This is explained by the close relationship between the apex of these teeth and the thinness of the antral floor. When the primary fistula repair fails to heal spontaneously during the first three weeks after surgery, a secondary repair may be indicated. During treatment process of the fistulas, there are procedures to make a direct close or the use of a sliding mucosal flap, all techniques own an equal and high degree of failure. Objective: To show a case report of oroantral fistula and its closure. Case Report: A 6-month-Surgical treatment of oroantral fistula, after a tooth removal, using the buccal fat pad method as a pedicled graft associated with a sliding mucosal flap. Conclusion: The mentioned treatment is simple, complete and allows an extensive applicability in most of cases.

Martins Junior, José Carlos; Keim, Frederico Santos; Kreibich, Mariana Schmidt

2008-01-01

142

[Influence of repeatedly injecting platelet-rich plasma on survival and quality of fat grafts in nude mice].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the effect of platelet-rich plasma (PRP) on the survival and quality of fat grafts in the nude mice so as to provide a method and the experimental basis for clinical practice. METHODS: Fat tissue was harvested from the lateral thigh of a 25-year-old healthy woman and the fat was purified by using saline. The venous blood was taken from the same donor. PRP was prepared by centrifugation (200 x g for 10 minutes twice) and activated by 10% calcium chloride (10 : 1). Then 24 female nude mice [weighing (20 +/- 3) g, 5-week-old] were allocated randomly to the experimental group and the control group (12 mice per group). Each subcutaneous layer of two sides of the back (experimental group) was infiltrated with 0.8 mL fat tissue-activated PRP mixtures (10 : 2); the control group was infiltrated with 0.8 mL fat tissue-saline mixtures (10 : 2); 0.14 mL activated PRP and 0.14 mL saline were injected into the experimental group and the control group respectively at 5 and 10 days after the first operation. At 15, 30, 90, and 180 days after the first operation, the samples were harvested for gross and histological observations. RESULTS: All nude mice survived to the end of the experiment. No inflammation and abscess formation of the graft were observed. Experimental group was better than control group in angiogenesis, liquefaction, and necrosis. The grafted fat weight and volume in the experimental group were significantly larger than those in the control group at 15, 30, and 90 days (P < 0.05); but there was no significant difference between the 2 groups at 180 days (P > 0.05). Histological observation showed good morphological and well-distributed adipocytes, increasing vacuoles, few necrosis and calcification in the experimental group; but disordered distribution, obvious necrosis, and calcification in the control group. The necrosis area ratio of the experimental group was significantly lower than that of the control group (P < 0.05), and the number of micro-vessels was significantly higher in the experimental group than in the control group at 15 and 180 days (P < 0.05). CONCLUSION: The method of repeatedly using the PRP within 180 days in assisting fat grafts can obviously improve the survival and quality.

Li J; Shi X; Chen W

2013-04-01

143

Increased survival of free fat grafts and vascularization in rats with local delivery of fragmin/protamine microparticles containing FGF-2 (F/P MP-F).  

UK PubMed Central (United Kingdom)

We evaluated the effects of fragmin/protamine micro-particles (F/P MPs) containing FGF-2 (F/P MP-F) as carriers for the controlled release of FGF-2 for adipocyte-survival and capillary formation in inbred rats with subdivided free fat grafts. F/P MPs could immobilize FGF-2, thereafter gradually releasing the bound FGF-2. Inbred Fisher 344 rats weighing around 150 g were anesthetized and implanted with paste comprising harvested fat combined with F/P MP-F. The effect of F/P MP-F on the survival, granulation, and capillary formation in fat grafts was histologically compared with control grafts containing either FGF-2, F/P MPs or PBS. The control fat grafts became attached to tissues adjacent to the implantation site and were significantly resorbed after 30 days. In contrast, pink, soft, supple grafts were compressible and were little resorbed in the group given F/P FP MP-F at 30-120 days. Normal adipocytes were obviously decreased in the control groups with increased granulation tissues, whereas normal adipocytes with capillary formations were maintained in the F/P MP-F group. Thus, adding F/P MP-F to subdivided fat grafts helps to improve graft volume retention and survival in soft-tissue reconstruction through accelerating adipocyte-survival rates and angiogenesis.

Nakamura S; Ishihara M; Takikawa M; Murakami K; Kishimoto S; Nakamura S; Yanagibayashi S; Mori Y; Fujita M; Kubo S; Yamamoto N; Kiyosawa T

2011-02-01

144

Fat grafts supplemented with adipose-derived stromal cells in the rehabilitation of patients with craniofacial microsomia.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although first reports of the clinical use of adipose-derived stromal cells suggest that this approach may be feasible and effective for soft-tissue augmentation, there is a lack of randomized, controlled clinical trials in the literature. Thus, this study aimed to investigate whether a faster protocol for isolation of adipose-derived stromal cells and their use in combination with fat tissue improve the long-term retention of the grafts in patients with craniofacial microsomia. METHODS: Patients with craniofacial microsomia (n = 14) were grafted either with supplementation of adipose-derived stromal cells (experimental group) or without supplementation of adipose-derived stromal cells (control group). The number of viable cells isolated before and after the supplementation of the grafts was calculated, and these cells were examined for mesenchymal cell surface markers using flow cytometry. Computed tomography was performed to assess both hemifaces preoperatively and at 6 months postoperatively. RESULTS: The average number of viable cells isolated before and after the supplementation of the grafts was 5.6 × 10 and 9.9 × 10 cells/ml of fat tissue (p = 0.015). Flow cytometric analysis revealed that the adipose-derived stromal cells were positive for mesenchymal cell markers (>95 percent for CD73 and CD105). Surviving fat volume at 6 months was 88 percent for the experimental group and 54 percent for the control group (p = 0.003). CONCLUSION: These results suggest that this strategy for isolation and supplementation of adipose-derived stromal cells is effective, safe, and superior to conventional lipoinjection for facial recontouring in patients with craniofacial microsomia. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Tanikawa DY; Aguena M; Bueno DF; Passos-Bueno MR; Alonso N

2013-07-01

145

Comparative study of the integration and viability of autonomised and nonautonomised autologous fat tissue grafts--experimental model in rabbits.  

UK PubMed Central (United Kingdom)

BACKGROUND: The free transplant of fatty tissue has gone through several phases of interest over the last 100 years of medical history, having undergone cycles of use and disuse. In the present study we aimed to create, through a delaying process, an improvement in the integration and lower resorption rates of autologous fat grafts. Similar research has not been found in the literature, and this was the motivating factor for the present study. METHODS: Twenty-three New Zealand male rabbits were used. The study consisted of two different modalities of autologous fatty tissue transplants [autonomised graft (A) vs nonautonomised grafts (NA)]. In order to characterise the histological differences that could contribute to the different macroscopic aspects in the samples of the autonomised and nonautonomised groups, three anatomic-pathological criteria were considered: steatonecrosis, viable adipocytes, and fibrous proliferation. For this analysis, the 'point-counting' technique proposed by Gundersen et al. was used, with a reticulum of 100 points and 50 lines. RESULTS: Statistically significant differences were found between the autonomised (A) and nonautonomised (NA) groups in both the macroscopic and microscopic aspects after the 6 month study period (P<0.05). CONCLUSIONS: We conclude that autonomisation of the fatty tissue and its transfer as an autologous implant, in rabbits, is capable of promoting lower rates of resorption and greater integration of the transplanted tissue, characterised by a greater number of viable adipocytes, lower rates of fibrosis and steatonecrosis in comparison with the nonautonomised graft.

Fraga MF; Helene A Jr; Nakamura F; Lellis RF; Kikuchi W; Esteban D

2008-09-01

146

Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid  

Directory of Open Access Journals (Sweden)

Full Text Available Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

Fida A. Khan

2004-01-01

147

Fat embolism in liposuction and intramuscular grafts in rabbits/ Embolia gordurosa na lipoaspiração e enxertia intramuscular em coelhos  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Avaliar a repercussão da embolia gordurosa em órgãos como pulmão e fígado. MÉTODOS: Vinte coelhos foram submetidos à enxertia autóloga intramuscular de gordura em coxa direita após lipoaspiração. Os grupos foram determinados conforme os dias pós-operatórios (DPO) em que ocorreu a eutanásia: 60 DPO, 90DPO, 120 DPO. Em seguida, o pulmão e o fígado foram ressecados e encaminhados ao laboratório de histopatologia para análise em busca de lesão tar (more) dia secundária a evento de embolia gordurosa prévia nos tecidos. RESULTADOS: Foi evidenciada uma alteração na amostra a analise macroscópica com alteração da coloração do tecido hepático de forma heterogênea. Não houve alterações compatíveis com repercussão de processo embólico à microscopia. CONCLUSÃO: A opção pela realização de uma técnica de lipoenxertia menos traumática e com pequeno tempo cirúrgico pode ser considerada protetora para eventos embólicos, não havendo repercussão embólica a tardiamente. Abstract in english PURPOSE: To evaluate the effects of fat embolism in organs such as lung and liver. METHODS: Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. (more) RESULTS: The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION: The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.

Felzemburgh, Victor Araujo; Barbosa, Rafaela Cavalcante das Neves; Nunes, Victor Luiz Correia; Campos, José Humberto Oliveira

2012-05-01

148

Fat embolism in liposuction and intramuscular grafts in rabbits Embolia gordurosa na lipoaspiração e enxertia intramuscular em coelhos  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To evaluate the effects of fat embolism in organs such as lung and liver. METHODS: Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. RESULTS: The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION: The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.OBJETIVO: Avaliar a repercussão da embolia gordurosa em órgãos como pulmão e fígado. MÉTODOS: Vinte coelhos foram submetidos à enxertia autóloga intramuscular de gordura em coxa direita após lipoaspiração. Os grupos foram determinados conforme os dias pós-operatórios (DPO) em que ocorreu a eutanásia: 60 DPO, 90DPO, 120 DPO. Em seguida, o pulmão e o fígado foram ressecados e encaminhados ao laboratório de histopatologia para análise em busca de lesão tardia secundária a evento de embolia gordurosa prévia nos tecidos. RESULTADOS: Foi evidenciada uma alteração na amostra a analise macroscópica com alteração da coloração do tecido hepático de forma heterogênea. Não houve alterações compatíveis com repercussão de processo embólico à microscopia. CONCLUSÃO: A opção pela realização de uma técnica de lipoenxertia menos traumática e com pequeno tempo cirúrgico pode ser considerada protetora para eventos embólicos, não havendo repercussão embólica a tardiamente.

Victor Araujo Felzemburgh; Rafaela Cavalcante das Neves Barbosa; Victor Luiz Correia Nunes; José Humberto Oliveira Campos

2012-01-01

149

Effects of a new centrifugation method on adipose cell viability for autologous fat grafting.  

UK PubMed Central (United Kingdom)

The use of adipose tissue transfer in plastic and reconstructive surgery is not new and has been studied extensively. Due to different results with regard to adipose cell damage and the level of survival of the transferred tissue in clinical practice, the authors aimed to investigate the effects of centrifugation on fat aspirates to optimize the centrifugal force for fat transplantation and to obtain an increased number of intact adipose progenitor cells. The following different centrifugation forces were evaluated in vitro in terms of fat decantation: 3,000 rpm (1,500×g), 1,300 rpm (250×g), and 500 rpm (50×g). Moreover, the density level, morphology of fat cells, cell viability, and progenitor cell number also were evaluated. Centrifugation leads to a good fat tissue density, with a significant number of progenitor cells, and efficiently removes the liquid portion. High centrifugal forces (at 3,000 rpm) caused significant damage to fat cells with low cell viability, whereas very low centrifugal forces (at 500 rpm) showed little effect on adipose tissue density, resembling fat decantation. Fat aspirates, withdrawn from 30 healthy donors in vivo, were centrifuged at different rotations per minute (rpm), as follows. For the 10 patients in group A, Coleman's technique was used with a centrifugation of the aspirated fat at 3,000 rpm (1,500×g) for 3 min. For the 10 patients in group B, the authors' technique was used, with centrifugation of the aspirated fat at 1,300 rpm (250×g) for 5 min. For the 10 patients in group C, simple decantation of fat was used. In conclusion, a centrifugal force of 1,300 rpm resulted in better density of adipose tissue, with good cell viability and increased ability to preserve a significant number of progenitor cells.

Ferraro GA; De Francesco F; Tirino V; Cataldo C; Rossano F; Nicoletti G; D'Andrea F

2011-06-01

150

Results of myringoplasty operations in active and inactive ears in adults.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: To determine whether the presence of aural discharge at the time of surgery adversely affects the success rate of myringoplasty operations. STUDY DESIGN: Case series comparing the success rate of surgery in active and inactive ears. METHODS: Data pertaining to 268 operations involving repair of the tympanic membrane without ossiculoplasty carried out in Edinburgh, United Kingdom, between 1999 and 2009 by one senior surgeon and trainees working under his supervision were collected prospectively. Other factors that might potentially influence the outcome of the surgery were investigated using logistical regression analysis. The main outcome measure was number of patients with an intact tympanic membrane 6 months after surgery in the two groups (active and inactive). RESULTS: Of the 268 operations carried out, 203 were successful, with an intact tympanic membrane, 6 months postoperatively, 43 had persistent perforations, and 22 patients were lost to follow-up before 6 months. The success rates for closure of the perforation at 6 months after surgery were 83% for inactive and 82% for active ears (P = .9). CONCLUSIONS: There is no clinically significant difference in the success rate for myringoplasty in patients whose ears are active or inactive at the time of surgery. LEVEL OF EVIDENCE: 4. Laryngoscope, 123:2245-2249, 2013.

Mills R; Thiel G; Mills N

2013-09-01

151

Utilizing muscle-derived stem cells to enhance long-term retention and aesthetic outcome of autologous fat grafting: pilot study in mice.  

Science.gov (United States)

Autologous fat grafting has been regarded as the ideal soft tissue filler for more than a century. Low long-term retention rate and unpredictability limit it from widespread clinical practice. Many theories for this have been proposed: lack of sufficient blood supply and subsequent necrosis is the most accepted. In this pilot study, we showed both macroscopically and microscopically the viability of muscle-derived stem cells (MDSCs) cotransplanted with fat placed intramuscularly for 3 months. MRI scanning showed a stronger fat signal in the MDSC-treated group than that of the control group. Moreover, histological evaluation exhibited well-preserved and intact fat cells in the MDSC-treated group. In contrast, the control group showed extensive fibrosis and fat graft loss. Furthermore, the MDSC-treated group possessed almost threefold greater capillary density than the control group. We conclude that cotransplantation of muscle-derived stem cells and autologous fat tissue improves the long-term survival of intramuscular fat transplants by promoting neovascularization. PMID:21607534

Ma, Zhiqiang; Han, Duanyang; Zhang, Peipei; Yang, Jenny F; Wang, Yiqiang; Zhang, Yingbo; Yang, Daping; Liu, Jianyu

2011-05-24

152

Autologous fat grafting to the lower one-third of the face.  

Science.gov (United States)

Volume loss contributes as much to the aging appearance of the face as sagging and rhytids. This occurs in the nasolabial and labiomental creases, as well as the lips, mandibular ramus, and the prejowl sulcus. Treatment of these areas with autogenous fat has yielded results that are generally good, but often of brief duration. To obtain the best results, trauma to the transplanted adipocytes must be avoided through meticulous attention to the details of technique. Observed complications are usually minor. Despite variability in the duration of effect, the fact that autogenous fat is relatively inexpensive and readily available makes it a viable alternative for facial volume replacement. PMID:22418813

Metzinger, Stephen; Parrish, James; Guerra, Aldo; Zeph, Rick

2012-03-14

153

Autologous fat grafting to the lower one-third of the face.  

UK PubMed Central (United Kingdom)

Volume loss contributes as much to the aging appearance of the face as sagging and rhytids. This occurs in the nasolabial and labiomental creases, as well as the lips, mandibular ramus, and the prejowl sulcus. Treatment of these areas with autogenous fat has yielded results that are generally good, but often of brief duration. To obtain the best results, trauma to the transplanted adipocytes must be avoided through meticulous attention to the details of technique. Observed complications are usually minor. Despite variability in the duration of effect, the fact that autogenous fat is relatively inexpensive and readily available makes it a viable alternative for facial volume replacement.

Metzinger S; Parrish J; Guerra A; Zeph R

2012-02-01

154

Autogenous bone graft combined with buccal fat pad as barrier in treatment of Class II furcation defect: a case report.  

UK PubMed Central (United Kingdom)

The treatment of furcation defects is a complex and difficult task that may compromise the success of periodontal therapy. Here we report a new clinical treatment of a Class II furcation defect using an autogenous bone graft associated with a buccal fat pad (BFP) used as a membrane. The surgical treatment was performed following initial periodontal therapy. Post-operative follow-up appointments were performed at 3, 7, and 12 months. Clinically, after 3 and 7 months, a reduction in probing depth without bleeding on probing and an increase in vertical and horizontal clinical attachment level were observed. After 7 post-operative months, an increase in keratinized gingiva was observed. Radiographically, a significant improvement was noted, with the furcation defect almost completely closed. These results could also be observed after 12 postoperative months. It can be concluded that the combined use of autogenous bone graft and a BFP yielded clinically favorable outcome in the treatment of a mandibular Class II furcation defect.

Deliberador TM; Mendes RT; Storrer CL; Giovanini AF; Zielak JC; Lopes TR

2012-01-01

155

Lipoestructura y relleno del polo superior de la mama frente a implantes Structural fat graft and lipofilling of mammary upper pole versus mammary implants  

Directory of Open Access Journals (Sweden)

Full Text Available La lipoestructura mamaria ofrece nuevas alternativas de tratamiento en la cirugía estética de aumento mamario, cumpliendo en algunos casos las expectativas esperadas y en otros no. Analizamos este hecho en 4 tipos de aplicación de lipoestructura mamaria que hemos venido realizando en los últimos años, centrándonos en un aspecto importante de esta cirugía que es el relleno del polo superior de la mama. Los tipos de aplicación empleados son: aumento mamario simple mediante lipoestructura en comparación con implantes; pexia más lipoestructura frente a pexia más implantes mamarios; reconstrucción de mama tuberosa mediante lipoestructura o implantes y finalmente, relleno periprotésico mediante lipoestructura en mamas sometidas a cirugía de aumento mamario con implantes. En definitiva, podríamos resumir este trabajo en una frase diciendo que la lipoestructura mamaria, a nuestro juicio, no sirve si lo que prima es conseguir el relleno del polo superior de la mama, siendo en este caso de elección la colocación de implantes mamarios. No obstante, en alguno de los casos señalados no solo es una alternativa, sino que obtiene resultados superiores a los logrados sólamente con implantes.The mammary structural fat graft offers news treatment options in breast augmentation cosmetic surgery, but it sometimes meets expectations and sometimes doesn´t. We analyze 4 different types of lipostructure mammary applications that we have been using in the last years, focused in an important aspect of this surgery as it´s the filling of the upper mammary pole. These applications are: mammary augmentation by simple structural fat compared with the use of mammary implants; structural fat graft and mastopexy versus implants and mastopexy; tuberous breast reconstruction using structural fat graft or implants and finally, periprosthetic filling in breast augmentation with mammary implants using structural fat graft. In short, we could summarize this paper telling that in our opinion, structural fat graft doesn´t work if our intention is to fill the upper mammary pole. However, structural fat graft is not only an alternative; in some cases it exceeds the expected results using mammary implants.

J.M. Cervilla Lozano

2012-01-01

156

Preoperatory Color Duplex Echographical Venous Mapping Before Autologous Fat Graft for Calf Augmentation: A Case Report of Superficial Vein Thrombosis and Prevalence of Intersaphenic Anastomosis.  

Science.gov (United States)

Autologous fat grafting for calf augmentation is considered an easy and safe technique. Only few cases of potential complications have been described in literature; among them, vein thrombosis was never reported. We report a case of superficial vein thrombosis of the intersaphenic anastomosis after fat graft for calf symmetrization in club-foot syndrome. A color duplex echographical study showed that such intersaphenic anastomoses are present in all patients, but they have an ectatic diameter in 70% of patients with great saphenous vein insufficiency and in 50% of patients without insufficiency. The plastic surgeon should be aware of the presence and topography of such anatomical variations before performing the procedure. Moreover, a preoperatory color duplex echographical venous mapping may help the surgeon in avoiding the trauma on vein variants and subsequent complications. PMID:23528632

Fraccalvieri, Marco; Contessa, Luigi; Salomone, Marco; Zingarelli, Enrico Maria; Bruschi, Stefano

2013-03-21

157

Preoperatory Color Duplex Echographical Venous Mapping Before Autologous Fat Graft for Calf Augmentation: A Case Report of Superficial Vein Thrombosis and Prevalence of Intersaphenic Anastomosis.  

UK PubMed Central (United Kingdom)

Autologous fat grafting for calf augmentation is considered an easy and safe technique. Only few cases of potential complications have been described in literature; among them, vein thrombosis was never reported. We report a case of superficial vein thrombosis of the intersaphenic anastomosis after fat graft for calf symmetrization in club-foot syndrome. A color duplex echographical study showed that such intersaphenic anastomoses are present in all patients, but they have an ectatic diameter in 70% of patients with great saphenous vein insufficiency and in 50% of patients without insufficiency. The plastic surgeon should be aware of the presence and topography of such anatomical variations before performing the procedure. Moreover, a preoperatory color duplex echographical venous mapping may help the surgeon in avoiding the trauma on vein variants and subsequent complications.

Fraccalvieri M; Contessa L; Salomone M; Zingarelli EM; Bruschi S

2013-03-01

158

Dermis Reconstruction and Dermis Fat Graft Through an Intraoral Incision: A New Method to Correct the Furrowed Philtral Column Deformity in Lesser-Form Cleft Lip.  

UK PubMed Central (United Kingdom)

Objective :? Minor cleft lip deformities are also called lesser-form cleft lips. A furrowed philtral column is one of the important characters of these deformities. Many surgical methods have been adopted to correct it with less than satisfactory results. In this article, a dermis reconstructive method was introduced. Patients :? From 2003 to 2010, 35 patients with lesser-form cleft lip were treated in our center. Interventions :? Through an intraoral and vermilion incision, the oral side of the orbicularis oris muscle on the affected side was dissected. Through a vermilion and perialar incision, the dermal side of the orbicularis oris muscle was dissected along the furrow. After restoring orbicularis oris muscular ring continuity, if necessary, the underdeveloped dermis was reconstructed with three sutures along the furrow. To reinforce lip thickness on the affected side and increase the philtral column prominence, retroauricular dermis fat was grafted between the muscle and skin. Results :? Thirty-five patients with lesser-form cleft lip were treated with dermis reconstruction and retroauricular dermis fat grafts. Congenital lip depressions were well corrected, and the philtral column prominences were reconstructed. The follow-up period was 6 to 20 months. All patients were satisfied with their results. Conclusion :? Dermis reconstruction and dermis fat grafting through an intraoral incision is effective in repairing a furrowed philtral column deformity in lesser-form cleft lip.

Wang Y; Qi Z; Wang X

2013-01-01

159

Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia/ Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A embolia gordurosa é definida como a ocorrência de bloqueio mecânico da luz vascular por gotículas circulantes de gordura. Acomete principalmente o pulmão, podendo afetar também o sistema nervoso central, a retina e a pele. A síndrome da embolia gordurosa é uma disfunção desses órgãos causada pelos êmbolos gordurosos. As causas mais comuns de embolia gordurosa e síndrome da embolia gordurosa são as fraturas de ossos longos, mas há relatos de sua ocorrênc (more) ia após procedimentos estéticos. O diagnóstico é clínico, e o tratamento ainda se restringe a medidas de suporte. Apresentamos o caso de uma paciente que evoluiu com síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia e respondeu bem às manobras de recrutamento alveolar e à ventilação mecânica protetora.Apresentamos também uma análise epidemiológica e fisiopatológica da síndrome da embolia gordurosa após procedimentos estéticos. Abstract in english Fat embolism is defined as mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin. Fat embolism syndrome is a dysfunction of these organs caused by fat emboli. The most common causes of fat embolism and fat embolism syndrome are long bone fractures, although there are reports of its occurrence after cosmetic procedures. The diagnosis is made clinically, (more) and treatment is still restricted to support measures. We report the case of a female patient who developed adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. In this case, the patient responded well to alveolar recruitment maneuvers and protective mechanical ventilation. In addition, we present an epidemiological and pathophysiological analysis of fat embolism syndrome after cosmetic procedures.

Costa, André Nathan; Mendes, Daniel Melo; Toufen, Carlos; Arrunátegui, Gino; Caruso, Pedro; Carvalho, Carlos Roberto Ribeiro de

2008-08-01

160

Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting  

Directory of Open Access Journals (Sweden)

Full Text Available A embolia gordurosa é definida como a ocorrência de bloqueio mecânico da luz vascular por gotículas circulantes de gordura. Acomete principalmente o pulmão, podendo afetar também o sistema nervoso central, a retina e a pele. A síndrome da embolia gordurosa é uma disfunção desses órgãos causada pelos êmbolos gordurosos. As causas mais comuns de embolia gordurosa e síndrome da embolia gordurosa são as fraturas de ossos longos, mas há relatos de sua ocorrência após procedimentos estéticos. O diagnóstico é clínico, e o tratamento ainda se restringe a medidas de suporte. Apresentamos o caso de uma paciente que evoluiu com síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia e respondeu bem às manobras de recrutamento alveolar e à ventilação mecânica protetora.Apresentamos também uma análise epidemiológica e fisiopatológica da síndrome da embolia gordurosa após procedimentos estéticos.Fat embolism is defined as mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin. Fat embolism syndrome is a dysfunction of these organs caused by fat emboli. The most common causes of fat embolism and fat embolism syndrome are long bone fractures, although there are reports of its occurrence after cosmetic procedures. The diagnosis is made clinically, and treatment is still restricted to support measures. We report the case of a female patient who developed adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. In this case, the patient responded well to alveolar recruitment maneuvers and protective mechanical ventilation. In addition, we present an epidemiological and pathophysiological analysis of fat embolism syndrome after cosmetic procedures.

André Nathan Costa; Daniel Melo Mendes; Carlos Toufen; Gino Arrunátegui; Pedro Caruso; Carlos Roberto Ribeiro de Carvalho

2008-01-01

 
 
 
 
161

Experiencia en miringoplastía transcanal con pericondrio tragai inlay Experience in transcanal myringoplasty with inlay tragal perichondrium  

Directory of Open Access Journals (Sweden)

Full Text Available Introducción: La timpanoplastía está orientada a la reconstrucción anatomofuncional del oído medio que realizada en la membrana timpánica se denomina miringoplastía. Objetivo: Evaluar los resultados anatomofuncionales de la miringoplastía transcanal con pericondrio tragal inlay en pacientes intervenidos en el Servicio de Otorrinolaringología del Hospital San Camilo entre 2004 y 2009. Material y método: Estudio retrospectivo descriptivo de fichas de 56 pacientes entre 7 y 77 años. Universo: 60 oídos, muestra: 48 oídos con edad promedio de 34 años. Se evaluaron resultados anatómicos según sexo, edad, ubicación, causa de perforación y mejoría funcional objetivada por audiometría. Resultados: La integridad anatómica posquirúrgica es de 81,3% sin diferencias según género. Según edad existe diferencia significativa de 93,3% para el tramo 7-19 años respecto del total. Las perforaciones centrales tuvieron un éxito de 100%. La causa más frecuente de perforación fue por otitis media crónica simple (75%) con una integridad posquirúrgica del 80,5%. El 97,6% logró mejorar o mantener el nivel de audición, estableciéndose diferencialmente mejoría funcional en 52,4%, y una mantención en 45,2%. Conclusión: Los mejores resultados para esta técnica se obtienen en menores de 20 años con perforaciones centrales, siendo una técnica ideal que conserva la estructura de la membrana timpánica para futuras intervenciones.Introduction: Tympanoplasty is orientated to the anatomofunctional reconstruction of the middle ear, which is named myringoplasty, when performed in the tympanic membrane. Aim: To evaluate the anatomofunctional results of transcanal myringoplasty with inlay tragal perichondrium in patients controlled in the Otorhinolaryngology Unit of San Camilo Hospital, between 2004 and 2009. Material and method: Retrospective descriptive study on files of 56 patients between 7 and 77 years of age. Universe: 60 ears, sample: 48 ears with average age 34 years. Anatomical results were evaluated according to sex, age, location, cause of perforation and functional improvement measured by audiometry. Results: The overall anatomical postsurgical integrity is 81,3 % without differences between sexes. According to age there is a significant difference for the section between 7-19 years of age respect of the total (93,3 %). Central perforations had a 100% success rate. The most frequent reason of perforation was simple chronic otitis media (75%) with a postsurgical integrity of 80,5 %. 97,6 % managed to improve or maintain hearing level, (52,4 % gained functional improvement, and 45,2 % maintained hearing level). Conclusion: Using this technique, best results are obtained in patients younger than 20 years of age, with central perforations. It is an ideal method that preserves the structure of the tympanic membrane for future interventions.

Mauricio Calderón R; Carmen Meléndez P; Cristian Morales S; Danisa Torres M

2012-01-01

162

Day-case pediatric middle ear surgery: from myringoplasty to bilateral cochlear implantation.  

UK PubMed Central (United Kingdom)

OBJECTIVE: In the English speaking literature there is very little evidence demonstrating safe and effective tympanomastoid day case surgery in pediatric practice. At a time when there is ongoing pressure for trusts to meet financial government targets and our care provision revolves around a patient centred approach, could otolaryngologists perform more pediatric middle ear surgery on a day case basis? We report our experience with a series of 52 pediatric middle ear day cases. METHOD: Prospective study from a London tertiary referral centre of 52 consecutive children undergoing tympanomastoid surgery. There were 6 categories of surgical procedure, ranging from myringoplasty to cochlear implantation. Post-operative recovery was monitored. The duration of anaesthesia was compared with the length of post-operative ward stay. RESULTS: The correlation co-efficient r=-0.2203, showing that there was no association between length of anaesthetic and duration of post-operative ward stay. CONCLUSIONS: Despite minor post-operative problems including pain, bleeding, and nausea and vomiting all patients in this series were discharged on the day of surgery. For tympanoplasty our series adds weight to already available evidence. It is the first series showing that mastoid surgery, whether combined approach, traditional mastoidectomy or cochlear implantation can be performed safely as day cases in a pediatric population.

Powell HR; Rowlands RG; Lavy JA; Wright A

2010-07-01

163

Fate of Adipose-Derived Stromal Vascular Fraction Cells after Co-implantation with Fat Grafts: Evidence of Cell Survival and Differentiation in Ischemic Adipose Tissue.  

UK PubMed Central (United Kingdom)

BACKGROUND: Some studies have suggested that adipose-derived stromal vascular fraction is a potential cell source responsible for the improved quality and long-term retention of fat grafts, but studies that have clearly demonstrated the survival and differentiation potential of the implanted stromal vascular fraction cells as being dynamic phenomena have not been widely reported. METHODS: The authors isolated stromal vascular fraction cells from C57BL/6J-GFP mice. Green fluorescence protein-positive stromal vascular fraction cells were mixed with minced inguinal adipose tissue harvested from C57BL/6J mice and then co-implanted into BALB/c nude mice. The survival of implanted green fluorescence protein-positive stromal vascular fraction cells was tracked by in vivo fluorescence imaging for 56 days. Immunofluorescence staining was used to analyze the differentiation of green fluorescence protein-positive stromal vascular fraction cells occurring in ischemic adipose tissue at 7, 14, 28, 35, 42, or 56 days. RESULTS: The fluorescence signal intensity fell drastically within the first 14 days after co-implantation and continued to decrease thereafter, with 17.3 percent signal intensity (relative to day 1) at 56 days. Immunofluorescence staining revealed that some green fluorescence protein-positive cells can spontaneously differentiate into adipocytes from day 7, and some of the implanted stromal vascular fraction cells can incorporate into new blood vessels. CONCLUSIONS: The authors show convincing evidence for dynamic changes of stromal vascular fraction cells after co-implantation with fat grafts. The results prove the principle that implanted stromal vascular fraction cells can survive in the ischemic microenvironment of fat grafts and participate in the process of adipogenesis and angiogenesis.

Fu S; Luan J; Xin M; Wang Q; Xiao R; Gao Y

2013-08-01

164

Stromal vascular fraction (SVF) cells enhance long-term survival of autologous fat grafting through the facilitation of M2 macrophages.  

Science.gov (United States)

Optimum perfusion may be the key to the endurance, and hence survival, of autologous adipose tissue transportation. Stromal vascular fraction (SVF) cell therapy can greatly improve the survival of fat grafts by enhancing angiogenesis. However, SVF cells are poorly retained in later stages of SVF-assisted adipose tissue transplant. Therefore, it hardly defines the angiogenic effect through long-term transportation. Adipose tissue suffers from acute hypoxia in the early stage of transportation, leading to the recruitment of macrophages. M2 macrophages enhance angiogenesis in adipose transplantation by acting as an angiogenic signal source, promoting tip cell migration and assisting tip cell fusion. Furthermore, the angiogenic and anti-inflammatory micro-environment in the graft created by M2 macrophages may stimulate the transformation of infiltrating macrophages to M2 macrophages. These M2 macrophages may enhance the long-term retention of graft through angiogenesis. Based on these observations, we postulate that the long-term angiogenic effect of SVF cells may be achieved through the facilitation of the M2 macrophages. PMID:23526646

Dong, Ziqing; Fu, Rong; Liu, Linqi; Lu, Feng

2013-04-18

165

Stromal vascular fraction (SVF) cells enhance long-term survival of autologous fat grafting through the facilitation of M2 macrophages.  

UK PubMed Central (United Kingdom)

Optimum perfusion may be the key to the endurance, and hence survival, of autologous adipose tissue transportation. Stromal vascular fraction (SVF) cell therapy can greatly improve the survival of fat grafts by enhancing angiogenesis. However, SVF cells are poorly retained in later stages of SVF-assisted adipose tissue transplant. Therefore, it hardly defines the angiogenic effect through long-term transportation. Adipose tissue suffers from acute hypoxia in the early stage of transportation, leading to the recruitment of macrophages. M2 macrophages enhance angiogenesis in adipose transplantation by acting as an angiogenic signal source, promoting tip cell migration and assisting tip cell fusion. Furthermore, the angiogenic and anti-inflammatory micro-environment in the graft created by M2 macrophages may stimulate the transformation of infiltrating macrophages to M2 macrophages. These M2 macrophages may enhance the long-term retention of graft through angiogenesis. Based on these observations, we postulate that the long-term angiogenic effect of SVF cells may be achieved through the facilitation of the M2 macrophages.

Dong Z; Fu R; Liu L; Lu F

2013-08-01

166

Autologous fat grafting and breast cancer recurrences: Retrospective analysis of a series of 100 procedures in 64 patients.  

UK PubMed Central (United Kingdom)

Abstract Autologous fat transfer (AFT) enhances the cosmetic results of breast reconstruction and corrects breast conserving operation sequelae. The question of its oncological safety remains, as in-vitro experiences have shown that adipocytes can stimulate cancer cell proliferation. This study analysed the records of patients who had AFT after breast cancer from 2004-2009. The primary end-point was cancer recurrence. The secondary end-points were AFT complications and post-AFT mammogram modifications. Sixty-four patients (100 AFT) were included. The mean follow-up for AFT was 46.44 months (SD = 21.4). Two breast cancer recurrences were recorded (3.1%). Among 55 mammograms analysed, only one patient presented radiological abnormalities. One complication of AFT (donor-site infection) was recorded. This series is in favour of the oncological safety of AFT after breast cancer. An accurate evaluation of the recurrence risk, before performing AFT, is an essential prerequisite and must lead one to postpone or avoid this procedure in high-risk patients.

Ihrai T; Georgiou C; Machiavello JC; Chignon-Sicard B; Figl A; Raoust I; Bourgeon Y; Fouche Y; Flipo B

2013-09-01

167

Autologous fat grafting and breast cancer recurrences: Retrospective analysis of a series of 100 procedures in 64 patients.  

Science.gov (United States)

Abstract Autologous fat transfer (AFT) enhances the cosmetic results of breast reconstruction and corrects breast conserving operation sequelae. The question of its oncological safety remains, as in-vitro experiences have shown that adipocytes can stimulate cancer cell proliferation. This study analysed the records of patients who had AFT after breast cancer from 2004-2009. The primary end-point was cancer recurrence. The secondary end-points were AFT complications and post-AFT mammogram modifications. Sixty-four patients (100 AFT) were included. The mean follow-up for AFT was 46.44 months (SD = 21.4). Two breast cancer recurrences were recorded (3.1%). Among 55 mammograms analysed, only one patient presented radiological abnormalities. One complication of AFT (donor-site infection) was recorded. This series is in favour of the oncological safety of AFT after breast cancer. An accurate evaluation of the recurrence risk, before performing AFT, is an essential prerequisite and must lead one to postpone or avoid this procedure in high-risk patients. PMID:23627644

Ihrai, Tarik; Georgiou, Charalambos; Machiavello, Jean-Christophe; Chignon-Sicard, Berengere; Figl, Andrea; Raoust, Ines; Bourgeon, Yveline; Fouche, Yves; Flipo, Bernard

2013-04-30

168

IL-18 level in patients undergoing coronary artery bypass grafting surgery or valve replacement: which link with epicardial fat depot?  

Science.gov (United States)

Interleukin-18 (IL-18) is a member of the interleukin-1 family of cytokines produced constitutively by different cell types and by adipose tissue. Due to the link between obesity, inflammation and cardiovascular diseases, we aimed to measure IL-18 circulating level in patients undergoing open-heart surgery both for elective coronary artery bypass grafting (CABG) or for valve replacement (VR), and we also evaluated whether epicardial adipose tissue (EAT) depot may be a potential source of IL-18. Circulating IL-18 protein was quantified by enzyme-linked immunosorbent assay. IL-18, IL-18 receptor 1 (IL-18 R1) and IL-18 receptor accessory protein (IL-18-RAP) gene expression in EAT depot were evaluated by one colour microarray platform. EAT thickness was measured by echocardiography. In this study we found that all cardiovascular patients (CABG and VR) have increased circulating IL-18 level compared to healthy control subjects (p < 0.0001), but no statistical significant difference was observed between CABG and VR groups (p = 0.35). A great increase in the gene expression of IL-18 (p < 0.05), IL-18 R1 (p < 0.01) and IL-18 RAP (p < 0.001) was observed in EAT samples obtained from CABG vs VR patients. In conclusion, CABG and VR patients had similar increased level of circulating IL-18 protein, but in EAT depots isolated from CABG gene expression of IL-18, IL-18 R1 and IL-18-RAP resulted higher than in VR patients. Future investigation on local IL-18 protein production, its autocrine-paracrine effect and its correlation with plasmatic IL-18 level could give more information on the relationship between IL-18 and coronary artery disease. PMID:23298491

Dozio, E; Dogliotti, G; Malavazos, A E; Bandera, F; Cassetti, G; Vianello, E; Zelaschi, R; Barassi, A; Pellissero, G; Solimene, U; Morricone, L; Sigruener, A; Tarabin, V; Schmitz, G; Menicanti, L; Corsi Romanelli, M M

169

Lipoenxertia autóloga periorbitária no rejuvenescimento facial: análise retrospectiva da eficácia e da segurança em 31 casos Autologous periorbital fat grafting in facial rejuvenation: a retrospective analysis of efficacy and safety in 31 cases  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: Os sulcos periorbitários e zigomático e o malar flácido estão entre as características mais marcantes de envelhecimento ou de desarmonia facial. A reposição do volume é um método simples e eficiente, e o lipoenxerto pode ser o melhor material. O presente trabalho traz uma análise de 31 pacientes submetidos a autolipoenxertia, com ênfase na eficácia e na segurança da técnica. MÉTODO: Análise retrospectiva de 31 pacientes consecutivos, submetidos a lipoenxertias periorbitária e malar, concomitantemente ou não a outros procedimentos estéticos. A avaliação foi feita por meio de comparação entre fotografias pré e pós-operatória, bem como pelo grau de satisfação dos pacientes. RESULTADOS: Dos 31 pacientes, 26 (83,9%) classificaram o resultado pós-operatório como ótimo, 3 (9,7%), bom, e 2 (6,4%), regular. Na avaliação dos autores, 24 (77,5%) pacientes apresentaram resultado ótimo, 5 (16,1%), bom, e 2 (6,4%), regular. Houve necessidade de retoque de lipoenxertia em apenas 4 pacientes, por sugestão do cirurgião. As complicações foram mínimas e passageiras. CONCLUSÕES: A lipoenxertia facial é fácil e eficaz, e as complicações são mínimas quando realizada por cirurgiões qualificados.BACKGROUND: Periorbital and zygomatic hollows as well as flaccid cheeks are among the most evident characteristics of aging or facial disharmony. Volume replacement is a simple and efficient procedure, and fat grafting is considered as the best treatment for these characteristics. This study evaluates 31 patients who underwent autologous fat grafting and emphasizes the safety and efficacy of this procedure. METHODS: A retrospective analysis of 31 consecutive patients who underwent periorbital and zygomatic fat grafting, alone or in combination with other cosmetic procedures, was carried out. Final evaluation was performed by assessing pre- and postoperative photographs as well as the degree of patient satisfaction. RESULTS: Of 31 patients, 26 (83.9%) reported excellent postoperative outcomes; 3 (9.7%), satisfactory outcomes; and 2 (6.4%), poor outcomes. According to the authors' evaluation, 24 (77.5%) patients had excellent outcomes, 5 (16.1%) had satisfactory outcomes, and 2 (6.4%) had poor outcomes. Retouching of the fat graft was recommended for only 4 patients. The complications observed were minimal and transient. CONCLUSIONS: Facial fat grafting is a simple and effective procedure that presents minimal complications when performed by skilled surgeons.

Chang Yung Chia; Diego Antonio Rovaris

2012-01-01

170

Lipoenxertia autóloga periorbitária no rejuvenescimento facial: análise retrospectiva da eficácia e da segurança em 31 casos/ Autologous periorbital fat grafting in facial rejuvenation: a retrospective analysis of efficacy and safety in 31 cases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese INTRODUÇÃO: Os sulcos periorbitários e zigomático e o malar flácido estão entre as características mais marcantes de envelhecimento ou de desarmonia facial. A reposição do volume é um método simples e eficiente, e o lipoenxerto pode ser o melhor material. O presente trabalho traz uma análise de 31 pacientes submetidos a autolipoenxertia, com ênfase na eficácia e na segurança da técnica. MÉTODO: Análise retrospectiva de 31 pacientes consecutivos, submetid (more) os a lipoenxertias periorbitária e malar, concomitantemente ou não a outros procedimentos estéticos. A avaliação foi feita por meio de comparação entre fotografias pré e pós-operatória, bem como pelo grau de satisfação dos pacientes. RESULTADOS: Dos 31 pacientes, 26 (83,9%) classificaram o resultado pós-operatório como ótimo, 3 (9,7%), bom, e 2 (6,4%), regular. Na avaliação dos autores, 24 (77,5%) pacientes apresentaram resultado ótimo, 5 (16,1%), bom, e 2 (6,4%), regular. Houve necessidade de retoque de lipoenxertia em apenas 4 pacientes, por sugestão do cirurgião. As complicações foram mínimas e passageiras. CONCLUSÕES: A lipoenxertia facial é fácil e eficaz, e as complicações são mínimas quando realizada por cirurgiões qualificados. Abstract in english BACKGROUND: Periorbital and zygomatic hollows as well as flaccid cheeks are among the most evident characteristics of aging or facial disharmony. Volume replacement is a simple and efficient procedure, and fat grafting is considered as the best treatment for these characteristics. This study evaluates 31 patients who underwent autologous fat grafting and emphasizes the safety and efficacy of this procedure. METHODS: A retrospective analysis of 31 consecutive patients who (more) underwent periorbital and zygomatic fat grafting, alone or in combination with other cosmetic procedures, was carried out. Final evaluation was performed by assessing pre- and postoperative photographs as well as the degree of patient satisfaction. RESULTS: Of 31 patients, 26 (83.9%) reported excellent postoperative outcomes; 3 (9.7%), satisfactory outcomes; and 2 (6.4%), poor outcomes. According to the authors' evaluation, 24 (77.5%) patients had excellent outcomes, 5 (16.1%) had satisfactory outcomes, and 2 (6.4%) had poor outcomes. Retouching of the fat graft was recommended for only 4 patients. The complications observed were minimal and transient. CONCLUSIONS: Facial fat grafting is a simple and effective procedure that presents minimal complications when performed by skilled surgeons.

Chia, Chang Yung; Rovaris, Diego Antonio

2012-09-01

171

The density of nociceptive SP- and CGRP-immunopositive nerve fibers in the dura mater lumbalis of rats is enhanced after laminectomy, even after application of autologous fat grafts  

Science.gov (United States)

A considerable number of patients complain about pain after lumbar surgery. The spinal dura mater has been debated as a possible source of this pain. However, there is no information if laminectomy influences the nociceptive sensory innervation of the dura. Therefore, we quantitatively evaluated the density of SP- and CGRP-immunopositive nerve fibers in the dura mater lumbalis in an animal model of laminectomy. Twelve adult Lewis rats underwent laminectomy, in six of them the exposed dura was covered by an autologous fat graft. Further six animals without surgical treatment served as controls. Six weeks after surgery, the animals were perfused and the lumbar dura was processed immunohistochemically for the detection of CGRP- and SP-containing nerve fibers. In controls, the peptidergic nerve fibers were found predominantly in the ventral but rarely in the dorsal dura mater lumbalis. After laminectomy, the density of SP- and CGRP-immunopositive neurons significantly increased in ventral as well as in dorsal parts of the dura. Axonal spines could be observed in some cases at the site of laminectomy. The application of autologous fat grafts failed to inhibit the significant increase in the density of peptidergic afferents. Thus, we have provided the first evidence that laminectomies induce an increase in the density of putative nociceptive SP- and CGRP-immunopositive neurons in the lumbar dura mater ascribable to an axonal sprouting of fine nerve fibers. This effect was not prevented by using autologous fat grafts. It is conceivable that the neuronal outgrowth of nociceptive afferents is a cause of low back pain observed after lumbar surgery.

Brankamp, Jochen; von Knoch, Marius; Loer, Franz; Hilken, Gero; Hanesch, Ulrike

2008-01-01

172

Uso de factores de crecimiento plaquetar unidos a injertos de grasa para lipofiling facial en ritidectomía Use of fat grafts enriched with platelet growth factors for facial lipofiling in ritidectomy  

Directory of Open Access Journals (Sweden)

Full Text Available Presentamos una serie de pacientes a los que hemos realizado infiltraciones de grasa enriquecida con Factores de Crecimiento Plaquetario (F.C.P.) como único procedimiento. Igualmente presentamos casos donde las infiltraciones van acompañadas con otros procedimientos (lifting temporal, lifting cérvico-frontal, etc.). También usamos el plasma rico en F.C.P. en forma de coágulo para rellenar el surco de la cuenca orbitaria (“Tear Through”), y como mesoterapia facial enriquecida con nutrientes. El objetivo de este trabajo es presentar una revisión detallada de los pasos a seguir para la realización de éste procedimiento, que van desde la simple extracción de sangre para la posterior obtención de F.C.P. hasta la técnica de infiltración de grasa enriquecida con dichos factores a nivel facial. Con esta técnica de enriquecimiento de la grasa hemos logrado tener mejores resultados y con mayor permanencia. Evaluando los postoperatorios de pacientes sometidos a este procedimiento, hemos observado que el volumen infiltrado en áreas como la región malar, se mantiene entre un 90% a 95%. En otras áreas como labios y surcos nasogenianos (áreas de gran movilidad), solo permanece entre el 50% a 60% del volumen infiltrado.We present a serie of patients with facial fat infiltration enriched with platelet-derived growth factors, some of them associated to other surgical procedures (temporal lifting, cervico-frontal lifting, etc.) We explain how to use this platelet - rich plasma to fill the tear - through and as a facial mesotherapy. Our purpose is to present a detailled review of our method: since blood extraction to the last obtention of the platelet - derived growth factors and the use of this plasma combined with fat infiltration in the facial area. With this methodology we have got better and more permanent results. We have evaluated 90-95 % fat grafts survival in malar region. In other facial areas such as lips or nasogenian folds (big movement areas), we only report about 50 to 60% fat graft survival.

J.M. Serra Renom; J.L. Muñoz del Olmo; C. Gonzalo Caballero

2006-01-01

173

Injertos de tejido adiposo: variables que influyen en la viabilidad del adipocito y de las células madre mesenquimales Fat grafting: variables that influence the viability of the adipocyte and mesenchimal stem cells  

Directory of Open Access Journals (Sweden)

Full Text Available Si bien los injertos de tejido adiposo se han venido utilizando durante décadas a lo largo del siglo pasado, la técnica se venía considerando como poco útil dado que el injerto tendía a la reabsorción. Fue Coleman quien introdujo un sistema de obtención-procesamiento-infiltración atraumático que aumentó el porcentaje de supervivencia del injerto y la obtención de resultados positivos similares en su aplicación en todo el mundo. Aún así, la publicación de resultados dispares en la literatura respecto a la supervivencia del injerto, con diferentes porcentajes de reabsorción y el descubrimiento de las células madre en el tejido adiposo, han llevado a la realización de numerosos trabajos de investigación encaminados a comprender la biología del injerto de tejido adiposo, a estudiar el papel de las células madre en este proceso y la influencia que sobre la viabilidad celular tienen los distintos pasos a los que los cirujanos plásticos sometemos al tejido adiposo para su trasplante. Hemos hecho una revisión de la literatura científica al respecto para reunir la información disponible sobre estas controversias.Though adipose tissue grafts have been used for decades in last century, the technique has been considered as slightly usefull provided that the graft was tending to reabsorption. It was Coleman who introduced a system of atraumatic harvesting-processing-infiltration that increased the percentage of survival of the graft obtaining positive similar results in its application all over the world. Nonetheless, publication of unlike results in the literature regarding survival of the graft with different percentages of reabsorption and the discovery of stem cells in the adipose tissue, have led to the accomplishment of numerous research works directed to understanding the biology of the fat graft, the role of the stem cells in this process and the influence that the different steps for transplantation have on the cellular viability. We present a review of the scientific literature about the theme to bring together the available information about these controversies.

J. Benito Ruiz

2011-01-01

174

Skin graft  

Science.gov (United States)

Skin transplant; Skin autografting; FTSG; STSG; Split thickness skin graft; Full thickness skin graft ... donor site. Most people who are having a skin graft have a split-thickness skin graft. This takes ...

175

Dietary Fat  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Dietary Fat What counts as fat? Are some fats better ... polyunsaturated and monounsaturated fats. How much total dietary fat do I need? The Dietary Guidelines for Americans ...

176

Autologous fat grafting and injectable dermal fillers for human immunodeficiency virus-associated facial lipodystrophy: a comparison of safety, efficacy, and long-term treatment outcomes.  

UK PubMed Central (United Kingdom)

BACKGROUND: Facial lipoatrophy is a common side effect of human immunodeficiency virus treatment with highly active antiretroviral therapy. To identify the most clinically durable and efficient way of addressing facial lipoatrophy, the authors reviewed all available evidence for the use of injectable dermal fillers and autologous fat transfers as treatment modalities, focusing on safety, outcomes, and long-term durability. METHODS: A systematic review of the Cochrane and MEDLINE databases for autologous fat transfer and injectable dermal fillers for the treatment of human immunodeficiency virus-associated lipodystrophy was performed. Based on U.S. Food and Drug Administration approval in human immunodeficiency virus lipoatrophy, studies were limited to the use of hyaluronic acid and/or poly-L-lactic acid. Facial volume, subjective patient satisfaction, standardized outcome scales, reinjection rates, and complications were recorded. RESULTS: Nineteen studies were included representing 724 patients, with 549 patients in the hyaluronic acid/poly-L-lactic acid cohort and 175 in the autologous fat transfer cohort. Improvements in facial volume and durability of treatment were similar between dermal fillers and fat transfer, as measured by both objective means and subjective patient outcomes. However, poly-L-lactic acid was reinjected at a rate three times that of autologous fat, and was associated with a relatively high rate of subcutaneous papule formation at 22 percent (range, 3 to 44 percent). CONCLUSIONS: Dermal fillers and autologous fat transfer are effective treatment modalities for human immunodeficiency virus-associated facial lipoatrophy, with high rates of facial volume restoration and patient satisfaction. Autologous fat transfer may offer similar to superior long-term durability but with less of a financial burden compared with injectable fillers.

Shuck J; Iorio ML; Hung R; Davison SP

2013-03-01

177

Uso de factores de crecimiento plaquetar unidos a injertos de grasa para lipofiling facial en ritidectomía/ Use of fat grafts enriched with platelet growth factors for facial lipofiling in ritidectomy  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Presentamos una serie de pacientes a los que hemos realizado infiltraciones de grasa enriquecida con Factores de Crecimiento Plaquetario (F.C.P.) como único procedimiento. Igualmente presentamos casos donde las infiltraciones van acompañadas con otros procedimientos (lifting temporal, lifting cérvico-frontal, etc.). También usamos el plasma rico en F.C.P. en forma de coágulo para rellenar el surco de la cuenca orbitaria (“Tear Through”), y como mesoterapi (more) a facial enriquecida con nutrientes. El objetivo de este trabajo es presentar una revisión detallada de los pasos a seguir para la realización de éste procedimiento, que van desde la simple extracción de sangre para la posterior obtención de F.C.P. hasta la técnica de infiltración de grasa enriquecida con dichos factores a nivel facial. Con esta técnica de enriquecimiento de la grasa hemos logrado tener mejores resultados y con mayor permanencia. Evaluando los postoperatorios de pacientes sometidos a este procedimiento, hemos observado que el volumen infiltrado en áreas como la región malar, se mantiene entre un 90% a 95%. En otras áreas como labios y surcos nasogenianos (áreas de gran movilidad), solo permanece entre el 50% a 60% del volumen infiltrado. Abstract in english We present a serie of patients with facial fat infiltration enriched with platelet-derived growth factors, some of them associated to other surgical procedures (temporal lifting, cervico-frontal lifting, etc.) We explain how to use this platelet - rich plasma to fill the tear - through and as a facial mesotherapy. Our purpose is to present a detailled review of our method: since blood extraction to the last obtention of the platelet - derived growth factors and the use of (more) this plasma combined with fat infiltration in the facial area. With this methodology we have got better and more permanent results. We have evaluated 90-95 % fat grafts survival in malar region. In other facial areas such as lips or nasogenian folds (big movement areas), we only report about 50 to 60% fat graft survival.

Serra Renom, J.M.; Muñoz del Olmo, J.L.; Gonzalo Caballero, C.

2006-09-01

178

Platelet-Rich Plasma Greatly Potentiates Insulin-Induced Adipogenic Differentiation of Human Adipose-Derived Stem Cells Through a Serine/Threonine Kinase Akt-Dependent Mechanism and Promotes Clinical Fat Graft Maintenance  

Science.gov (United States)

The potential plasticity and therapeutic utility in tissue regeneration of human adipose-derived stem cells (ASCs) isolated from adult adipose tissue have recently been highlighted. The use of autologous platelet-rich plasma (PRP) represents an alternative strategy in regenerative medicine for the local release of multiple endogenous growth factors. Here we investigated the signaling pathways and effects of PRP and human recombinant insulin on proliferation and adipogenic differentiation of ASCs in vitro. PRP stimulated proliferation (EC50 = 15.3 ± 1.3% vol/vol), whereas insulin's effect was the opposite (IC50 = 3.0 ± 0.5 ?M). Although PRP alone did not increase adipogenesis, in association with insulin it prevented ASC proliferative arrest, greatly enhanced intracytoplasmic lipid accumulation, strongly increased serine/threonine kinase Akt phosphorylation and mouse monoclonal anti-sterol regulatory element binding protein-1 accumulation, and downregulated Erk-1 activity; adipogenic effects were markedly prevented by the Akt inhibitor wortmannin. PRP with insulin synergistically upregulated fibroblast growth factor receptor (FGFR) and downregulated epidermal growth factor receptor (ErbB) expression; moreover, PRP in association prevented insulin-induced insulin-like growth factor-1 receptor and insulin receptor downregulation. The inhibition of FGFR-1, epidermal growth factor receptor (EGFR), and epidermal growth factor receptor-2 (ErbB2) activity reduced ASC proliferation, but only that of FGFR-1 reduced adipogenesis and Akt phosphorylation, whereas the ErbB2 inhibition effects were the opposite. However, EGFR activity was needed for ErbB2-mediated inhibition of ASC adipogenesis. Clinically, the injection of insulin further ameliorated patients' 1-year PRP-induced fat graft volume maintenance and contour restoring. Our results ascertain that PRP in association with insulin greatly potentiates adipogenesis in human ASCs through a FGFR-1 and ErbB2-regulated Akt mechanism. The ameliorated clinical fat graft maintenance suggests additional useful translational applications of combined PRP-insulin treatment in regenerative medicine.

Cervelli, Valerio; Scioli, Maria G.; Gentile, Pietro; Doldo, Elena; Bonanno, Elena; Spagnoli, Luigi G.

2012-01-01

179

Injertos de tejido adiposo: variables que influyen en la viabilidad del adipocito y de las células madre mesenquimales/ Fat grafting: variables that influence the viability of the adipocyte and mesenchimal stem cells  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Si bien los injertos de tejido adiposo se han venido utilizando durante décadas a lo largo del siglo pasado, la técnica se venía considerando como poco útil dado que el injerto tendía a la reabsorción. Fue Coleman quien introdujo un sistema de obtención-procesamiento-infiltración atraumático que aumentó el porcentaje de supervivencia del injerto y la obtención de resultados positivos similares en su aplicación en todo el mundo. Aún así, la publicación de re (more) sultados dispares en la literatura respecto a la supervivencia del injerto, con diferentes porcentajes de reabsorción y el descubrimiento de las células madre en el tejido adiposo, han llevado a la realización de numerosos trabajos de investigación encaminados a comprender la biología del injerto de tejido adiposo, a estudiar el papel de las células madre en este proceso y la influencia que sobre la viabilidad celular tienen los distintos pasos a los que los cirujanos plásticos sometemos al tejido adiposo para su trasplante. Hemos hecho una revisión de la literatura científica al respecto para reunir la información disponible sobre estas controversias. Abstract in english Though adipose tissue grafts have been used for decades in last century, the technique has been considered as slightly usefull provided that the graft was tending to reabsorption. It was Coleman who introduced a system of atraumatic harvesting-processing-infiltration that increased the percentage of survival of the graft obtaining positive similar results in its application all over the world. Nonetheless, publication of unlike results in the literature regarding survival (more) of the graft with different percentages of reabsorption and the discovery of stem cells in the adipose tissue, have led to the accomplishment of numerous research works directed to understanding the biology of the fat graft, the role of the stem cells in this process and the influence that the different steps for transplantation have on the cellular viability. We present a review of the scientific literature about the theme to bring together the available information about these controversies.

Benito Ruiz, J.

2011-12-01

180

Saturated Fat  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Saturated Fat You may have heard that saturated fats are ... coconut oil. How do I control my saturated fat intake? In general, saturated fat can be found ...

 
 
 
 
181

Parry-Romberg Reconstruction: Beneficial Results Despite Poorer Fat Take.  

UK PubMed Central (United Kingdom)

OBJECTIVE: For the treatment of Parry-Romberg syndrome or progressive hemifacial atrophy, we studied the volume retention and skin changes after autologous fat grafts within diseased regions. SUMMARY BACKGROUND DATA: The long-term survival and volume retention of fat grafts used in soft tissue reconstruction of Parry-Romberg syndrome is still unknown, as are skin changes after fat grafting. METHODS: Sex, age, severity of deformity, number of procedures, operative times, and augmentation volumes were recorded. Preoperative/postoperative 3-dimensional computed tomographic scans were also reviewed. A digital 3-dimensional photogrammetry system was used to determine "final fat take" and symmetry. Romberg fat grafting volumes were compared to nonaffected, cosmetic fat-grafted patients. For skin changes, a spectrophotometer was used to quantify percent improvement in melanin index. Physician and patient satisfaction surveys (5-point scale) were elicited, including overall outcome and skin color/texture. RESULTS: The mean number of procedures correlated to the severity of deformity: mild, 1.8 procedures; moderate, 3.4; and severe, 5.2. With Romberg patients, fat grafting injected: per case, 48 mL; total, 188 mL; and final measured volume, 101 mL. Romberg patients had less "fat take" than nonaffected grafted patients (final take, 41% vs 81%). Skin color/texture showed 3-fold improvement after fat grafting procedures. The mean melanin index improvement seen in the diseased regions of Romberg patients after fat grafting was 42% (+3%). Skin color and texture improvement was also shown in patient surveys (preoperative = 2.4 + 0.06 to follow-up = 3.4 + 0.09) and physician (preoperatively = 2.1 + 0.1 to follow-up = 3.6 + 0.1). CONCLUSIONS: Despite poorer fat graft take within the disease region of Romberg patients, fat grafting resulted in long-term improvement in hypoplasia and skin hyperpigmentation.

Slack GC; Tabit CJ; Allam KA; Kawamoto HK; Bradley JP

2013-05-01

182

Parry-Romberg Reconstruction: Beneficial Results Despite Poorer Fat Take.  

Science.gov (United States)

OBJECTIVE: For the treatment of Parry-Romberg syndrome or progressive hemifacial atrophy, we studied the volume retention and skin changes after autologous fat grafts within diseased regions. SUMMARY BACKGROUND DATA: The long-term survival and volume retention of fat grafts used in soft tissue reconstruction of Parry-Romberg syndrome is still unknown, as are skin changes after fat grafting. METHODS: Sex, age, severity of deformity, number of procedures, operative times, and augmentation volumes were recorded. Preoperative/postoperative 3-dimensional computed tomographic scans were also reviewed. A digital 3-dimensional photogrammetry system was used to determine "final fat take" and symmetry. Romberg fat grafting volumes were compared to nonaffected, cosmetic fat-grafted patients. For skin changes, a spectrophotometer was used to quantify percent improvement in melanin index. Physician and patient satisfaction surveys (5-point scale) were elicited, including overall outcome and skin color/texture. RESULTS: The mean number of procedures correlated to the severity of deformity: mild, 1.8 procedures; moderate, 3.4; and severe, 5.2. With Romberg patients, fat grafting injected: per case, 48 mL; total, 188 mL; and final measured volume, 101 mL. Romberg patients had less "fat take" than nonaffected grafted patients (final take, 41% vs 81%). Skin color/texture showed 3-fold improvement after fat grafting procedures. The mean melanin index improvement seen in the diseased regions of Romberg patients after fat grafting was 42% (+3%). Skin color and texture improvement was also shown in patient surveys (preoperative = 2.4 + 0.06 to follow-up = 3.4 + 0.09) and physician (preoperatively = 2.1 + 0.1 to follow-up = 3.6 + 0.1). CONCLUSIONS: Despite poorer fat graft take within the disease region of Romberg patients, fat grafting resulted in long-term improvement in hypoplasia and skin hyperpigmentation. PMID:23676519

Slack, Ginger C; Tabit, Christina J; Allam, Karam A; Kawamoto, Henry K; Bradley, James P

2013-05-15

183

Fat test  

Science.gov (United States)

Nutrients include fats, protein, minerals, water, and carbohydrates. Brown paper can be used as an indicator of how much fat is in a food. The food that makes the largest grease spot has the most fat.

Olivia Worland (Purdue University;Biological Sciences)

2008-06-06

184

Facial Soft Tissue Augmentation using Autologous Fat Mixed with Stromal Vascular Fraction.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting evolved over the twentieth century to become a quick, safe, and reliable method for restoring volume. However, autologous fat grafts have some problems including uncertain viability of the grafted fat and a low rate of graft survival. To overcome the problems associated with autologous fat grafts, we used uncultured adipose tissue-derived stromal cell (stromal vascular fraction, SVF) assisted autologous fat grafting. Thus, the purpose of this study was to evaluate the effect of SVF in a clinical trial. METHODS: SVF cells were freshly isolated from half of the aspirated fat and were used in combination with the other half of the aspirated fat during the procedure. Between March 2007 and February 2008, a total of 9 SVF-assisted fat grafts were performed in 9 patients. The patients were followed for 12 weeks after treatment. Data collected at each follow-up visit included clinical examination of the graft site(s), photographs for historical comparison, and information from a patient questionnaire that measured the outcomes from the patient perspective. The photographs were evaluated by medical professionals. RESULTS: Scores of the left facial area grafted with adipose tissue mixed with SVF cells were significantly higher compared with those of the right facial area grafted with adipose tissue without SVF cells. There was no significant adverse effect. CONCLUSIONS: The subjective patient satisfaction survey and surgeon survey showed that SVF-assisted fat grafting was a surgical procedure with superior results.

Lee SK; Kim DW; Dhong ES; Park SH; Yoon ES

2012-09-01

185

[Breast reconstruction by autologous fat transfer].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Autologous fat tissue transfer has recently become extremely popular in the field of plastic and reconstructive surgery. Fat represents a filling material with ideal properties - it naturally incorporates into tissues and it is autologous, and therefore 100% biocompatible. An increasing number of publications describe the regenerative properties of autologous fat tissue, especially when used in soft tissue with post-radiation damage. The aim of this article is to describe our experience with fat grafting in breasts. MATERIALS AND METHODS: An autologous fat grafting operation consists in 3 phases - harvesting of fat tissue, its processing, and application of the graft. Fat harvesting is similar to classic liposuction. Common methods of fat tissue processing are centrifugation and the use of the PureGraft filter bags. The most important precondition for a favourable result of the operation is the correct graft application. RESULTS: In the period between March 2011 and January 2012, we used this fagrafting to perform surgical breast reconstruction in 15 patients; 8 patients with a breast deformity after partial mastectomy and radiation, 2 patients after complete mastectomy, 2 patients after complete mastectomy reconstructed with the additional use of external expansion, 2 patients after implant reconstruction presenting with subsequent deformity and 1 patient with pectus excavatum. The patients were followed up for 3-12 months. Long-term retention of the graft was considered good. CONCLUSION: By use of fatgrafting, we can achieve excellent results with minimal risk of complications in reconstructive breast surgery. Autologous fat has plenty of advantages when compared to other biomaterials. It is absolutely biocompatible and able to regenerate the surrounding tissue.

Mestak O; Zimovjanová M

2012-07-01

186

Facial Soft Tissue Augmentation using Autologous Fat Mixed with Stromal Vascular Fraction  

Directory of Open Access Journals (Sweden)

Full Text Available Background Autologous fat grafting evolved over the twentieth century to become a quick,safe, and reliable method for restoring volume. However, autologous fat grafts have someproblems including uncertain viability of the grafted fat and a low rate of graft survival. Toovercome the problems associated with autologous fat grafts, we used uncultured adiposetissue-derived stromal cell (stromal vascular fraction, SVF) assisted autologous fat grafting.Thus, the purpose of this study was to evaluate the effect of SVF in a clinical trial.Methods SVF cells were freshly isolated from half of the aspirated fat and were used incombination with the other half of the aspirated fat during the procedure. Between March2007 and February 2008, a total of 9 SVF-assisted fat grafts were performed in 9 patients.The patients were followed for 12 weeks after treatment. Data collected at each follow-upvisit included clinical examination of the graft site(s), photographs for historical comparison,and information from a patient questionnaire that measured the outcomes from the patientperspective. The photographs were evaluated by medical professionals.Results Scores of the left facial area grafted with adipose tissue mixed with SVF cells weresignificantly higher compared with those of the right facial area grafted with adipose tissuewithout SVF cells. There was no significant adverse effect.Conclusions The subjective patient satisfaction survey and surgeon survey showed that SVFassistedfat grafting was a surgical procedure with superior results.

Sang Kyun Lee; Deok-Woo Kim; Eun-Sang Dhong; Seung-Ha Park; Eul-Sik Yoon

2012-01-01

187

Food fats  

UK PubMed Central (United Kingdom)

A hard butter for confectionery use has an Iodine Value of at most 20, a maximum slip melting point of about 45 DEG C., a dilatation at 20 DEG C. of at least 900 and the combined fatty acid composition in random distribution of a blend of a lauric fat with a smaller amount of a non-lauric, C16-C18 edible fat. Preferably the fats are coconut oil and a stearine of a palmitic fat i.e. a palm fat or cottonseed oil having an Iodine Value from 5 to 40.

COTTIER DEREK; ROSSELL JOHN B

188

Fat blend  

UK PubMed Central (United Kingdom)

The invention relates to a fat blend comprising 2-35 parts by weight of hardstock, 30-98 parts by weight of oil liquid at room temperature and 0-35 parts by weight of hydrogenated fat having a slip melting point of 25 DEG -45 DEG C. The fat blend can be used for producing margarines, low calorie margarines containing e.g. 35-60% by wt. of fat, and cooking fats. The hardstock is an interesterified hydrogenated blend of (1) triglycerides derived from a fat rich in fatty acid residues having 16-18 carbon atoms, most of which are saturated, and (2) an olein fraction of a fat rich in lauric acid residues. The hydrogenation can be carried out before or after interesterification. The ratio of (1):(2) can be (20-80):(80-20), preferably (40-58):(60-42).

VAN HETEREN JAN; PRONK JACOBUS N; SMEENK WILLEM J; VERMAAS LEO F

189

Skin Graft  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin grafts are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital skin deficiencies, hair restorat...

Shimizu, Ruka; Kishi, Kazuo

190

Fat blend  

UK PubMed Central (United Kingdom)

The invention relates to a fat blend comprising an oil liquid at room temperature and a hardstock (the former preferably being an oil rich in polyunsaturated fatty acid residues such as linoleic acid) and to a process for the preparation of such a fat blend. The fat blend can comprise 2-35 parts by weight of hardstock, 30-98 parts by weight of oil liquid at room temperature and 0-35 parts by weight of hydrogenated fat having a slip melting point of 25-45°C. The fat blend can be used for producing margarines, low calorie margarines containing e.g. 35-60% by wt. of fat, and cooking fats. The hardstock is an interesterified hydrogenated blend of (1) triglycerides derived from a fat rich in fatty acid residues having 16-18 carbon atoms, most of which are saturated, and (2) a lower melting fraction of a fat rich in lauric acid residues. The hydrogenation can be carried out before or after interesterification. The ratio of (1) : (2) can be (20-80) : (80-20), preferably (40-58) : (60-42).

Van Heteren Jan; Pronk Jacobus Nicolaas; Smeenk Willem Jan; Vermaas Leo Frans

191

Optimizing the fat and water content of impaction bone allograft.  

UK PubMed Central (United Kingdom)

Fresh morselized impacted bone graft usually fails due to shear forces. The presence of fat, water, and marrow particles act as interparticle lubricants, reducing the interlocking of particles and allowing the graft to move more freely. Furthermore, the presence of this incompressible fluid damps and resists compressive forces during impaction, preventing the graft particles from moving into a closer formation. We believe there exists an ideal concentration of fat and water that will maximize resistance to shear forces. We performed mechanical shear testing in vitro on morselized human femoral heads, varying the amount of fat and water to determine their optimum concentrations. Level of fat and water were determined that increased strength by 36% over unaltered bone graft. This is most closely approximated in an operating room by washing and subsequently squeezing the bone graft. Optimizing the fat and water content of bone graft produces a stronger graft that is more resistant to shear stresses, protecting the surgical construct until bone growth can occur.

McKenna PB; Leahy JJ; Masterson EL; McGloughlin TM

2013-02-01

192

Autologous fat transplantation - animal models and methods for in vitro analysis of viability Autologe Fetttransplantation - Tierversuche und Methoden für In-vitro-Vitalitätsanalysen  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Since Peer presented his "cell survival theory" it is assumed that the grafted tissue will be implemented in some way into the host tissue. This lead to a big effort to produce a fat graft that is as much viable as possible. Various studies have been performed to analyse viability of fat grafts prep...

Herold, C; Pflaum, M; Utz, P; Wilhelmi, M; Vogt, PM; Rennekampff, HO

193

Gum Graft Surgery  

Science.gov (United States)

... Treatments and Procedures › Gum Graft Surgery Gum Graft Surgery Exposed tooth roots are the result of gum ... sensitivity. What are the benefits of gum graft surgery? A gum graft can reduce further recession and ...

194

Trans Fat  

Science.gov (United States)

... Everyone can: Read the Nutrition Facts label and ingredient list to compare foods. Choose products with 0 grams trans fat. Check the Ingredient List to see if there is any partially hydrogenated ...

195

Fat composition  

UK PubMed Central (United Kingdom)

The present invention is concerned with a fatty composition comprising fat essentially consisting of a blend of one or more non-digestible polyol fatty acid polyesters and glyceride fat, wherein the fat comprises from 25% to 75% by weight of the polyol fatty acid polyesters, the blend of said polyesters having a slip melting point of between 35 and 50°C and the fatty composition having an S20 in the range of 400 to 1400 g. The fatty composition according to the present invention can advantageously be used in the preparation and baking of dough, in particular layered dough. Layered dough product prepared with the present fatty composition display ample lift upon baking. Another aspect of the present invention is the use of a fatty composition according to the invention in the preparation of layered dough. Yet another aspect of the invention is a layered dough comprising: (a) 10 to 45 wt.% of fat essentially consisting of glyceride fat and a blend of one or more polyol fatty acid polyesters, the blend of said polyesters constituting at least 40 wt.% of the fat and having a slip melting point of between 35 and 55°C, (b) 25 to 75 wt.% flour and (c) 10 to 30 wt.% water.

Lansbergen Adrianus Jacobus; Liefkens Theodorus Johannes; Verhoef Nicolaas Jan Frederik Dirk; Zock Hendrik Frits

196

Nerve grafting.  

UK PubMed Central (United Kingdom)

By avoiding tension and securing anatomical neurorrhaphy, regeneration of nerve is obtainable. When the gap exceeds a certain limit, the only way to avoid tension is the use of grafts. Experience in animal experiments and clinical practice has demonstrated that regenerating axons can cross 2 optimal suture lines much more easily than one sub-standard one. For bridging a gap autografts are used, because in autografts the fascicular pattern is preserved and its Swann cells survive. With the interfascicular technique the dissection of the nerve stumps proceeds from normal to abnormal tissues and the epineurium is resected. The coaptation must be exact so that the grafts cover the whole cross sectional area of the fascicle. All this can be achieved by the use of one 10--0 or 11--0 nylon suture. The clinical results show that in the median nerve 82%, in the ulnar 80% and in the radial nerve 92% of good functional results can be obtained. Also in brachial plexus injuries the interfascicular nerve grafting procedure opened new ways. Therefore interfascicular nerve grafting, using autografts in cases of nerve repair, where a gap may occur, currently is the method of choice.

Berger A; Millesi H

1978-06-01

197

The buccal fat pad in oral reconstruction  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The use of the buccal fat pad (BFP) as an uncovered pedicled graft to close oral defects is relatively recent. A series of 29 consecutive cases of reconstruction utilizing the BFP is presented, showing excellent results and without added surgical morbidity. Indications include defects after benign o...

Samman, N; Cheung, LK; Tideman, H

198

Fat liquoring  

UK PubMed Central (United Kingdom)

Hydroxylated phosphatides are used as component in or as the sole fattening agent in fat-liquoring. The liquoring bath may also contain a fatty oil e.g. neatsfoot oil, sperm oil, and soyabean oil; a sulphonated oil e.g. sulphonated sperm oil; a chromium resistance improving agent e.g. an ethoxylated alkylphenol; and/or an emulsifier.

199

Fat and Diabetes  

Medline Plus

Full Text Available ... Fat and Diabetes Fruits Making Healthy Food Choices Dairy What Can I Drink? Lean Meats Non-starchy ... stroke. Foods containing saturated fat include: High-fat dairy products such as full-fat cheese, cream, ice ...

200

Location, location, location: Beneficial effects of autologous fat transplantation.  

UK PubMed Central (United Kingdom)

Visceral adiposity is a risk factor for cardiovascular disorders, type 2 diabetes mellitus (T2D) and associated metabolic diseases. Sub-cutaneous fat is believed to be intrinsically different from visceral fat. To understand molecular mechanisms involved in metabolic advantages of fat transplantation, we studied a rat model of diet-induced adiposity. Adipokine genes (Adiponectin, Leptin, Resistin and Visfatin) were expressed at 10,000 to a million-fold lower in visceral fat depot as compared to peripheral (thigh/chest) fat depots. Interestingly, autologous transplantation of visceral fat to subcutaneous sites resulted in increased gene transcript abundance in the grafts by 3 weeks post-transplantation, indicating the impact of local (residence) factors influencing epigenetic memory. We show here that active transcriptional state of adipokine genes is linked with glucose mediated recruitment of enzymes that regulate histone methylation. Adipose depots have "residence memory" and autologous transplantation of visceral fat to sub-cutaneous sites offers metabolic advantage.

Satoor SN; Puranik AS; Kumar S; Williams MD; Ghale M; Rahalkar A; Karandikar MS; Shouche Y; Patole M; Bhonde R; Yajnik CS; Hardikar AA

2011-01-01

 
 
 
 
201

Location, location, location: Beneficial effects of autologous fat transplantation  

Science.gov (United States)

Visceral adiposity is a risk factor for cardiovascular disorders, type 2 diabetes mellitus (T2D) and associated metabolic diseases. Sub-cutaneous fat is believed to be intrinsically different from visceral fat. To understand molecular mechanisms involved in metabolic advantages of fat transplantation, we studied a rat model of diet-induced adiposity. Adipokine genes (Adiponectin, Leptin, Resistin and Visfatin) were expressed at 10,000 to a million-fold lower in visceral fat depot as compared to peripheral (thigh/chest) fat depots. Interestingly, autologous transplantation of visceral fat to subcutaneous sites resulted in increased gene transcript abundance in the grafts by 3 weeks post-transplantation, indicating the impact of local (residence) factors influencing epigenetic memory. We show here that active transcriptional state of adipokine genes is linked with glucose mediated recruitment of enzymes that regulate histone methylation. Adipose depots have “residence memory” and autologous transplantation of visceral fat to sub-cutaneous sites offers metabolic advantage.

Satoor, Sarang N.; Puranik, Amrutesh S.; Kumar, Sandeep; Williams, Michael D.; Ghale, Mallikarjun; Rahalkar, Anand; Karandikar, Mahesh S.; Shouche, Yogesh; Patole, Milind; Bhonde, Ramesh; Yajnik, Chittaranjan S.; Hardikar, Anandwardhan A.

2011-01-01

202

Skin graft survival on subcutaneous hinge flaps: an algorithm for nasal reconstruction.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: To assess the survival of full-thickness skin grafts and perichondrial cutaneous grafts when placed on subcutaneous soft tissue flaps used in nasal reconstruction. STUDY DESIGN: Retrospective case series from a secondary-care cutaneous cancer practice. METHODS: Twenty-eight patients with nasal defects secondary to basal cell carcinoma excision were included. Clinical information, including case notes and photography, was obtained and analyzed. Graft survival was assessed in relation to type of graft and subcutaneous soft tissue flap employed for the reconstruction. RESULTS: Overall graft survival was 79%, with 89% and 74% for perichondrial cutaneous graft and full-thickness skin grafts, respectively. Anecdotally, procerus and nasalis flaps were found to yield higher graft survival than cheek fat flaps. CONCLUSIONS: The combination of subcutaneous soft tissue flap and skin graft cover offers a valuable addition to the treatment algorithm for nasal reconstruction following cutaneous malignancy excision.

Almeyda R; van der Eerden P; Vuyk H

2013-03-01

203

Fat and Diabetes  

Medline Plus

Full Text Available ... Food and Fitness > Food > What Can I Eat Fat and Diabetes Listen Unhealthy fats Healthy fats More about fats No doubt about it, carbohydrate gets all of the attention in diabetes management. How much total fat you eat depends on many factors but more ...

204

Fat and Diabetes  

Medline Plus

Full Text Available ... eat less of the unhealthy fats – saturated and trans fat. At the same time, you can protect ... cutting back on the sources of saturated and trans fats, you'll want to substitute the healthy ...

205

Dietary Fat and Toddlers  

Science.gov (United States)

... Dietary Fat and Toddlers Ages & Stages Listen Dietary Fat and Toddlers Article Body If you’re worried ... about cutting down on the amount of dietary fat he consumes. However, you should think again. Here’s ...

206

Saturated fat (image)  

Science.gov (United States)

Saturated fat can raise blood cholesterol and can put you at risk for heart disease and stroke. You should ... limit any foods that are high in saturated fat. Sources of saturated fat include whole-milk dairy ...

207

Fat and Diabetes  

Medline Plus

Full Text Available ... by eating the healthy fats—monounsaturated, polyunsaturated and omega-3 fats. It is true that all fat is ... sunflower seeds Soft (tub) margarine Mayonnaise Salad dressings Omega-3 Fatty Acids Omega-3 fatty acids help prevent ...

208

Bone grafting: An overview  

Directory of Open Access Journals (Sweden)

Full Text Available Bone grafting is the process by which bone is transferred from a source (donor) to site (recipient). Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of the surgeon. A search for ideal bone graft is on and may continue till time to time. [Vet World 2010; 3(4.000): 198-200

D. O. Joshi; P. H. Tank; H. K. Mahida; M. A. Dhami; H. S. Vedpathak; A. S. Karle

2010-01-01

209

Grafting onto polyformaldehyde fibers  

International Nuclear Information System (INIS)

[en] Acrylic acid (AA), acrylonitrile (AN), and acrylamide (AM) were grafted onto polyformaldehyde (PF) fibers employing ?-ray irradiation as well as benzoyl peroxide initiation. The nature of the graft copolymer obtained from a given monomer was dependent on the type of method used for the grafting reactions. This was reflected in the various characteristics of the grafted PF fibers such as moisture regain and dyeability to disperse, direct, basic, and acid dyes. The extent of grafting was dependent on time, concentration of the initiator, concentration of monomer, and irradiation dose. The grafting reaction with all the three monomers and both methods of grafting studied followed first-order kinetics. The rate constant values for grafting with AA, AN, and AM were 0.493, 0.576, and 0.420 hr-1, respectively for the irradiation method and 0.385, 0.385, and 0.346 hr-1, respectively, for the benzoyl peroxide initiation technique. The increase in the moisture regain was directly proportional to the amount of graft in the fiber. Acrylic acid grafted PF fibers were rendered hydrophilic to the highest extent (7.9 percent M.R. for 42 percent graft), while AM-grafted fibers were rendered so to the lowest extent (7.23 percent M.R. for 76.5 percent graft). The AA-grafted PF fibers gave a six- to sevenfold increase in disperse dye content when the irradiation method was followed and a four- to fivefold improvement when the chemical method was used during the grafting reaction. The AA- and AN-grafted PF fibers could be dyed in intense deep shades with cationic dyes. Similarly, AM-grafted substrates gave bright deep shades with acid dyes. Infrared studies, used to analyze the grafted PF fibers, indicated the presence of --COOH, --CN, and --NH2 groups introduced in the fiber structure as a result of grafting with AA, AN, and AM. 2 tables, 14 figures

1978-01-01

210

Retropubic repair of genitourinary fistula using a free supporting graft.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report the repair of genitourinary fistulae using a retropubic extraperitoneal transvesical approach using a support graft (free graft) from the anterior abdominal wall fat. PATIENTS AND METHODS: In all, 26 women with genitourinary fistulae (25 with vesicovaginal and one uterovesical) were operated using the free graft method. RESULTS: All patients had no leakage after surgery; while 15 developed urgency three had recurrent urinary tract infection and one developed a small bladder capacity. CONCLUSION: This operation has the advantages of a short operative duration, an easy technique and fewer postoperative complications with a high success rate.

el-Lateef Moharram AA; el-Raouf MA

2004-03-01

211

The role of frozen storage in preserving adipose tissue obtained by suction-assisted lipectomy for repeated fat injection procedures.  

UK PubMed Central (United Kingdom)

BACKGROUND: The injection of autologous free fat obtained by suction-assisted lipectomy for the correction of soft tissue defects is a common procedure in plastic surgery. However, unpredictable partial absorption of the injected fat often necessitates repeated procedures. OBJECTIVE: To examine the role of frozen storage as a means of preserving the fat obtained by suction-assisted lipectomy for repeated procedures. METHODS: Human adipose tissue obtained by suction-assisted lipectomy was stored in a domestic refrigerator at -18 degrees C for 2 weeks. After thawing, the fat was injected into nude mice. In the control group, the fat was injected immediately after the harvesting procedure. Grafts were dissected out and compared 15 weeks postinjection. RESULTS: Injected fat survived in both study and control groups. No significant differences were found between fat graft weight and volume, or in any of the histologic parameters examined. CONCLUSION: Fat obtained by suction-assisted lipectomy may be preserved for future use by freezing.

Shoshani O; Ullmann Y; Shupak A; Ramon Y; Gilhar A; Kehat I; Peled IJ

2001-07-01

212

Autologous fat transfer in aesthetic facial recontouring.  

Science.gov (United States)

Autologous fat graft transplantation has become increasingly popular in recent years. The recognition that soft tissue volume loss contributes to the aging of the face has driven the use of this procedure. Tumescent lipoaspirate provides ready accessibility of tissue for this transplantation, despite some perceived deficiencies in the predictability of volume maintenance with this method. We report our experience with immediately processed sedimented fat transfer for facial grooves and volume correction. A retrospective review of a consecutive series of 75 autologous fat transfers from October 2008 to July 2011 in 8 female patients between ages 46 and 73 years was conducted at Georgia Health Sciences University. The grafting was performed to improve facial aesthetic contours. Twenty-two were performed for correction of grooves and creases: 12 for nasolabial fold, 4 glabella, and 6 nasojugal. Fifty-three transfers were performed for volume augmentation: 17 malar, 14 submalar, 11 lip, 8 temple, 2 chin, and 1 jowl. A tumescent technique with manual syringe harvest was used. The abdomen was the most frequently used donor site. The tumescent was decanted from the lipoaspirate. Oil and nonviable fat were excluded. Care was taken to reduce the time from harvest to transplantation, with no syringe transfers, minimizing potential oxidation and injury of the tissue. The mean volume of fat transferred was 24 mL (range, 4-54 mL). Mean follow-up was 25 months (range, 6-36 months). A second session of fat transfer was required in a small percentage. Complications included minor asymmetry in 1 patient (resolved with graft manipulation) and prolonged swelling in another. No postoperative cellulitis or fat necrosis was reported. Clinical evaluations and patients reported a satisfactory result 88% of the time. Patients universally reported (100%) a desire to have the procedure performed again. Autologous fat transfer for facial soft tissue contouring is simple, safe, inexpensive, and effective. Its ready availability, natural integration into host tissues, and potentially permanent correction make it particularly useful for this application. All patients were satisfied with the soft, natural appearance. PMID:23542845

Gamboa, Gloria Mabel; Ross, William A

2013-05-01

213

Autologous fat transfer in aesthetic facial recontouring.  

UK PubMed Central (United Kingdom)

Autologous fat graft transplantation has become increasingly popular in recent years. The recognition that soft tissue volume loss contributes to the aging of the face has driven the use of this procedure. Tumescent lipoaspirate provides ready accessibility of tissue for this transplantation, despite some perceived deficiencies in the predictability of volume maintenance with this method. We report our experience with immediately processed sedimented fat transfer for facial grooves and volume correction. A retrospective review of a consecutive series of 75 autologous fat transfers from October 2008 to July 2011 in 8 female patients between ages 46 and 73 years was conducted at Georgia Health Sciences University. The grafting was performed to improve facial aesthetic contours. Twenty-two were performed for correction of grooves and creases: 12 for nasolabial fold, 4 glabella, and 6 nasojugal. Fifty-three transfers were performed for volume augmentation: 17 malar, 14 submalar, 11 lip, 8 temple, 2 chin, and 1 jowl. A tumescent technique with manual syringe harvest was used. The abdomen was the most frequently used donor site. The tumescent was decanted from the lipoaspirate. Oil and nonviable fat were excluded. Care was taken to reduce the time from harvest to transplantation, with no syringe transfers, minimizing potential oxidation and injury of the tissue. The mean volume of fat transferred was 24 mL (range, 4-54 mL). Mean follow-up was 25 months (range, 6-36 months). A second session of fat transfer was required in a small percentage. Complications included minor asymmetry in 1 patient (resolved with graft manipulation) and prolonged swelling in another. No postoperative cellulitis or fat necrosis was reported. Clinical evaluations and patients reported a satisfactory result 88% of the time. Patients universally reported (100%) a desire to have the procedure performed again. Autologous fat transfer for facial soft tissue contouring is simple, safe, inexpensive, and effective. Its ready availability, natural integration into host tissues, and potentially permanent correction make it particularly useful for this application. All patients were satisfied with the soft, natural appearance.

Gamboa GM; Ross WA

2013-05-01

214

LOW FAT BAKERY PRODUCT  

UK PubMed Central (United Kingdom)

The invention provides a comestible product, such as bread, cake, pastry, biscuit or cookie, comprising a water-in-oil emulsion, the water-in-oil emulsion comprising bakery fat continuous phase and an aqueous phase dispersed substantially throughout the bakery fat continuous phase. The bakery fat is typically selected from butter, margarine, animal fat and vegetable shortening.

NORTON IAN TIMOTHY; NORTON JENNIFER ELIZABETH

215

Fat and Diabetes  

Medline Plus

Full Text Available ... as full-fat cheese, cream, ice cream, whole milk, 2% milk and sour cream. High-fat meats like regular ... include: High-fat dairy products (whole or 2% milk, cream, ice cream, full-fat cheese) Egg yolks ...

216

Grafting and curing  

International Nuclear Information System (INIS)

Progress in radiation grafting and curing is briefly reviewed. The two processes are shown to be mechanistically related. The parameters influencing yields are examined particularly for grafting. For ionising radiation grafting systems (EB and gamma ray) these include solvents, substrate and monomer structure, dose and dose-rate, temperature and more recently role of additives. In addition, for UV grafting, the significance of photoinitiators is discussed. Current applications of radiation grafting and curing are outlined. The recent development of photoinitiator free grafting and curing is examined as well as the potential for the new excimer laser sources. The future application of both grafting and curing is considered, especially the significance of the occurrence of concurrent grafting during cure and its relevance in environmental considerations

1998-01-01

217

Skin graft - series (image)  

Science.gov (United States)

... entire body, and acts as a protective barrier. Skin grafts may be recommended for: extensive wounds burns specific surgeries that may require skin grafts for healing to occur. The most common sites ...

218

Bone grafts in dentistry.  

UK PubMed Central (United Kingdom)

Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

Kumar P; Vinitha B; Fathima G

2013-06-01

219

Fat free or low fat cookie production  

UK PubMed Central (United Kingdom)

The present invention provides a method for reducing rubberiness in the production of shelf-stable fat free or low-fat cookies caused by increased gluten functionality resulting from the elimination of shortening or fat in wheat-based cookies. At least about 50% by weight of the wheat flour is replaced with a flour mix comprising at least about 30% by weight white rye flour, at least about 30% by weight corn flour, and at least about 10% by weight rice flour. The particle size distribution of the flour mix is preferably about 55% by weight to about 65% by weight passes through a 60 mesh screen and none remains on a 30 mesh screen. The flour mix of the present invention may be used to produce shelf stable no fat, low fat, or reduced fat soft cookies, crisp cookies and other baked goods.

SEYAM ABDELMONEM A

220

Grafting on polyester fibers  

International Nuclear Information System (INIS)

[en] Acrylic acid (AA) and acrylonitrile (AN) were used to carry out grafting on polyester (PE) fibers using the techniques of initiation by ?-radiation as well as benzoyl peroxide. Extent of grafting depended upon the time, concentration of the initiator, and the monomer as well as on the irradiation dose. AA grafted fibers were rendered more hydrophilic than AN grafted fibers for equivalent amount of grafts. Considerable improvement in dyeability of the PE fibers was possible through grafting. About 50 percent to 100 percent improvement with disperse dyes was observed in case of PE fibers containing 22.4 percent and 9.0 percent graft of AA and AN, respectively. Intense fast dyeing with direct and basic (cationic) dyes was also possible, and the dye content was proportional to the extent of graft introduced in the fiber. The CN groups were reduced to NH2 groups in the AN graft on the fiber. With the increased amount of AA graft, the maxima in the zeta potential curve shifted toward higher acidic pH as greater amounts of alkali were utilized by the --COOH groups in the graft. In this respect, CN groups were less sensitive due to their lesser polarity as compared to the carboxylic groups. Surface charge density (S.C.D.) studies showed that the effective surface area of the fiber decreased with the increase in the amount of graft. Surface conductivity (S.C.) studies revealed that with increase in the number of polar groups (--COOH) on the surface of the fiber, the S.C. increased with the increase in the amount of AA graft. In case of AN grafts, the reduction in effective surface area of the fiber played a more important role than the contribution by the CN groups to surface conductivity. (U.S.)

1975-01-01

 
 
 
 
221

Autologous fat transfer to the cranio-maxillofacial region: updates and controversies.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafts have gained popularity among Cranio-Maxillofacial surgeons within the past years. Most publications report favourable outcomes but lack quantifiable evidence of graft survival. OBJECTIVES: To assess autologous fat transfer for facial asymmetry, and review the literature focusing on current indications, techniques, complications, fat survival and patient satisfaction. PATIENTS AND METHODS: Nine patients presented facial asymmetry due to onchological resection, congenital anomaly, or craniofacial traumatism. A total of 11 autologous fat transfers were performed. Four procedures followed the Coleman technique; in the other seven procedures, fat centrifugation was obviated. RESULTS: No significant complications derived. Progressive volumetric decrease was evidenced for up to 6 months after surgery. A second procedure was performed in two patients. No clinical differences in cosmetic outcomes or graft survival were observed between centrifuged and non-centrifuged grafts. Patients reported high satisfaction. CONCLUSIONS: Facial recontouring with autologous fat transfer restores volumetric defects with high patient satisfaction. The scientific literature offers inconsistent results. The authors did not find clinical differences between centrifuged and non-centrifuged grafts. Volume gain may result from induced fibrosis, inflammation and native adipocyte growth or differentiation. The heightened interest in these procedures should instigate further investigation to refine surgical procedures and improve predictability.

Guijarro-Martínez R; Miragall Alba L; Marqués Mateo M; Puche Torres M; Pascual Gil JV

2011-07-01

222

Fat embolism syndrome.  

UK PubMed Central (United Kingdom)

Fat embolism syndrome is an often overlooked cause of breathlessness in trauma wards. Presenting in a wide range of clinical signs of varying severity, fat embolism is usually diagnosed by a physician who keeps a high degree of suspicion. The clinical background, chronology of symptoms and corroborative laboratory findings are instrumental in a diagnosis of fat embolism syndrome. There are a few diagnostic criteria which are helpful in making a diagnosis of fat embolism syndrome. Management is mainly prevention of fat embolism syndrome, and organ supportive care. Except in fulminant fat embolism syndrome, the prognosis is usually good.

George J; George R; Dixit R; Gupta RC; Gupta N

2013-01-01

223

Trans Fat Now Listed With Saturated Fat and Cholesterol  

Science.gov (United States)

... Trans Fat Now Listed With Saturated Fat and Cholesterol. ... What Can I Do About Saturated Fat, Trans Fat, and Cholesterol? ... More results from www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition

224

Thoracic stent-graft  

Directory of Open Access Journals (Sweden)

Full Text Available The stent-graft is a device constructed from a stent and vascular graft and is inserted by means of an interventional procedure under imaging guidance. In 1986, Balko et al.1 reported the first stentgraft experiment, in which a Z stent covered with polyurethane was inserted into an animal aorta. In the early 1990s, Parodi et al.2 reported clinical introduction of the stent-graft for abdominal aortic aneurysm. In comparison to the abdominal aortic stent-graft, the thoracic stent-graft has several disadvantages, including difficulties associated with the aortic arch curvature and the relatively large caliber of the stent-graft, and the risk of central nervous system or spinal complication. However, the thoracic stentgraft is advantageous because of minimal procedural invasiveness in comparison to surgical graft replacement. In 1994, Dake et al.3 reported transluminal placement of an endovascular stent-graft for thoracic aortic aneurysm, and Kato et al.4 reported use of a stent-graft for aortic dissection and suggested that the stent-graft could be considered an alternative to surgical treatment.

Hyodoh H.

2007-01-01

225

Fat and Diabetes  

Medline Plus

Full Text Available ... much total fat you eat depends on many factors but more important than total fat is the ... cholesterol levels. High blood cholesterol is a risk factor for heart disease. People with diabetes are at ...

226

Fat and Diabetes  

Medline Plus

Full Text Available ... and " unhealthy fats ." To lower you risk of heart disease, try to eat less of the unhealthy ... At the same time, you can protect your heart by eating the healthy fats—monounsaturated, polyunsaturated and ...

227

Fat and Diabetes  

Medline Plus

Full Text Available ... and turkey) skin One of the important diabetes nutrition guidelines is to eat less than 7% of ... than saturated fat and for a heart-healthy diet, you want to eat as little trans fat ...

228

Fat and Diabetes  

Medline Plus

Full Text Available ... well. As you are cutting back on the sources of saturated and trans fats, you'll want ... oil is listed first in the ingredient list. Sources of trans fat include: Processed foods like snacks ( ...

229

Toxicity of abdominal fat  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal fat or truncal obesity consists of both subcutaneous and visceral fat. It has been found that visceral fat is more metabolically active than subcutaneous fat. The low-level inflammation linked with abdominal fat is associated with insulin resistance and with increases in the release of inflammatory adipokines and cytokines. As a result of these changes, abdominal fat can cause a variety of health conditions. In this review, we focus on the adverse effects of abdominal fat on the body and how it can lead to the development of cardiovascular disease, hypertension, type 2 diabetes mellitus, hyperlipidemia, stroke and cancer. Additionally, we discuss how abdominal fat can be reduced as a result from correction of hormonal deficiencies.

Shawn Mathew; Constantine E. Kosmas; Robert R. Siegel; Timothy J. Vittorio

2013-01-01

230

Fat and Diabetes  

Medline Plus

Full Text Available ... trans fat as possible, you must read the ingredient list on food labels. Look for words like hydrogenated ... a liquid oil is listed first in the ingredient list. Sources of trans fat include: Processed foods like ...

231

Fat and Diabetes  

Science.gov (United States)

... trans fat as possible, you must read the ingredient list on food labels. Look for words like hydrogenated ... a liquid oil is listed first in the ingredient list. Sources of trans fat include: Processed foods like ...

232

Fat and Diabetes  

Medline Plus

Full Text Available ... dairy products such as full-fat cheese, cream, ice cream, whole milk, 2% milk and sour cream. High- ... fat dairy products (whole or 2% milk, cream, ice cream, full-fat cheese) Egg yolks Liver and other ...

233

Lamination fat product  

UK PubMed Central (United Kingdom)

A lamination fat product is provided that has a continuous fat phase and optionally a dispersed aqueous phase, wherein the fat of the fat phase comprises: less than 10% trans unsaturated fatty acid residues 25-70% liquid oil (A) at least 10% C16+ fat (B) having a SAFA content of at least 60% and comprising at least 30% H3 triglycerides wherein H indicates C16, C18, C20 and C22 acids optionally a H2M fat (C), preferably in an amount such that the fat of the fatphase comprises at least 0.5% H2M triglycerides wherein M indicates C8, C10, C12, and C14 acids, and optionally up to 25% other fat (D) having a slip melting point of at least 38°C, while the total of fats (C) and (D) in more than 0wt% and wherein the fat has solid fat contents of N20=20-50 N35< =25 (N15-N25)/N20< =0.40 The fat product can be used for lamination at a wider temperature range.

Van der Schee Gerrit Leendert c/o Unilever Res.

234

Vegetable grafting tool  

UK PubMed Central (United Kingdom)

This utility model provides a vegetable grafting tool, and belongs to gardening vegetable grafting tool. It sets inserted cone (2) on one end of the handle (1) and handle (3) whose top is fixed with tongue shape curved surface knife (4), the other end sets knife rest (6) fixing the double-edge blade (8) and U shape bayonet lock (9), etc. this utility model combines several independent tools rationally, and it can complete the whole work with tools in hand in the whole grafting operation process, thus makes the operation steps reduced, speeds up the grafting, improves the quality of cutting and grafting and saves the labor of operation. The use of which is convenient with lower cost, it's proper to be promoted and applied in the vegetable grafting and seeding production.

XU ZHIHAO SHOU

235

Correction of liposuction sequelae by autologous fat transplantation.  

UK PubMed Central (United Kingdom)

BACKGROUND: In many countries, liposuction is the most frequently performed aesthetic procedure. Although liposuction has been considered a safe surgical procedure, reports indicate that it can have significant sequelae. Irregularities ranging from "oversuctioning" to bumpy skin and asymmetries result from inadequate experience of the surgeon. METHODS: A total of 57 consecutive female patients were operated on from June 2005 to June 2007. The age distribution of the patients ranged from 22 to 53 years, with a mean of 34.2 years. All the patients that were included in the study had undergone from one to three liposuction procedures. Overall satisfaction with the body appearance after autologous fat transplantation for correction of postliposuction irregularities was rated on a scale of 1-5, where 1 is poor, 2 is fair, 3 is good, 4 is very good, and 5 is excellent. RESULTS: The total amount of clean adipose tissue transplanted varied from 14 to 120 ml. There were no cases of liponecrosis, which developed in the grafted area, and no liponecrotic lumps were palpated on postoperative evaluation on any operated cases. There were no cases of cellulitis at the donor or grafted area, no deep vein thrombosis, and no pulmonary embolism. There were nine cases that needed one additional session of fat grafting of 5-35 ml. Seven of those cases needed further fat grafting on the abdominal area and the remaining two needed further grafting of the infragluteal depressions. At 12 months, 68% reported that their appearance after autologous fat grafting was "very good" to "excellent" and 23% responded that their appearance was "good." Only 9% of patients thought their appearance was less than good. CONCLUSION: With the overall acceptance of aesthetic surgery increasing and the number of patients undergoing liposuction increasing, it is likely that plastic surgeons will see more patients requesting secondary contour surgery in the future. The key to successful autologous fat grafting is familiarity with the technique, recognizing its limitations, and understanding the goals of the patient. This study has shown that the patient satisfaction rate observed after autologous fat transplantation produces aesthetically acceptable results in correcting post liposuction deformities.

Pereira LH; Nicaretta B; Sterodimas A

2011-12-01

236

Pedicled pelvic bone graft  

International Nuclear Information System (INIS)

[en] The pedicled pelvic bone graft is a new operative technique for the treatment femoral head necrosis. 29 femoral head necrosis were examined by i.a. DSA before a pedicled pelvic bone graft was implanted. 11 pedicled pelvic bone grafts were investigated postoperatively. The pre- and postoperative findings are presented. I.a. DSA is a valuable method for the evaluation of the vascularisation of the femoral head before and after surgery. (orig.)

1990-01-01

237

Free graft foreskin anoplasty.  

UK PubMed Central (United Kingdom)

AIM: Reconstruction of a stenotic anal canal and repair of a stenotic perineal colostomy using a free graft foreskin. METHOD: The use of free graft foreskin anoplasty was described by Freeman for the treatment of mucosal prolapse in pediatric patients. The original surgical technique was modified and employed in two adult patients for the reconstruction of the anal region. RESULTS: The graft, in both cases, took well with a satisfactory functional and morphological recovery of the anal canal. CONCLUSION: Free graft foreskin anoplasty, has proved to be an effective solution to stenosis in the anal canal following major local surgery.

Fucini C; Caminati F; Basiricò F; Bartolini N; Mirasolo VM

2012-08-01

238

Synthetic blood vessel grafts  

UK PubMed Central (United Kingdom)

A synthetic blood vessel graft (e.g., for use with a prosthetic heart valve) includes a mounting cuff adjacent at least one end for facilitating attachment of the graft to another structure (e.g., a sewing cuff of a heart valve). The mounting cuff may be sized and shaped to provide good conformance to the target structure to which it may be attached (e.g., the heart valve sewing cuff). The graft is preferably preclotted. Especially for use with a tissue valve (which must be supplied in a packaging solution that would react with a preclotting agent), the graft is preferably supplied separately from the valve.

WOO YI-REN

239

FAT EMBOLISM AND FAT EMBOLISM SYNDROME;  

Directory of Open Access Journals (Sweden)

Full Text Available Fat Embolism and the associated Fat Embolism Syndrome is a serious and potentially life threatening condition. It tends tooccur usually after fractures or intramedullary instrumentation of long bones. Non-traumatic conditions such as Diabetes Mellitus severe Burns,SLE, sickle cell disease and Pancreatitis can also lead to Fat Embolic syndrome. Young adults are commonly affected. Presentation consistsof an asymptomatic interval followed by pulmonary and neurological manifestations combined with petechial haemorrhages. The diagnosislargely depends on high index of suspicion and exclusion of other conditions. Treatment of this condition remains supportive. Mortalityassociated with this condition is significant, ranging from 10-20%1.

ANSAR LATIF

2008-01-01

240

Fat and Dachsous cadherins.  

UK PubMed Central (United Kingdom)

Fat and Dachsous (Ds) are very large cell adhesion molecules. They bind each other and have important, highly conserved roles in planar cell polarity (PCP) and growth control. PCP is defined as the directionally coordinated development of cellular structures or behavior. Cellular and tissue growth needs to be modulated in terms of rate and final size, and the Hippo pathway regulates growth in a variety of developmental contexts. Fat and Ds are important upstream regulators of these pathways. There are two Fat proteins in Drosophila, Fat and Fat2, and four in vertebrates, Fat1-4. There is one Ds protein in Drosophila and two in vertebrates, Dachsous1-2. In this chapter, we discuss the roles of Fat and Ds family members, focusing on Drosophila and mouse development.

Sharma P; McNeill H

2013-01-01

 
 
 
 
241

Effect of centrifugation and washing on adipose graft viability: a new method to improve graft efficiency.  

UK PubMed Central (United Kingdom)

BACKGROUND: Adipose tissue grafting is a promising method in the field of surgical filling. We studied the effect of centrifugation on fat grafts, and we propose an optimised protocol for the improvement of adipose tissue viability. METHODS: Adipose tissue was subjected to different centrifugations, and the volumes of interstitial liquid and oil released were measured to choose the optimal condition. Tissue from this condition was then compared to tissue obtained from two traditional techniques: strong centrifugation (commonly 3 min at 3000 rpm/900 g), and decantation, by injecting into immunodeficient mice. The cytokine interleukin-6 (IL-6) and chemokine monocyte chemotactic protein-1 (MCP-1) were assayed 24 h post-injection, and after 1 month of grafting the state of the lipografts was evaluated through macroscopic and histological analysis, with oil gap area measurement. RESULTS: Strong centrifugation (900 g, 1800 g) is deleterious for adipose tissue because it leads to until threefold more adipocyte death compared to low centrifugation (100 g, 400 g). In addition, mice injected with strong centrifuged and non-centrifuged adipose tissue have higher rates of blood IL-6 and MCP-1, compared to those grafted with soft centrifuged fat. Moreover, extensive lipid vacuoles were detectable on histological sections of the non-centrifuged lipografts, whereas lipografts from soft centrifugation contain a higher amount of connective tissue containing collagen fibres. CONCLUSION: It is necessary to wash and centrifuge adipose tissue before reinjection in order to remove infiltration liquid and associated toxic molecules, which in the long term are deleterious for the graft. However, strong centrifugation is not recommended since it leads very quickly to greater adipocyte death. Thus, soft centrifugation (400 g/1 min), preceded by washings, seems to be the most appropriate protocol for the reinjection of adipose tissue.

Hoareau L; Bencharif K; Girard AC; Gence L; Delarue P; Hulard O; Festy F; Roche R

2013-05-01

242

Autologous fat transplantation for the treatment of progressive hemifacial atrophy (Parry-Romberg syndrome: case report and review of medical literatute).  

Science.gov (United States)

Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a rare disorder characterized by slow and progressive hemifacial atrophy. The treatment offered for the syndrome generally aims at improving aesthetics. Fat grafts, silicone injections or acrylic prosthesis are alternatives suggested for correction of facial atrophy. Currently, the recommended technique for correction of facial atrophy is cosmetic dermatologic surgery with autologous fat grafting. This study reports a case of Parry-Romberg syndrome and demonstrates that dermatologic surgery can relieve serious damage to the patient's anatomy, starting from the discussion of the therapeutic aspects of the syndrome with emphasis on autologous fat grafting. PMID:22068780

Alencar, Júlio César Garcia de; Andrade, Sarah Hanna de Carvalho; Pessoa, Salustiano Gomes de Pinho; Dias, Iana Silva

243

Autologous fat transplantation for the treatment of progressive hemifacial atrophy (Parry-Romberg syndrome: case report and review of medical literatute).  

UK PubMed Central (United Kingdom)

Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a rare disorder characterized by slow and progressive hemifacial atrophy. The treatment offered for the syndrome generally aims at improving aesthetics. Fat grafts, silicone injections or acrylic prosthesis are alternatives suggested for correction of facial atrophy. Currently, the recommended technique for correction of facial atrophy is cosmetic dermatologic surgery with autologous fat grafting. This study reports a case of Parry-Romberg syndrome and demonstrates that dermatologic surgery can relieve serious damage to the patient's anatomy, starting from the discussion of the therapeutic aspects of the syndrome with emphasis on autologous fat grafting.

Alencar JC; Andrade SH; Pessoa SG; Dias IS

2011-07-01

244

Calcar bone graft  

Energy Technology Data Exchange (ETDEWEB)

A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

1986-01-01

245

Pear grafting method  

UK PubMed Central (United Kingdom)

The invention discloses a grafting method of a pear tree. The main stem or main branch of pear tree with deterioration of strains and low quality is cut at the place 1 m away from the ground as a stock A branch of the good-quality pear tree with the length less than 15 cm and 2 to 3 sprouts is used, wherein, the bottom of the branch is cut into wedge shape. A slit with the same width as that of a graft is cut on the pear tree as stock. The graft is stably and tightly inserted into the slit of stock. And then a ventilated plastic film is tightly tightened at the grafting place. 2 to 4 grafts are grafted in the four directions according to the size of the stock. The survival rate of grafts grafted by aforementioned method is over 90% the operation is simple and needs no special trainer and the method can quickly improve variety and has high economic benefit.

QIAOYING LI

246

Advances in radiation grafting  

Energy Technology Data Exchange (ETDEWEB)

Graft copolymerization is an attractive means for modifying base polymers because grafting frequently results in the superposition of properties relating to the backbone and pendent chains. Among the various methods for initiating the grafting reaction, ionizing radiation is the cleanest and most versatile method of grafting available. Ion-exchange membranes play an important role in modern technology, especially in separation and purification of materials. The search for improved membrane composition has considered almost every available polymeric material because of its great practical importance. Grafting of polymers with a mixture of monomers is important since different types of chains containing different functional groups are included. A great deal is focused on the waste treatment of heavy and toxic metals from wastewater because of the severe problems of environmental pollution. Functionalized polymers suitable for metal adsorption with their reactive functional groups such as carboxylic and pyridine groups suitable for waste treatment were prepared by radiation grafting method. More reactive chelating groups were further introduced to the grafted copolymer through its functional groups by chemical treatments with suitable reagents. The advances of radiation grafting and possible uses are briefly discussed.

Hegazy, El-Sayed A. E-mail: hegazy_ea@hotmail.com; AbdEl-Rehim, H.A.; Kamal, H.; Kandeel, K.A

2001-12-01

247

Advances in radiation grafting  

International Nuclear Information System (INIS)

Graft copolymerization is an attractive means for modifying base polymers because grafting frequently results in the superposition of properties relating to the backbone and pendent chains. Among the various methods for initiating the grafting reaction, ionizing radiation is the cleanest and most versatile method of grafting available. Ion-exchange membranes play an important role in modern technology, especially in separation and purification of materials. The search for improved membrane composition has considered almost every available polymeric material because of its great practical importance. Grafting of polymers with a mixture of monomers is important since different types of chains containing different functional groups are included. A great deal is focused on the waste treatment of heavy and toxic metals from wastewater because of the severe problems of environmental pollution. Functionalized polymers suitable for metal adsorption with their reactive functional groups such as carboxylic and pyridine groups suitable for waste treatment were prepared by radiation grafting method. More reactive chelating groups were further introduced to the grafted copolymer through its functional groups by chemical treatments with suitable reagents. The advances of radiation grafting and possible uses are briefly discussed.

2001-01-01

248

Sliding grafted polymer layers  

CERN Multimedia

We study theoretically the structure of sliding grafted polymer layers or SGP layers. These interfacial structures are built by attaching each polymer to the substrate with a ring-like molecule. Such a topological grafting mode allows the chains to freely slide along the attachment point. Escape from the sliding link is prevented by bulky capping groups. We show that grafts in the mushroom regime adopt mainly symmetric configurations (with comparable branch sizes) while grafts in dense layers are highly dissymmetric so that only one branch per graft participates in the layer. Sliding layers on small colloids or star-like sliding micelles exhibit an intermediate behavior where the number of longer branches participating in the corona is independent of the total number of branches. This regime also exists for sliding surface-micelles comprising less chains but it is narrower.

Baulin, V A; Marques, C M; Baulin, Vladimir A.; Johner, Albert; Marques, Carlos M.

2005-01-01

249

FRYING-FAT COMPOSITION  

UK PubMed Central (United Kingdom)

The present invention is concerned with a frying fat composition essentially consisting of a mixture of one or more non-digestible polyol fatty acid polyesters and one or more glyceride fats, wherein the composition comprises of from 25 % to 75 % by weight of said polyesters, the blend of said polyesters having a slip melting point of between 35 and 50°C, and the blend of said glyceride fats having a slip melting point of below 40°C. The frying fat composition according to the invention offers the advantage that, upon frying, deficiencies such as surface fattiness, poor drip-off and mildewing polyol fatty acid polyester are not observed. Another aspect of the present invention is the use of a frying fat composition according to the invention for frying food products. Yet another aspect of the invention are fried food products that have been fried in a frying fat according to the invention.

VAN OOSTEN Cornelis Willem

250

Frying fat composition  

UK PubMed Central (United Kingdom)

The present invention is concerned with a frying fat composition essentially consisting of a mixture of one or more non-digestible polyol fatty acid polyesters and one or more glyceride fats, wherein the composition comprises of from 25% to 75% by weight of said polyesters, the blend of said polyesters having a slip melting point of between 35 and 50°C, and the blend of said glyceride fats having a slip melting point of below 40°C. The frying fat compositions according to the invention offers the advantage that, upon frying, deficiencies such as surface fattiness, poor drip-off and mildewing polyol fatty acid polyester are not observed. Another aspect of the present invention is the ue of a frying fat composition according to the invention for frying food products. Yet another aspect of the invention are fried food products that have been fried in a frying fat according to the invention.

van Oosten Cornelis Willem

251

A novel foldable stent graft  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This dissertation concerns the structural design of medical stent grafts. A new type of an innovative stent graft has been developed. Unlike the conventional stent grafts which consist of a wire mesh and a covering membrane, the proposed stent graft can be made from a single folded sheet of material...

Kuribayashi, Kaori; You, Z.

252

Grafting in Arabidopsis.  

Science.gov (United States)

Grafting provides a simple way to generate chimeric plants with regions of different genotypes and thus to assess the cell autonomy of gene action. The technique of grafting has been widely used in other species, but in Arabidopsis, its small size makes the process rather more demanding. However, there are now several well-established grafting procedures available, which we described here, and their use has already contributed greatly to understanding of such processes as shoot branching control, flowering, disease resistance, and systemic silencing. PMID:24057364

Bainbridge, Katherine; Bennett, Tom; Crisp, Peter; Leyser, Ottoline; Turnbull, Colin

2014-01-01

253

Grafting in Arabidopsis.  

UK PubMed Central (United Kingdom)

Grafting provides a simple way to generate chimeric plants with regions of different genotypes and thus to assess the cell autonomy of gene action. The technique of grafting has been widely used in other species, but in Arabidopsis, its small size makes the process rather more demanding. However, there are now several well-established grafting procedures available, which we described here, and their use has already contributed greatly to understanding of such processes as shoot branching control, flowering, disease resistance, and systemic silencing.

Bainbridge K; Bennett T; Crisp P; Leyser O; Turnbull C

2014-01-01

254

The use of autologous fat for facial rejuvenation.  

UK PubMed Central (United Kingdom)

Adding volume to the aging face is a notion that has come into vogue as of late but is, however, not a new idea. With the advent of miro-liposuction techniques, there is renewed interest in the use of aspirated fat. Commercial fillers have a valuable place in the cosmetic surgeon's armamentarium and offer immediate volume correction with a more modest financial commitment. Nevertheless, the standardization of fat grafting techniques marks an exciting shift in facial aesthetics with the ability to correct all aspects of the aging face with safe, natural, and lasting results.

Marcus BC

2010-12-01

255

Fractional CO(2) laser treatment vs autologous fat transfer in the treatment of acne scars: a comparative study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Acne scars present a highly challenging and frustrating clinical problem. Fractional CO2 laser treatment has led to marked improvement in scars, and fat transfer, or fat grafting, has also recently proven very useful in regenerative medicine. OBJECTIVE: To compare fractional CO2 laser treatment and fat grafting in the treatment of acne scars. MATERIALS AND METHODS: Twenty patients were included in this study, 10 received 3 sessions of fractional CO2 laser therapy, and 10 received fat grafting. All patients were then followed up for 3 months, and results were assessed with digital photographs taken by a committee of 3 physicians, by a single-blinded physician, and by reports of patient satisfaction. RESULTS: In the fractional CO2 laser treatment group, under 20% of patients were graded as having excellent scar improvement, 0 as having marked scar improvement, under 10% as having mild scar improvement, and almost 70% as having moderate scar improvement. In the fat-grafting group, the scar and overall improvement were graded as 30% excellent, 30% marked, 20% moderate, and 20% mild. CONCLUSION: Fat grafting proved to be more effective in the treatment of acne scars than ablative fractional CO2 laser treatment. There were many points in its favor, the most significant being the clinical improvement in scars and texture. This supports the stem cell theory of adipose tissue in regenerative medicine.

Azzam OA; Atta AT; Sobhi RM; Mostafa PI

2013-01-01

256

Cardiac and pulmonary fat embolectomy for suspected fat embolus  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Nelson, C. S. (1974).Thorax, 29, 134-137. Cardiac and pulmonary fat embolectomy for suspected fat embolus. There is no specific treatment of fat embolism, whether the embolism is predominantly cerebral, pulmonary, renal or mesenteric.

Nelson, Cyril S.

257

Assessment of Effects of Physical or Chemical Factors on the Fat Particle Viability by Glucose Transport Test.  

Science.gov (United States)

BACKGROUND: It is important to protect fat viability during grafting. This study aimed to clarify whether physical or chemical factors damage fat viability. METHODS: Fat was harvested under high and low tumescence pressure, using syringes and a liposuction machine; this fat was injected through different gauge needles and cultured with lidocaine or epinephrine. Samples were subjected to glucose transport test and observed histologically. RESULT: The viability and microstructure of fat harvested under high and low tumescence pressure, and by syringe and liposuction machine, were similar (P > 0.05). The viability and intactness of fat cells injected through needles decreased with decreasing needle diameter (P liposuction machine. Fat cell viability during injection increases with increasing needle diameter. Fat should be purified to remove drugs. PMID:23528631

Lei, Hua; Zheng, Danning; Ma, Gui-E; Li, Qingfeng

2013-03-21

258

Breast augmentation using preexpansion and autologous fat transplantation: a clinical radiographic study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Despite the increased popularity of fat grafting of the breasts, there remain unanswered questions. There is currently no standard for technique or data regarding long-term volume maintenance with this procedure. Because of the sensitive nature of breast tissue, there is a need for radiographic evaluation, focusing on volume maintenance and on tissue viability. This study was designed to quantify the long-term volume maintenance of mature adipocyte fat grafting for breast augmentation using recipient-site preexpansion. METHODS: This is a prospective examination of 25 patients in 46 breasts treated with fat grafting for breast augmentation from 2007 to 2009. Indications included micromastia, postexplantation deformity, tuberous breast deformity, and Poland syndrome. Preexpansion using the BRAVA device was used in all patients. Fat was processed using low-g-force centrifugation. Patients had preoperative and 6-month postoperative three-dimensional volumetric imaging and/or magnetic resonance imaging to quantify breast volume. RESULTS: All women had a significant increase in breast volume (range, 60 to 200 percent) at 6 months, as determined by magnetic resonance imaging (n = 12), and all had breasts that were soft and natural in appearance and feel. Magnetic resonance imaging examinations postoperatively revealed no new oil cysts or breast masses. CONCLUSIONS: Preexpansion of the breast allows for megavolume (>300 cc) grafting with reproducible, long-lasting results that can be achieved in less than 2 hours. These data can serve as a benchmark with which to evaluate the safety and efficacy of other core technology strategies in fat grafting. The authors believe preexpansion is useful for successful megavolume fat grafting to the breast.

Del Vecchio DA; Bucky LP

2011-06-01

259

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... lower your blood cholesterol can help slow the process that clogs arteries. Exercise and losing weight, under ... the clogged arteries. Coronary Artery Bypass Graft This process of taking blood vessels from one part of ...

260

Fats and Satiety  

UK PubMed Central (United Kingdom)

Dietary fat has frequently been blamed for the increase in prevalence of obesity (Bray et al., 2004). Epidemiological studies have demonstrated a positive relationship between high-fat diets and excess energy intake due to their high energy density and palatability (Prentice and Poppitt, 1996). However, this association is confounded by differences in physical activity, smoking, and food availability and variety (Willett, 1998; Bray et al., 2004). Furthermore, epidemiological studies investigating the association between high fat intake and obesity have been inconsistent (Seidell, 1998; Willett, 1998). Preload studies have shown that fat exerts the weakest effect on satiety compared to carbohydrate and protein, suggesting that fat may lead to “passive overconsumption” (Blundell et al., 1993). But when preloads were matched for energy density and palatability, differences in satiety were not obvious (Geliebter, 1979; Stubbs and Harbron, 1996; McCrory et al., 2000), pointing to energy density as the key driver of satiety under experimental conditions. Furthermore, lipids suppress later food intake when present in the small intestine of both humans and animals (Welch et al., 1988; Greenberg et al., 1990; Drewe et al., 1992; Woltman and Reidelberger, 1995; Castiglione et al., 1998; Van Wymwlbeke et al., 1998). Relatively few studies have investigated the responses of specific fats and fatty acids on food intake. Furthermore, studies have used different fats and fatty acids making it almost impossible to draw conclusions. However, it is clear that not all fats are equal in their effect on appetite and associated biological processes.

Samra RA

 
 
 
 
261

FAT METABOLISM IN NEPHRITIS  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Determinations of the plasma lipoids and of the respiratory quotient and total metabolism (Tissot method) have been performed with nephritics and normal subjects before and after they ingested fat in the proportion of 1 gm. per kilo body weight. After fat ingestion a greater increase of fatty acids...

Hiller, A.; Linder, G. C.; Lundsgaard, C.; Van Slyke, D. D.

262

FAT SOLUBLE FOOD BAR  

UK PubMed Central (United Kingdom)

The present invention provides a food bar having a core section that is laden with calcium and fat soluble vitamins. Preferably the core section comprises chocolate and may include crisp rice cereal, marshmallow or other material. The fat soluble vitamins provided in the present invention are vitamins A, D, E and K. The present invention may include vitamin C.

IGBANUGO ANSELM

263

Fat Emulsions for Injection  

Science.gov (United States)

Your doctor has ordered fat emulsion to be used as a source of calories and fatty acids to maintain or increase your weight. The medication ... Before you administer fat emulsion, look at the solution closely. It should be free of floating material. Gently squeeze the bag or observe ...

264

Fat embolism syndrome.  

UK PubMed Central (United Kingdom)

Fat embolism syndrome (FES) is an ill-defined clinical entity that arises from the systemic manifestations of fat emboli within the microcirculation. Embolized fat within capillary beds cause direct tissue damage as well as induce a systemic inflammatory response resulting in pulmonary, cutaneous, neurological, and retinal symptoms. This is most commonly seen following orthopedic trauma; however, patients with many clinical conditions including bone marrow transplant, pancreatitis, and following liposuction. No definitive diagnostic criteria or tests have been developed, making the diagnosis of FES difficult. While treatment for FES is largely supportive, early operative fixation of long bone fractures decreases the likelihood of a patient developing FES.

Kwiatt ME; Seamon MJ

2013-01-01

265

Human milk fat substitutes  

UK PubMed Central (United Kingdom)

The invention concerns fat compositions that resemble human milk fat. These compositions comprise triglycerides in which at least 40 wt.% of the total amount of saturated fatty acid residues present in the triglycerides are bonded at the 2-position, while the fatty acid residues in 1- and 3-positions are randomly or non-randomly distributed between these positions and include oleic, linoleic and linolenic acid and other unsaturated residues. The invention is further concerned with substitute milk fat, infant food and a process for the preparation of the compositions.

Quinlan Paul Thomas Unilever Research; Chandler Ian Christopher Unilever Research

266

Fat embolism syndrome.  

Science.gov (United States)

Fat embolism syndrome (FES) is an ill-defined clinical entity that arises from the systemic manifestations of fat emboli within the microcirculation. Embolized fat within capillary beds cause direct tissue damage as well as induce a systemic inflammatory response resulting in pulmonary, cutaneous, neurological, and retinal symptoms. This is most commonly seen following orthopedic trauma; however, patients with many clinical conditions including bone marrow transplant, pancreatitis, and following liposuction. No definitive diagnostic criteria or tests have been developed, making the diagnosis of FES difficult. While treatment for FES is largely supportive, early operative fixation of long bone fractures decreases the likelihood of a patient developing FES. PMID:23724388

Kwiatt, Michael E; Seamon, Mark J

2013-01-01

267

[Intraabdominal fat necrosis].  

Science.gov (United States)

The processes that course with intraabdominal fat necrosis often manifest with acute or subacute abdominal pain; these clinical findings can be caused by various conditions, including epiploic appendagitis, omental infarction, encapsulated fat necrosis, mesenteric panniculitis, appendicitis, diverticulitis, and certain neoplasms. In this context, although the anatomic location of the pain and accompanying symptomatology can help orient the diagnosis, there is a risk of unnecessary surgery. Imaging tests like ultrasonography and especially computed tomography are essential for diagnosing intraabdominal fat necrosis. Radiologists must be familiar with the characteristic findings for all the conditions that can cause acute or subacute abdominal pain to ensure appropriate management and prevent unnecessary surgery. PMID:22019421

Aguilar-García, J J; Alcaide-León, P; Vargas-Serrano, B

2011-10-22

268

[Intraabdominal fat necrosis].  

UK PubMed Central (United Kingdom)

The processes that course with intraabdominal fat necrosis often manifest with acute or subacute abdominal pain; these clinical findings can be caused by various conditions, including epiploic appendagitis, omental infarction, encapsulated fat necrosis, mesenteric panniculitis, appendicitis, diverticulitis, and certain neoplasms. In this context, although the anatomic location of the pain and accompanying symptomatology can help orient the diagnosis, there is a risk of unnecessary surgery. Imaging tests like ultrasonography and especially computed tomography are essential for diagnosing intraabdominal fat necrosis. Radiologists must be familiar with the characteristic findings for all the conditions that can cause acute or subacute abdominal pain to ensure appropriate management and prevent unnecessary surgery.

Aguilar-García JJ; Alcaide-León P; Vargas-Serrano B

2012-09-01

269

Determination of the milk fat content of fat mixtures  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Methods for the determination of the milk fat content of fat mixtures are usually based on a butyric acid determination. This fatty acid is specific for milk fat. A conversion factor is used to calculate the milk fat content from the butyric acid content of the mixture. When applying this procedure,...

Glaeser, H.

270

Fat embolism in infancy after intravenous fat infusions.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Four cases of fat embolism are described in infants receiving prolonged intravenous infusion of fat (Intralipid 20%). This therapeutic complication has been termed 'fat overloading syndrome' but bears a clinical similarity to post-traumatic fat embolism. These 4 cases are the first to be recorded in...

Barson, A J; Chistwick, M L; Doig, C M

271

Fat Grams: How to Track Your Dietary Fat  

Science.gov (United States)

... may be reprinted for personal, noncommercial use only. Fat grams: How to track your dietary fat By Mayo Clinic staff Original Article: http://www. ... share your e-mail address Sign up Question Fat grams: How to track your dietary fat To ...

272

Axillobifemoral bypass grafting  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION Axillo-femoral bypass (AxF) means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF). This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%), and donor's left axillary artery was used in 9 cases (29.7%). Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft occlusion was reported in four patients. As the cause of occlusion, the progression of occlusive disease of receptive artery was identified in three patients, while anastomotic neointimae hyperplasia of recipient artery was identified in one patient. Three patients died during the follow up period. As the cause of death, CVI was reported in two patients and malignancy of the urinary tract was fpund in one patient. The other complications were - artery angulation on the level of proximal anastomosis in one patient (Figure 1), false aneurysm in one patient, perigraft seroma in one patient and graft infection in three patients. Life table method has shown that cumulative rate of late graft patency is 80.39% after five years (Graph 1). DISCUSSION Our results were analyzed and compared with the results of the study on 283 patients who had undergone aortobifemoral bypass (AFF) operation due to the aortoiliac occlusive disease. This study was completed in 1995 (18). The results showed that there was no statistically significant differences between AxFF and AFF group (p>0.05), considering early mortality rate and late graft patency (Graph 2). The review of mortality and late patency rate after AxFF bypass grafting in a world well known studies has shown the similar results (Table 1). CONCLUSION The authors suggest that axilobifemoral bypass is indicated when there are contraindications or difficulties to perform anatomic reconstruction due to the abdomen condition (infection, adhesion, comorbidity) as well as in high risk patients with low life expectancy.

Davidovi? Lazar B.; Mitri? Milan S.; Kosti? Dušan M.; Maksimovi? Živan V.; Cvetkovi? Slobodan D.; ?inara Ilijas S.; Dimi? Andreja D.; Ili? Nikola S.

2004-01-01

273

Alternative fat sources to animal fat for pigs  

DEFF Research Database (Denmark)

The use of fats and oils in diets for pigs is of great importance due to their high energy value. As a consequence of the BSE-crisis in the European Union, the amount of animal fat available for animal feeds has been reduced, and alternative fat sources are of increasing importance. In this paper, we review our main findings on the effects of diets with different fat sources on apparent fat digestibility in pigs. A method for quantitative measurement of fat extraction from feed and faeces has been developed, and this method has been used in a digestibility trial, in which diets added 5% of either animal fat, palm oil mix, palm oil, vegetable oil mix, coconut oil, or rapeseed oil were tested in weaned and growing pigs. It was concluded that several vegetable fat sources (palm oil mix, palm oil, coconut oil, rapeseed oil) could be used as alternatives to animal fat in pig feed, whereas fat blends should be avoided.

Lauridsen, Charlotte; Christensen, Thomas Bruun

2007-01-01

274

Fat and Diabetes  

Medline Plus

Full Text Available ... Seniors Skin Complications Safe at School Women's Health Men's Health Blood Glucose Level Medication Ask the Expert ... saturated fat. Many adults, especially women or sedentary men, may need less. To find out a specific ...

275

Fat and Diabetes  

Medline Plus

Full Text Available ... Meals What Can I Eat Cookbooks Fitness Fitness Management Getting Motivated Ideas for Exercise Weight Loss Diabetes ... carbohydrate gets all of the attention in diabetes management. How much total fat you eat depends on ...

276

Fat and Diabetes  

Medline Plus

Full Text Available ... oil and olives Peanut butter and peanut oil Sesame seeds ADA recommends eating more monounsaturated fats than ... shortening when cooking. Sprinkling a few nuts or sesame seeds on a salad is an easy way ...

277

Fat and Diabetes  

Medline Plus

Full Text Available ... Food Choices Dairy What Can I Drink? Lean Meats Non-starchy Vegetables Sugar and Desserts Artificial Sweeteners ... milk, 2% milk and sour cream. High-fat meats like regular ground beef, bologna, hot dogs, sausage, ...

278

Fat and Diabetes  

Medline Plus

Full Text Available ... fats are: Corn oil Cottonseed oil Safflower oil Soybean oil Sunflower oil Walnuts Pumpkin or sunflower seeds ... 3 fatty acids. Sources include: Tofu and other soybean products Walnuts Flaxseed and flaxseed oil Canola oil ...

279

FAT METABOLISM IN NEPHRITIS.  

UK PubMed Central (United Kingdom)

Determinations of the plasma lipoids and of the respiratory quotient and total metabolism (Tissot method) have been performed with nephritics and normal subjects before and after they ingested fat in the proportion of 1 gm. per kilo body weight. After fat ingestion a greater increase of fatty acids and lecithin was noted in the plasma of nephritics with initially high blood lipoids than in the plasma of normal subjects or of nephritics without constant lipemia. In cholesterol no differences were found. The nephritic patients with constant lipemia were able to burn fat as efficiently as normal individuals. The accumulation of fat in their blood may be due to a disturbance in the mechanism for transferring lipoids from the blood to the tissue depots.

Hiller A; Linder GC; Lundsgaard C; Van Slyke DD

1924-05-01

280

FAT CONTAINING PRODUCTS  

UK PubMed Central (United Kingdom)

Fat based product in particular food products are taught. The products contain oil in water and water in oil emulsions and in addition contain isoflavones and preferably petroselinic acid and polyunsaturated fatty acids.

RAWLINGS Anthony V.; CHEN Mandy K.; PATRICK Matthew

 
 
 
 
281

Fat and Diabetes  

Medline Plus

Full Text Available ... Patient Access to Research Diabetes Journals Clinical Trials Food & Fitness Food What Can I Eat Alcohol Be Sodium-Savvy ... Eating Out Fat and Diabetes Fruits Making Healthy Food Choices Dairy What Can I Drink? Lean Meats ...

282

Fat and Diabetes  

Medline Plus

Full Text Available ... fat include: Processed foods like snacks (crackers and chips) and baked goods (muffins, cookies and cakes) with ... near you. Food & Fitness Nice Nibbles Ditch the chips! We've got recipes for eight healthy snacks ...

283

Fat and Diabetes  

Medline Plus

Full Text Available ... oil Nuts like almonds, cashews, pecans, and peanuts Olive oil and olives Peanut butter and peanut oil Sesame seeds ADA ... To include more monounsaturated fats, try to substitute olive or canola oil instead of butter, margarine or ...

284

Imaging cardiac fat.  

UK PubMed Central (United Kingdom)

Ectopic fat deposition has been associated with lipotoxicity and derangement in local and systemic metabolism, insulin resistance, cardiac dysfunction, atherosclerosis, local, and systemic inflammation. The mechanisms and potentially detrimental effects of such an accumulation should be fully investigated in order to establish preventive strategies. The aim of this review is to provide an overview of current knowledge regarding imaging techniques to measure cardiac fat deposition and its potential clinical relevance, if any.

Davidovich D; Gastaldelli A; Sicari R

2013-07-01

285

Imaging cardiac fat.  

Science.gov (United States)

Ectopic fat deposition has been associated with lipotoxicity and derangement in local and systemic metabolism, insulin resistance, cardiac dysfunction, atherosclerosis, local, and systemic inflammation. The mechanisms and potentially detrimental effects of such an accumulation should be fully investigated in order to establish preventive strategies. The aim of this review is to provide an overview of current knowledge regarding imaging techniques to measure cardiac fat deposition and its potential clinical relevance, if any. PMID:23539476

Davidovich, Daniel; Gastaldelli, Amalia; Sicari, Rosa

2013-03-28

286

Endothelial cell transplantation onto polymeric arteriovenous grafts evaluated using a canine model.  

Science.gov (United States)

Prosthetic arteriovenous grafts (AVG) placed for hemodialysis access fail in humans due to the thrombogenicity of the flow surface and development of cellular intimal hyperplasia, particularly at the venous anastomosis. The poor patency rates of prosthetic AVG result in significant morbidity and mortality in dialysis patients. Consequently, investigators have been evaluating methods to improve the patency of prosthetic grafts by examining endothelial cell transplantation as a means of creating an antithrombogenic lining on artificial polymers. A canine model was developed to study the effects of cell transplantation of autologous, fat-derived microvessel endothelial cells (MVEC) onto the luminal surface of expanded polytetrafluoroethylene (ePTFE) grafts. Microvessel endothelial cells were isolated from falciform ligament fat, with each dog receiving its own endothelial cells. Isolated cells were subsequently placed into the lumen of the graft (4 mm by 20 cm ePTFE). The graft lumen was pressurized to 5 pounds per square inch (psi) resulting in the partial denucleation of the graft, due to the flow of buffer into the interstices of the graft, and the forced deposition of cells onto the luminal surface. Animals were maintained on aspirin and persantine during the implant phase. During the implant phase, grafts were evaluated by both duplex ultrasound and magnetic resonance angiography (MRA). At explant, gross observation of the sodded grafts revealed a glistening white flow surface with no evidence of thrombosis. Morphologic and scanning electron microscopic evaluations revealed the presence of a cellular lining on the luminal flow surface that exhibited characteristics of antithrombogenic endothelial cells. Midgraft samples were evaluated by immunocytochemistry and indicated that cells on the luminal surface react positively with antibodies to von Willebrand factor. Results from this study demonstrate that the canine model provides an excellent method of studying the effects of MVEC sodding on the thrombogenicity and hyperplastic response of prosthetic arteriovenous graft. PMID:7893637

Williams, S K; Jarrell, B E; Kleinert, L B

287

Alveolar bone grafting  

Directory of Open Access Journals (Sweden)

Full Text Available In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.

Lilja Jan

2009-01-01

288

Rib grafts in septorhinoplasty.  

UK PubMed Central (United Kingdom)

Autogenous cartilage has generally been considered the gold standard grafting material in reconstructive septorhinoplasty for volume filling and structural support. In the restructuring of the nasal skeleton, autogenous cartilage can be harvested from the nasal septum, the auricle or the rib, but costal cartilage is considered the best graft material in patients requiring major reconstruction. Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery and when large amounts of tissue are required. This autologous material has a low rate of complications such as resorption, infection and extrusion compared to homografts and alloplastic implants. In the present study, the authors analyze and discuss the use of autogenous rib cartilage in 54 patients who underwent primary and revision septorhinoplasty. Its use is also suggested in cases in which there is a need to have a fair amount of cartilaginous tissue to be grafted for nasal framework reconstruction and respiratory function improvement.

Moretti A; Sciuto S

2013-06-01

289

Rib grafts in septorhinoplasty.  

Science.gov (United States)

Autogenous cartilage has generally been considered the gold standard grafting material in reconstructive septorhinoplasty for volume filling and structural support. In the restructuring of the nasal skeleton, autogenous cartilage can be harvested from the nasal septum, the auricle or the rib, but costal cartilage is considered the best graft material in patients requiring major reconstruction. Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery and when large amounts of tissue are required. This autologous material has a low rate of complications such as resorption, infection and extrusion compared to homografts and alloplastic implants. In the present study, the authors analyze and discuss the use of autogenous rib cartilage in 54 patients who underwent primary and revision septorhinoplasty. Its use is also suggested in cases in which there is a need to have a fair amount of cartilaginous tissue to be grafted for nasal framework reconstruction and respiratory function improvement. PMID:23853415

Moretti, A; Sciuto, S

2013-06-01

290

Crosslinked grafted PVC obtained by direct radiation grafting  

International Nuclear Information System (INIS)

[en] Direct radiation-induced grafting of 4-vinylpyridine onto both pure and plasticized poly(vinyl chloride) has been studied. The effect of grafting conditions such as solvent, monomer concentration, irradiation dose, and inhibitor concentration on the grafting yield was investigated. The grafting process was enhanced by using distilled water as diluent and higher degrees of grafting were obtained as compared with other solvents used (benzene, methanol, and a mixture of methanol and water). The homopolymerization of 4-vinylpyridine was reduced to a minimum using ammonium ferrous sulfate and the suitable optimum concentration of the inhibitor was found to be 0.25 wt%. It was observed that the degrees of grafting onto plasticized PVC were higher than those onto pure one, at constant grafting conditions. The diffusibility of the monomer solution through the trunk polymers enhanced at higher monomer concentrations. The higher the monomer concentration the higher the degrees of grafting obtained. The dependence of the grafting rate on monomer concentration was found to be 0.15 and 0.4 order for the grafting onto pure and plasticized PVC films, respectively. The gel content in both grafted extracted pure and plasticized PVC films increased with the degree of grafting to reach certain limiting values. (author)

1985-01-01

291

Crosslinked grafted PVC obtained by direct radiation grafting  

Energy Technology Data Exchange (ETDEWEB)

Direct radiation-induced grafting of 4-vinylpyridine onto both pure and plasticized poly(vinyl chloride) has been studied. The effect of grafting conditions such as solvent, monomer concentration, irradiation dose, and inhibitor concentration on the grafting yield was investigated. The grafting process was enhanced by using distilled water as diluent and higher degrees of grafting were obtained as compared with other solvents used (benzene, methanol, and a mixture of methanol and water). The homopolymerization of 4-vinylpyridine was reduced to a minimum using ammonium ferrous sulfate and the suitable optimum concentration of the inhibitor was found to be 0.25 wt%. It was observed that the degrees of grafting onto plasticized PVC were higher than those onto pure one, at constant grafting conditions. The diffusibility of the monomer solution through the trunk polymers enhanced at higher monomer concentrations. The higher the monomer concentration the higher the degrees of grafting obtained. The dependence of the grafting rate on monomer concentration was found to be 0.15 and 0.4 order for the grafting onto pure and plasticized PVC films, respectively. The gel content in both grafted extracted pure and plasticized PVC films increased with the degree of grafting to reach certain limiting values.

Hegazy, E.-S.A.; Dessouki, A.H.; El-Dessouky, M.M.; El-Sawy, N.M.

1985-01-01

292

Carnitine and fat oxidation.  

UK PubMed Central (United Kingdom)

Fat and carbohydrate are the primary fuel sources for mitochondrial ATP production in human skeletal muscle during endurance exercise. However, fat exhibits a relatively low maximal rate of oxidation in vivo, which begins to decline at around 65% of maximal oxygen consumption (VO?max) when muscle glycogen becomes the major fuel. It is thought that if the rate of fat oxidation during endurance exercise could be augmented, then muscle glycogen depletion could be delayed and endurance improved. The purpose of the present review is to outline the role of carnitine in skeletal muscle fat oxidation and how this is influenced by the role of carnitine in muscle carbohydrate oxidation. Specifically, it will propose a novel hypothesis outlining how muscle free carnitine availability is limiting to the rate of fat oxidation. The review will also highlight recent research demonstrating that increasing the muscle carnitine pool in humans can have a significant impact upon both fat and carbohydrate metabolism during endurance exercise which is dependent upon the intensity of exercise performed.

Stephens FB; Galloway SD

2013-01-01

293

Comparison of fat tissues used in intracordal autologous fat injection.  

UK PubMed Central (United Kingdom)

CONCLUSIONS: The buccal fat pad appears to be more useful as a source of fat tissues in intracordal fat injection than the abdominal fat tissues used previously. However, further studies are required to confirm this point. OBJECTIVES: Fat tissues used in vocal fold augmentation surgery have primarily been harvested from the subcutaneous region of the lower abdomen. It is often difficult to obtain sufficient fat tissue for injection due to the physical features of the individual patient. We have thus adopted a method using fat tissue from the buccal fat pad, which is already used in other plastic surgeries. METHODS: This was a retrospective study. We evaluated and compared the histological characteristics of fat cells and the condition of vocal folds after injection of fat tissue extracted from the subcutaneous region of the lower abdomen and from the buccal fat pad. RESULTS: Buccal fat cells were relatively smaller than abdominal fat cells and were not influenced by body mass index (BMI), showing less individual differences according to the physical features of the patient. Numbers of vascular endothelial cells tended to be higher in buccal fat tissues. The percentage of cases showing continuous effects for more than 6 months was slightly higher in cases using buccal fat.

Tamura E; Okada S; Shibuya M; Iida M

2010-03-01

294

[Pathophysiology of intestinal grafts].  

UK PubMed Central (United Kingdom)

Following the introduction of tacrolimus, intestinal transplantation is now a valid option for patients with chronic intestinalfailure. However, its outcome is undermined by the abundant lymphoid component of the graft and the septic nature of the procedure. The heavy immunosuppression necessitated by this transplant, and its non specific nature, creates a risk of infectious and tumoral complications. Several approaches are being tested to improve the immune tolerance of intestinal grafts, both in animals models and in the clinic. The most promising seek to induce specific tolerance while sparing antimicrobial and antitumoral immunity.

Sarnacki S; Goulet O; Brousse N; Cerf-Bensussan N

2012-02-01

295

Automatic grafting machine for vegetable  

UK PubMed Central (United Kingdom)

There is disclosed an automatic vegetable grafting machine for vegetable grafting. Its stake clamp, which is on the operating platform, is aligned with the center of the graft clamp. The graft clamp's two explorators positions can be adjusted according to the sprout size one leaf of stake sprout is relied to the exploratory, and scion stalk is relied to the exploratory and is a little bent. The stake and the graft incision fold automatically because of the two knives relative positions on knife-carrier slide and the graft scion bending. Wherein, compression lever and support swing link are separately joined with frame by means of gemels the stake clamp swing link and the graft clamp swing link are contacted with cam and are joined with the support by means of gemels, and control opening or shutting of the stake and the graft incision and up-or-down movement of the lifter and the knife carrier. After cutting, the stake and the graft incision ascend along the stake and the scion until the graft stalk is unbend and automatically fold with the stake sprout incision, then the stake clamp and the graft clamp open and graft is completed. The machine has simple structure and high work efficiency of 600 trees per hour.

GAO YINGWU LI

296

Skin grafting of the penis.  

Science.gov (United States)

Penile skin loss may occur after trauma, infection, or as a result of surgical resection. This article reviews indications for reconstruction of the penile skin, skin anatomy, and skin graft physiology. Choice of reconstructive options, skin grafting techniques, and complications of skin grafting are also discussed. PMID:23905942

Thakar, Hema J; Dugi, Daniel D

2013-06-28

297

Cystocele repair with interpositional grafting.  

Science.gov (United States)

This article discusses a systematic approach to the repair of cystoceles using interposition grafting. Surgeons' opinions vary regarding which graft is most appropriate as there are several varieties for mesh interposition. High-grade cystocele repair using the porcine dermis interposition graft is successful and associated with few complications. Cystocele repair is typically low grade and does not require additional surgery. PMID:21353079

Leu, Patrick B; Scarpero, Harriette M; Dmochowski, Roger R

2011-02-01

298

Cystocele repair with interpositional grafting.  

UK PubMed Central (United Kingdom)

This article discusses a systematic approach to the repair of cystoceles using interposition grafting. Surgeons' opinions vary regarding which graft is most appropriate as there are several varieties for mesh interposition. High-grade cystocele repair using the porcine dermis interposition graft is successful and associated with few complications. Cystocele repair is typically low grade and does not require additional surgery.

Leu PB; Scarpero HM; Dmochowski RR

2011-02-01

299

Skin grafting of the penis.  

UK PubMed Central (United Kingdom)

Penile skin loss may occur after trauma, infection, or as a result of surgical resection. This article reviews indications for reconstruction of the penile skin, skin anatomy, and skin graft physiology. Choice of reconstructive options, skin grafting techniques, and complications of skin grafting are also discussed.

Thakar HJ; Dugi DD 3rd

2013-08-01

300

The safety of autologous fat transfer in breast cancer: lessons from stem cell biology.  

Science.gov (United States)

Autologous fat grafting is versatile tool in plastic surgery and is increasing used for reconstruction following breast conserving surgery for breast cancer. Part of the reconstructive qualities of the transferred fat may be due to the presence of adipose derived mesenchymal stem cells (ADMSC) playing an angiogenic and an adipogenic role. In this context it must be considered if autologously engrafted fat tissue could contribute to carcinogenesis following breast conserving surgery. In this article we review the current stem cell biology evidence on engraftment, transdifferentiation and potential carcinogenic contribution in the breast and other solid organ stem cell niches in an attempt to highlight possible areas of concern. PMID:21820375

Pearl, Robert A; Leedham, Simon J; Pacifico, Marc D

2011-08-04

 
 
 
 
301

The safety of autologous fat transfer in breast cancer: lessons from stem cell biology.  

UK PubMed Central (United Kingdom)

Autologous fat grafting is versatile tool in plastic surgery and is increasing used for reconstruction following breast conserving surgery for breast cancer. Part of the reconstructive qualities of the transferred fat may be due to the presence of adipose derived mesenchymal stem cells (ADMSC) playing an angiogenic and an adipogenic role. In this context it must be considered if autologously engrafted fat tissue could contribute to carcinogenesis following breast conserving surgery. In this article we review the current stem cell biology evidence on engraftment, transdifferentiation and potential carcinogenic contribution in the breast and other solid organ stem cell niches in an attempt to highlight possible areas of concern.

Pearl RA; Leedham SJ; Pacifico MD

2012-03-01

302

Poly-L-lactic acid facial rejuvenation: an alternative to autologous fat?  

UK PubMed Central (United Kingdom)

Facial volume loss is an important component of facial aging and tends to present at an earlier age than other aspects of aging. Several surgical and nonsurgical products and techniques are available to replace volume loss associated with aging. One surgical technique uses a patient's fat cells to replace or augment volume deficiency. Poly-L-lactic acid (PLLA) injection is a nonsurgical option. This article compares these 2 volume augmentation procedures and discusses characteristics of facial aging, the consultation process involved in assessing individual volume loss, procedure details of autologous fat grafting and PLLA injection, the decision of PLLA versus autologous fat, and patient outcomes.

Buckingham ED

2013-05-01

303

Poly-L-lactic acid facial rejuvenation: an alternative to autologous fat?  

Science.gov (United States)

Facial volume loss is an important component of facial aging and tends to present at an earlier age than other aspects of aging. Several surgical and nonsurgical products and techniques are available to replace volume loss associated with aging. One surgical technique uses a patient's fat cells to replace or augment volume deficiency. Poly-L-lactic acid (PLLA) injection is a nonsurgical option. This article compares these 2 volume augmentation procedures and discusses characteristics of facial aging, the consultation process involved in assessing individual volume loss, procedure details of autologous fat grafting and PLLA injection, the decision of PLLA versus autologous fat, and patient outcomes. PMID:23731588

Buckingham, Edward D

2013-05-01

304

Vascular graft infections.  

UK PubMed Central (United Kingdom)

Vascular procedures are rarely complicated by infection, but if prosthetic vascular graft infection (PVGI) occurs, morbidity and mortality are high. Several patient-related, surgery-related and postoperative risk factors are reported, but they are not well validated. PVGI is due to bacterial colonisation of the wound and the underlying prosthetic graft, generally as a result of direct contamination during the operative procedure, mainly from the patient's skin or adjacent bowel. There is no consensus on diagnostic criteria or on the best management of PVGI. On the basis of reported clinical studies and our own experience, we advocate a surgical approach combining repeated radical local debridement, with graft preservation whenever possible or partial excision of the infected graft, depending on its condition, plus simultaneous negative-pressure wound therapy (NPWT). In addition, antimicrobial therapy is recommended, but there is no consensus on which classes of agent are adequate for the treatment of PVGI and whether certain infections may be treated by means of NPWT alone. Since staphylococci and Gram-negative rods are likely to be isolated, empirical treatment might include a penicillinase-resistant beta-lactam or a glycopeptide, plus an aminoglycoside, the latter for Gram-negative coverage and synergistic treatment of Gram-positive cocci. Additionally, empirical treatment might include rifampicin since it penetrates well into biofilms.

Hasse B; Husmann L; Zinkernagel A; Weber R; Lachat M; Mayer D

2013-01-01

305

Vascular graft infections.  

Science.gov (United States)

Vascular procedures are rarely complicated by infection, but if prosthetic vascular graft infection (PVGI) occurs, morbidity and mortality are high. Several patient-related, surgery-related and postoperative risk factors are reported, but they are not well validated. PVGI is due to bacterial colonisation of the wound and the underlying prosthetic graft, generally as a result of direct contamination during the operative procedure, mainly from the patient's skin or adjacent bowel. There is no consensus on diagnostic criteria or on the best management of PVGI. On the basis of reported clinical studies and our own experience, we advocate a surgical approach combining repeated radical local debridement, with graft preservation whenever possible or partial excision of the infected graft, depending on its condition, plus simultaneous negative-pressure wound therapy (NPWT). In addition, antimicrobial therapy is recommended, but there is no consensus on which classes of agent are adequate for the treatment of PVGI and whether certain infections may be treated by means of NPWT alone. Since staphylococci and Gram-negative rods are likely to be isolated, empirical treatment might include a penicillinase-resistant beta-lactam or a glycopeptide, plus an aminoglycoside, the latter for Gram-negative coverage and synergistic treatment of Gram-positive cocci. Additionally, empirical treatment might include rifampicin since it penetrates well into biofilms. PMID:23348860

Hasse, Barbara; Husmann, Lars; Zinkernagel, Annelies; Weber, Rainer; Lachat, Mario; Mayer, Dieter

2013-01-24

306

Slicing, skinning, and grafting  

CERN Multimedia

We prove that a Bers slice is never algebraic, meaning that its Zariski closure in the character variety has strictly larger dimension. A corollary is that skinning maps are never constant. The proof uses grafting and the theory of complex projective structures.

Dumas, David

2007-01-01

307

The graft selection for haemodialysis.  

UK PubMed Central (United Kingdom)

BACKGROUND: In patients with chronic renal failure, a major concern is to provide safe and reliable long-term vascular access for haemodialysis. The radiocephalic arteriovenous (AV) fistula remains the first choice vascular access procedure, however the grafts are used in order to obtain vascular access in patients with failed native distal and proximal AV fistulas. The aim of this study was to compare the patency rate of different grafts such as standard wall polytetrafluoroethylene (sPTFE), bovine vein graft, Diastat graft, in these patients. PATIENTS AND METHODS: Four hundred and forty-six AV fistulas were surgically created in 361 patients. Eighty-four out of 361 patients undergoing different graft replacements were retrospectively reviewed. We evaluated the primary patency rates, days between the fistula placement and the last dialysis treatment before thrombosis had occurred, and the secondary patency rate, days between the fistula placement and the last dialysis treatment before the graft was considered completely lost. The graft survival was calculated according to the Kaplan-Meier method. RESULTS: There were 58 (69%) women and 26 (31%) men with a mean age of 54.5 years. The sPTFE (Gore-Tex) graft was used in 41 (41.8%), bovine vein graft (ProCol) in 38 (38.7%) and Diastat vascular grafts in 19 (19.5%) patients. Primary and secondary patency rates for sPTFE graft were 37% and 60%, 68% and 85% for bovine graft and 26% and 42% for Diastat vascular grafts, respectively. CONCLUSIONS: This study demonstrates that the bovine vein graft provides the longest patency rate compared to the other grafts even in patients with multiple failed accesses.

Senkaya I; Aytac II; Eercan AK; Aliosman A; Percin B

2003-11-01

308

Applicability and safety of autologous fat for reconstruction of the breast.  

UK PubMed Central (United Kingdom)

BACKGROUND: Autologous fat grafting to the breast for cosmetic and reconstructive purposes is still controversial with respect to its safety and efficacy. The objective of this study was to conduct a systematic review of the clinical applicability and safety of the technique. METHODS: An online search of the Cochrane Library, MEDLINE, Embase and SciELO was conducted from July 1986 to June 2011. Studies included in the review were original articles of autologous liposuctioned fat grafting to the female breast, with description of clinical complications and/or radiographic changes and/or local breast cancer recurrence. RESULTS: This review included 60 articles with 4601 patients. Thirty studies used fat grafting for augmentation and 41 for reconstructive procedures. The incidence of clinical complications, identified in 21 studies, was 3·9 per cent (117 of 3015); the majority were induration and/or palpable nodularity. Radiographic abnormalities occurred in 332 (13·0 per cent) of 2560 women (17 studies); more than half were consistent with cysts. Local recurrence of breast cancer (14 of 616, 2·3 per cent) was evaluated in three studies, of which only one was prospective. CONCLUSION: There is broad clinical applicability of autologous fat grafting for breast reconstruction. Complications were few and there was no evidence of interference with follow-up after treatment for breast cancer. Oncological safety remains unclear.

Claro F Jr; Figueiredo JC; Zampar AG; Pinto-Neto AM

2012-06-01

309

Stent-grafts improve secondary patency of failing hemodialysis grafts.  

UK PubMed Central (United Kingdom)

PURPOSE: Failing hemodialysis grafts continue to pose a challenge in the care of patients with end-stage renal disease (ESRD). We review our experience using percutaneous stent-grafts for the treatment of venous outflow stenosis and occlusion in order to assess their efficacy in nonautologous graft salvage. METHODS: This is a retrospective review of patients treated with percutaneous Viabahn® stent-grafts for failing hemodialysis arteriovenous grafts (AVGs), between 6/2006 and 12/2009. All stent-grafts were deployed across the venous anastomosis to address the outflow obstruction. Patency and re-intervention rates were estimated using Kaplan-Meier analysis. RESULTS: Twenty patients had stent-grafts placed. Successful stent-grafting was defined as <30% residual stenosis and the ability to dialyze through the graft post-treatment. Technical success for stent-grafting was 100%. Median follow-up was 23 months (range 3 to 37 months). Stent-graft patency at 6 months: 94.7%, 12 months: 94.7%, 18 months: 82.1%, 24 months: 82.1%, 36 months: 82.1%. Freedom from re-intervention was 69% at 24 months and 50% at 36 months. Two AVGs failed and had to be removed without further interventions, because of complete occlusion and infection. Two patients (10%) required re-intervention for arterial inflow stenosis. One patient (5%) required balloon angioplasty and stenting of stenosis distal to the stent-graft. One patient (5%) developed in-stent stenosis and was treated with placement of a new stent. Graft salvage rate was 80% at 36 months. CONCLUSIONS: Stent-grafts can be successfully used to improve freedom from re-intervention rates and overall patency rates of failing AVGs.

Davila Santini L; Etkin Y; Nadelson AJ; Safa T

2012-01-01

310

Brain fat embolism  

International Nuclear Information System (INIS)

Recently CT and MR imaging have demonstrated that cerebral edema is present in cases of fat embolism syndrome. To simulate this we have made a model of brain-fat embolism in rats under MR imaging. In 20 rats, we did intravenous injection of heparinized blood, 1.5 ml·kg-1 taken from femoral bone marrow cavity. Twenty four hours after the injection, we examined the MR images (1.5 tesla, spin-echo method) of brains and histologic findings of brains and lungs were obtained. In 5 of 20 rats, high signal intensity on T2-weighted images and low signal intensity on T1-weighted images were observed in the area of the unilateral cerebral cortex or hippocampus. These findings showed edema of the brains. They disappeared, however, one week later. Histologic examinations showed massive micro-fat emboli in capillaries of the deep cerebral cortex and substantia nigra, but no edematous findings of the brain were revealed in HE staining. In pulmonary arteries, we also found large fat emboli. We conclude that our model is a useful one for the study of brain fat embolism. (author)

1994-01-01

311

MODIFYING AGENT FOR PLASTIC FAT  

UK PubMed Central (United Kingdom)

Provided are a modifying agent for a plastic fat to be used in a plastic fat comprising palm oil, which inhibits changes in physical properties of the plastic fat such as hardness or crude crystal formation and gives an air-containing plastic fat and a plastic fat using the same. a plastic fat is prepared by using, as modifying agent, an appropriate amount of a fat composition which comprised triglycerides comprising, as constituting fatty acids, a saturated fatty acid (A) having a melting point of 60 DEG C or higher and a saturated fatty acid (B) having a melting point of 40 DEG C or lower, wherein the fat composition contains 40-85 wt%, relative to the total fat composition, of ABB type triglycerides, and the weight ratio (ABB/AAB) of said ABB type triglycerides o AAB type triglycerides is 2-15.

SAKAI MIDORI; MURAYAMA MASAYUKI

312

MODIFYING AGENT FOR PLASTIC FAT  

UK PubMed Central (United Kingdom)

Provided are a modifying agent for a plastic fat to be used in a plastic fat comprising palm oil, which inhibits changes in physical properties of the plastic fat such as hardness or crude crystal formation and gives an air-containing plastic fat and a plastic fat using the same. A plastic fat is prepared by using, as modifying agent, an appropriate amount of a fat composition which comprised triglycerides comprising, as constituting fatty acids, a saturated fatty acid (A) having a melting point of 60 DEG C. or higher and a saturated fatty acid (B) having a melting point of 40 DEG C. or lower, wherein the fat composition contains 40-85 wt %, relative to the total fat composition, of ABB type triglycerides, and the weight ratio (ABB/AAB) of said ABB type triglycerides o AAB type triglycerides is 2-15.

SAKAI MIDORI; MURAYAMA MASAYUKI

313

Obese visceral adipose tissue grafted in lean mice can alter glucose homeostasis and energy efficiency.  

Science.gov (United States)

Fat transplantation experiments have previously shown regulatory properties of lean adipose tissue on glucose homeostasis in the whole animal. In the current study, we addressed whether obese visceral white adipose tissue grafted in lean mice could alter glucose homeostasis. Obese visceral fat (VF) tissue was effective in increasing body weight gain and energy efficiency but not energy intake, when transplanted into the epididymal VF depot in lean recipient mice. These changes were accompanied by impaired glucose and insulin tolerance tests, showing altered glucose homeostasis. None of these effects were observed when transplants were grafted subcutaneously. These effects show that both physiologic state of donor VF (obese vs lean) and graft location (epididymal vs subcutaneous) in the recipient animal are critical to express deleterious effects of VF on glucose homeostasis in the whole organism. PMID:23034260

Barrera, C; Gatica, A; Morgan, C

314

Obese visceral adipose tissue grafted in lean mice can alter glucose homeostasis and energy efficiency.  

UK PubMed Central (United Kingdom)

Fat transplantation experiments have previously shown regulatory properties of lean adipose tissue on glucose homeostasis in the whole animal. In the current study, we addressed whether obese visceral white adipose tissue grafted in lean mice could alter glucose homeostasis. Obese visceral fat (VF) tissue was effective in increasing body weight gain and energy efficiency but not energy intake, when transplanted into the epididymal VF depot in lean recipient mice. These changes were accompanied by impaired glucose and insulin tolerance tests, showing altered glucose homeostasis. None of these effects were observed when transplants were grafted subcutaneously. These effects show that both physiologic state of donor VF (obese vs lean) and graft location (epididymal vs subcutaneous) in the recipient animal are critical to express deleterious effects of VF on glucose homeostasis in the whole organism.

Barrera C; Gatica A; Morgan C

2012-07-01

315

Autologous fat transplantation for the treatment of Parry-Romberg syndrome.  

UK PubMed Central (United Kingdom)

Progressive facial hemiatrophy or Parry-Romberg syndrome is characterised by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The restoration of contour and symmetry is the main challenge in patients affected by this syndrome. We describe the case of a patient with stabilised mild hemifacial atrophy, successfully treated by autologous fat transplantation. Although two- or three-stage fat grafting may be needed in order to accomplish the desired result, in this specific case it was achieved in a single procedure. An accurate soft tissue substitution with creation of multiple subcutaneous and intramuscular tunnels for lipografting ensured adequate blood supply of the transplanted fat. The aesthetic improvement and the patient satisfaction show that autologous fat transplantation could be a safe technique for the correction of the mild Parry-Romberg syndrome.

Sterodimas A; Huanquipaco JC; de Souza Filho S; Bornia FA; Pitanguy I

2009-11-01

316

Autologous fat transplantation for the treatment of Parry-Romberg syndrome.  

Science.gov (United States)

Progressive facial hemiatrophy or Parry-Romberg syndrome is characterised by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The restoration of contour and symmetry is the main challenge in patients affected by this syndrome. We describe the case of a patient with stabilised mild hemifacial atrophy, successfully treated by autologous fat transplantation. Although two- or three-stage fat grafting may be needed in order to accomplish the desired result, in this specific case it was achieved in a single procedure. An accurate soft tissue substitution with creation of multiple subcutaneous and intramuscular tunnels for lipografting ensured adequate blood supply of the transplanted fat. The aesthetic improvement and the patient satisfaction show that autologous fat transplantation could be a safe technique for the correction of the mild Parry-Romberg syndrome. PMID:18708310

Sterodimas, Aris; Huanquipaco, Julio Cesar; de Souza Filho, Sinezio; Bornia, Fabio Antonio; Pitanguy, Ivo

2008-08-15

317

Fat Embolism Syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available The characteristics of fat embolism syndrome (FES), and the complications occurring in fractures of long bones or pelvic bones are considered. Clinical picture classically develops after “lucid space“, then appear pulmonary and neurological manifestations combined with petechial hemorrhage. Basic theories of FES pathophysiology are analyzed. Early signs are likely to be caused by mechanic vascular occlusion by fat globules. Vascular occlusions in FES are frequently temporary or partial as fat globules block capillary blood flow incompletely due to their flowability and deformity. The diagnosis is made based on clinical presentations using A.R. Gurd’s criteria (1970). Laboratory and instrumental methods are used for clinical diagnosis confirmation or therapy monitoring. The treatment is aimed mainly at supporting respiratory function and hemodynamics stabilization. Prevention, early diagnosis and adequate symptomatic treatment are of primary importance.

?.?. Gabdullin; N.N. Mitrakova; R.G. Gatiatulin; ?.?. Rozhentsov; ?.V. Koptina; R.V. Sergeev

2012-01-01

318

Dynamical fat link fermions  

International Nuclear Information System (INIS)

[en] The use of APE smearing or other blocking techniques in fermion actions can provide many advantages. There are many variants of these fat link actions in lattice QCD currently, such as FLIC fermions. Frequently, fat link actions make use of the APE blocking technique in combination with a projection of the blocked links back into the special unitary group. This reunitarisation is often performed using an iterative maximisation of a gauge invariant measure. This technique is not differentiable with respect to the gauge field and thus prevents the use of standard Hybrid Monte Carlo simulation algorithms. The use of an alternative projection technique circumvents this difficulty and allows the simulation of dynamical fat link fermions with standard HMC and its variants

2004-01-01

319

Clinical Application of Human Adipose Tissue-Derived Mesenchymal Stem Cells in Progressive Hemifacial Atrophy (Parry-Romberg Disease) With Microfat Grafting Techniques Using Three-Dimensional Computed Tomography and Three-Dimensional Camera.  

UK PubMed Central (United Kingdom)

BACKGROUND: Parry-Romberg disease is a rare condition that results in progressive hemifacial atrophy, involving the skin, dermis, subcutaneous fat, muscle, and, finally, cartilage and bone. Patients have been treated with dermofat or fat grafts or by microvascular free flap transfer. We hypothesized that adipose-derived stem cells (ASCs) may improve the results of microfat grafting through enhancing angiogenesis. We evaluated the utility of ASC in microfat grafting of patients with Parry-Romberg disease by measuring the change in the hemifacial volumes after injection of ASCs with microfat grafts or microfat grafts alone. METHODS: In April 2008, this investigation was approved by the Korean Food and Drug Administration and the institutional review board of the Asan Medical Center (Seoul, Korea) that monitor investigator-initiated trials. Between May 2008 and January 2009, 10 volunteers with Parry-Romberg disease (5 men and 5 women; mean age, 28 y) were recruited; 5 received ASC and microfat grafts and 5 received microfat grafts only. The mean follow-up period was 15 months. Adipose-derived stem cells were obtained from abdominal fat by liposuction and were cultured for 2 weeks. On day 14, patients were injected with fat grafts alone or plus (in the test group) 1 × 10 ASCs. Patients were evaluated postoperatively using a 3-dimensional camera and 3-dimensional CT scans, and grafted fat volumes were objectively calculated. RESULTS: Successful outcomes were evident in all 5 patients receiving microfat grafts and ASCs, and the survival of grafted fat was better than in patients receiving microfat grafts alone. Before surgery, the mean difference between ipsilateral and contralateral hemiface volume in patients receiving microfat grafts and ASCs was 21.71 mL decreasing to 4.47 mL after surgery. Overall resorption in this ASC group was 20.59%. The mean preoperative difference in hemiface volume in those receiving microfat grafts alone was 8.32 mL decreasing to 3.89 mL after surgery. Overall resorption in this group was 46.81%. The preoperative and postoperative volume differences between the groups was statistically significant (P = 0.002; random-effects model [SAS 9.1]). CONCLUSIONS: Adipose-derived stem cells enhance the survival of fat grafted into the face. A microfat graft with simultaneous ASC injection may be used to treat Parry-Romberg disease without the need for microvascular free flap transfer.

Koh KS; Oh TS; Kim H; Chung IW; Lee KW; Lee HB; Park EJ; Chung JS; Shin IS; Ra JC; Choi JW

2012-08-01

320

Fat-reducing massager  

UK PubMed Central (United Kingdom)

The utility model relates to a fat-reducing massager which mainly makes use of the master gear of a governor motor to drive a driven gear to rotate, enabling at least one massage convex ball to make eccentrically rotating movement when the driven gear is started. Local muscles are rapidly squeezed during the operation of two adjacent massage convex balls. An ultra-red ray effect or anion effect generator is added to the utility model. The utility model obtains the desired effects of reducing fat and massaging.

CHEN RONGZONG

 
 
 
 
321

Fat chance for longevity.  

UK PubMed Central (United Kingdom)

The health benefits of specific fatty acids and physiological roles of fat metabolism are important subjects that are still poorly understood. In this issue of Genes & Development, O'Rourke and colleagues (pp. 429-440) uncovered a role for lipase-generated ?-6 fatty acids in promoting autophagy and, consequently, life span extension under both fed and fasting conditions. The impact of this finding is discussed with regard to the nutritional value of ?-6 fatty acids and regulatory functions of fat metabolism beyond its well-known role in energy storage.

Kniazeva M; Han M

2013-02-01

322

FAT CONTAINING COMPOSITION  

UK PubMed Central (United Kingdom)

A composition comprises a fat phase wherein the fat phase comprises: more than 10 wt.% DHA and/or EPA or derivatives thereof or more than 5 wt.% GLA or a derivative thereof or more than 10 wt.% of GLA. EPA and/or DHA in tot al or derivatives thereof and secoisolariciresinol (SECO) or a derivative t hereof, with the proviso that when the composition comprises GLA, the compos ition is substantially free of isoflavones. The composition and mixtures or blends comprising the composition may be used for the treatment of PMS and p rostate conditions.

KAPOOR RAKESH; FUSICK JEANETTE MARIE; HUGHES ADRIAN DAVID

323

EDIBLE FAT PRODUCT AND INTERESTERIFIED FAT FOR USE THEREIN  

UK PubMed Central (United Kingdom)

An edible fat product is provided that comprises a fatphase the fat (A) of which has a content of trans fatty acid residues of at most 10 % and which comprises interesterified fat (B) derived from a fatblend (C) comprising hydrogenated fish oil having a slip melting point of at least 45 °C and liquid oil, and optionally other fat (D). Further provided is an interesterified fat (B) suitable for use in the fat product, which has a content of trans fatty acid residues of at most 15 % and which is derived from a fatblend (C) comprising 20-80 % hydrogenated fish oil with a slip melting point of at least 45 °C, 80-10 % of liquid oil and optionally up to 40 % of fat rich in lauric acid residues. The fat product has improved nutritional properties while the costs are modest.

HUIZINGA Hindrik; LIVINGSTON Robert Middleton; ROZENDAAL Adrianus

324

Comparison of Fat7-bar and HYP fat links  

CERN Document Server

We study various methods of constructing fat links based upon the HYP (by Hasenfratz & Knechtli) and Fat7-bar (by W. Lee) algorithms. We present the minimum plaquette distribution for these fat links. This enables us to determine which algorithm is most effective at reducing the spread of plaquette values.

Bilson-Thompson, S O

2004-01-01

325

Radiographic findings after breast augmentation by autologous fat transfer.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fat transfer to healthy breasts, that is, in women with no history of breast disease, particularly breast cancer, is becoming increasingly popular. The main issue remains whether the transfer of fat cells to the native breast hampers breast imaging. This pilot study aimed to assess the effectiveness of radiographic evaluation after breast lipomodeling and to propose objective elements for the detection of mammographic signs, and for postoperative evaluation of breast density and Breast Imaging Reporting and Data System (American College of Radiology) classification. METHODS: The authors retrospectively reviewed the radiographic findings of patients undergoing breast lipomodeling between 2000 and 2008. A descriptive semiologic analysis was conducted. Then, the authors compared breast tissue density and Breast Imaging Reporting and Data System categorization in 20 patients with preoperative and postoperative images available for review. RESULTS: The descriptive analysis identified 16 percent of mammograms with microcalcifications, 9 percent with macrocalcifications, 25 percent with clear well-focused images of cystic lesions, and 12 percent with tissue remodeling. The comparative study showed no statistically significant difference between breast density findings before and after fat injection, whether using the American College of Radiology classification or a personalized rating system. Similarly, no significant difference was observed using the American College of Radiology Breast Imaging Reporting and Data System categorization before and after fat grafting. CONCLUSIONS: Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure. However, the authors' preliminary results should be confirmed in larger series, and the radiographic follow-up of women undergoing breast lipomodeling should be standardized to ensure reproducibility and improve patient safety.

Veber M; Tourasse C; Toussoun G; Moutran M; Mojallal A; Delay E

2011-03-01

326

Longitudinally compliant vascular graft  

UK PubMed Central (United Kingdom)

A longitudinally compliant PTFE graft is provided by compressing at least a portion of a porous PTFE tube along its longitudinal axis and coating at least the outer wall of the compressed portion of the PTFE tube with a biocompatible elastomer for allowing the compressed portion of the tube to be stretched along the longitudinal axis. The PTFE tube is compressed by pulling the tube over a cylindrical mandrel of like diameter and applying a compression force to the tube along its longitudinal axis. The compressed portion(s) is (are) secured against movement upon the mandrel, and a coating of liquified polyurethane or other biocompatible elastomer is then applied over at least the compressed portion(s) of the tube. The elastomeric coating may be applied by dip coating or spray coating techniques. After the elastomeric coating has dried, the completed graft is removed from the mandrel.

DELLA CORNA LINDA V; FARNAN ROBERT C; COLONE WILLIAM M; KOWLIGI RAJAGOPAL R

327

Siloxane-grafted membranes  

Energy Technology Data Exchange (ETDEWEB)

Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional groups. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

Friesen, Dwayne T. (Bend, OR); Obligin, Alan S. (Catonville, MD)

1989-01-01

328

Ginger, fat and fibrinolysis.  

Science.gov (United States)

Administration of 50 gm of fat to 30 healthy adult volunteers decreased fibrinolytic activity from a mean of 64.20 +/- 5.31 to 52.10 +/- 3.20 units (P ginger powder with fatty meal not only prevented the fall in fibrinolytic activity but actually increased it significantly (P ginger. PMID:11482162

Verma, S K; Bordia, A

2001-02-01

329

The trochanteric fat pad  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Technological developments based on the use of autologous white adipose tissue (WAT) attracted attention to minor fat depots as possible sources of adipose tissue. In plastic surgery, the trochanteric fatty pad is one of the most used WAT depots for its location and organoleptic characteristics that...

P. Panettiere; D. Accorsi; L. Marchetti; A.M. Minicozzi; G. Orsini; P. Bernardi; D. Benati; G. Conti; A. Sbarbati

330

Big, Fat World of Lipids  

Science.gov (United States)

... Articles | Inside Life Science Home Page The Big, Fat World of Lipids Emily Carlson Posted August 9, ... the doctor typically provides your levels of three fats found in the blood: LDL, HDL and triglycerides. ...

331

Are the additional grafts necessary?  

Directory of Open Access Journals (Sweden)

Full Text Available The goals of surgery for spinal deformity are to correct or improve the deformity to get a stable, balanced and fused spine. The long-term success of any procedure for scoliosis depends on a solid arthrodesis. Getting fusion of the instrumented segment with the aid of copious autogenous iliac graft has been the most important goal of treatment. However, harvesting copious graft from teenage iliac bone has its limitation in the quantity of graft, surgical time, and other complications of graft sites. Bone substitute is a promising concept, but there is not ideal bone substitute with all the characteristics of an autogenous bone graft. Several alternative graft materials like tricalcium phosphate, hydroxyapatite, and demineralized bone matrix have osteoinductive properties. Bone morphogenic protein has osteoconductive properties. The limitations with bone substitutes are osteoinduction and osteoconduction properties, sterilization, chances of transmitting infective disease and cost. We consider that the introduction of segmental spinal instrumentation which enables strong and firm correction and fixation of the scoliotic deformity has enabled getting fusion with less graft. We can obtain that quantity of graft after laminae and spinous process decortication. This retrospective study has been done in our hospital from January 2002 to December 2004. A total of 188 patients underwent posterior corrections for adolescent idiopathic scoliosis using segmental fixation by Moss-Miami. No autogenous iliac crest graft was taken or graft substitutes. After meticulous decortication and destruction of facet joints, we used local graft taken from spinous process and laminae. All patients had minimum thirty months follow- up. We have excellent results. Out of these 188 patients, 177 patients have fused spine, no implant failure, no pain, no infection and no loss of correction. Eleven (5.8%) patients underwent re-operation; four among them because of infection, three for symptomatic implants and four due to pseudarthrosis. We consider that the use of local harvesting graft is enough for getting good spondylodesis.

Milinkovi? Z.B.; Krneta O.; Mili?kovi? S.; Doži? D.; ?ur?i? A.

2010-01-01

332

Unusual costochondral bone graft complication.  

UK PubMed Central (United Kingdom)

In hemifacial microsomia, patients with severely hypoplastic mandibles (Pruzansky type III) require replacement of the ramus and condyle unit. Common complications of this procedure include graft fracture and overgrowth of the graft. An uncommon case of osteolysis of the costochondral graft with osteitis of the middle cranial fossa is reported herein. To our knowledge, no such case has been reported in the literature previously. The aim of this report is to present the only known case and to discuss the contributing factors.

Tabchouri N; Kadlub N; Diner PA; Picard A

2013-08-01

333

Obliquely inserting vegetable grafting device  

UK PubMed Central (United Kingdom)

The invention discloses an obliquely inserting vegetable grafting device. A graft clamping mechanism and a parental stock punching mechanism are fixed on both sides of a frame through a mounting rack respectively a parental stock growing point removing mechanism and a parental block clamping root pruning mechanism are arranged on the frame between the graft clamping mechanism and the parental stock punching mechanism respectively the parental stock growing point removing mechanism is arranged just behind the parental block clamping root pruning mechanism a graft and parental stock butt joint guide mechanism is arranged on the parental block clamping root pruning mechanism and a graft cutting mechanism is arranged on the frame between the graft clamping mechanism and the parental stock punching mechanism. The device can automatically complete graft clamping, graft cutting, parental block clamping, parental block growing point removing, parental block root pruning, parental block punching and graft and parental block butt joint guiding operations. The device has the characteristics of simple structure, high automatic degree, small operation labor intensity, precise operation, stable quality and high reliability.

JIANPING LI; QIANG LI; JIANZHONG LOU; GULAI LU; LIXING YU; ZHUAN ZHU

334

Vascular pericranial graft: a viable resource for frontal sinus obliteration.  

UK PubMed Central (United Kingdom)

Inappropriate treatments of frontal sinus fractures may lead to serious complications, such as mucopyocele, meningitis, and brain abscess. Assessment of nasofrontal duct injury is crucial, and nasofrontal duct injury requires sinus obliteration, which is often accomplished by autologous grafts such as fat, muscle, or bone. These avascular grafts have an increased risk of resorption and infection, as well as donor site morbidity. For these reasons, pericranial flap, which is vascular, should be used for frontal sinus obliteration. The pericranial flap presented with less morbidity procedure and has decreased infection rates, which justifies its use in frontal sinus obliteration. This paper aims to report a case of a comminuted frontal sinus fracture in a 29-year-old man who was successfully treated by frontal sinus obliteration, using pericranial local flap. The patient was followed up postoperatively for 16 months without infection.

Morais de Melo W; Koogi Sonoda C; Garcia IR Jr

2013-01-01

335

What Are the Types of Fat?  

Science.gov (United States)

What Are The Types Of Fat? Limiting your fat intake is key to losing weight. Healthy eating includes small amounts of fats, but some fats are much ... fats may help improve your blood cholesterol. Good Fats Monounsaturated: Canola, olive, nut and peanut oils (use ...

336

Fat Replacers in Meat Products  

Directory of Open Access Journals (Sweden)

Full Text Available There is a great interest regarding demand for foods with health enhancing properties as low-fat meat products due to the human health and nutrition correlation. Various aspects of interest relating to product design and fat reducing strategy has been reported. These aspects concerning nutritional, sensory, technological, safety, appreciation, legal and cost procedures are important to a improved new product design. Due to their different texture properties, processing conditions and different quality evaluations used in the reformulated meat derivatives, the feasibility of low-fat meat products manufacturing has been investigated. In previous review paper, various factors such as consumer acceptability, technological, emerging strategies for the modification of meat fat level, fatty acid (FA) composition, and non-meat ingredients or fat-replacers for the production were monitored for low-fat meat products and fat reduction concept.

Ozlem Tokusoglu; M. Kemal Unal

2003-01-01

337

DEODORIZED FAT MANUFACTURING PROCESS  

UK PubMed Central (United Kingdom)

FIELD: fat-and-oil industry. ^ SUBSTANCE: process is carried out in deodorizer at 220-230 and residual pressure 0.13-0.4 kPa. Reaction zone of deodorizer is loaded with, as catalyst, organomineral sulfocationite prepared by polycondensation of lignin on granulated aluminosilicate followed by sulfonation. ^ EFFECT: improved quality of deodorized product, intensified deodorization process, and reduced power consumption. ^ 2 ex

TYRSIN JU A; PARONJAN V KH; JUSOV S M; TYRSINA A V; KAMYSHAN E M; MESHCHERJAKOV S V; SKRJABINA N M

338

The trochanteric fat pad  

Directory of Open Access Journals (Sweden)

Full Text Available Technological developments based on the use of autologous white adipose tissue (WAT) attracted attention to minor fat depots as possible sources of adipose tissue. In plastic surgery, the trochanteric fatty pad is one of the most used WAT depots for its location and organoleptic characteristics that make it particularly suitable for reconstructive procedures. Despite its wide use in clinic, the structure of this depot has never been studied in detail and it is not known if structural differences exist among trochanteric fat and other subcutaneous WAT depots. The present study was performed on trochanteric fat pad with the aim to clarify the morphology of its adipocytes, stroma and microcirculation, with particular reference to the stem niches. Histological and ultrastructural studies showed that the main peculiar feature of the trochanteric fat concerns its stromal component, which appears less dense than in the other subcutaneous WATs studied. The intra-parenchymal collagen stroma is poor and the extracellular compartment shows large spaces, filled with electron-light material, in which isolated collagen bundles are present. The adipocytes are wrapped in weak and easily detachable collagen baskets. These connective sheaths are very thin compared to the sheaths in other subcutaneous WAT depots. The capillaries are covered by large, long and thin elements surrounded by an external lamina; these perivascular cells are poor in organelles and mainly contain poly-ribosomes. In conclusion, when compared to other WAT deposits, the trochanteric fatty pad shows structural peculiarities in its stroma and microcirculation suggesting a high regenerative potential. Resistance, dissociability, microvascular weft and high regenerative potential make the trochanteric fatty pad a privileged source for harvesting in autologous WAT-based regenerative procedures.

P. Panettiere; D. Accorsi; L. Marchetti; A.M. Minicozzi; G. Orsini; P. Bernardi; D. Benati; G. Conti; A. Sbarbati

2011-01-01

339

Ectopic fat and cardiometabolic and vascular risk.  

UK PubMed Central (United Kingdom)

Given that the variation in how regional adipose tissue handles and stores excess dietary energy has substantial cardiometabolic implications, ectopic fat distribution might be an important predictor of cardiometabolic and vascular risk, in addition to overall obesity itself. Conceptually, ectopic fat depots may be divided into systemically acting fat depots and locally acting fat depots. Systemically acting fat depots include visceral fat, fat in the liver, muscle, or neck, and subcutaneous fat. Accumulation in the abdominal visceral area, compared with overall obesity, has an equally or more important role in the development of cardiometabolic risk. Fat depots in liver/muscle tissue cause adverse cardiometabolic effects by affecting energy metabolism. Fat depots in lower-body subcutaneous areas may be protective regarding cardiometabolic risk, by trapping remnant energy. Fat accumulation in the neck is a unique type of fat depot that may increase cardiovascular risk by increasing insulin resistance. Locally acting fat depots include pericardial fat, perivascular fat, and renal sinus fat. These fat depots have effects primarily on adjacent anatomic organs, directly via lipotoxicity and indirectly via cytokine secretion. Pericardial fat is associated with coronary atherosclerosis. Perivascular fat may play an independent role in adverse vascular biology, including arterial stiffness. Renal sinus fat is a unique fat depot that may confer additional cardiometabolic risk. Thus, ectopic fat depots may contribute to the understanding of the link between body composition and cardiometabolic risk. In this review, we focus on the role and clinical implications of ectopic fat depots in cardiometabolic and vascular risk.

Lim S; Meigs JB

2013-09-01

340

LONGITUDINALLY COMPLIANT VASCULAR GRAFT  

UK PubMed Central (United Kingdom)

A longitudinally compliant PTFE graft (20) is provided by compressing at least a portion of a porous PTFE tube (32) along its longitudinal axis (22) and coating at least the outer wall of the compressed portion of the PTFE tube (32) with a biocompatible elastomer for allowing the compressed portion of the tube (32) to be stretched along the longitunal axis (22). The PTFE tube (32) is compressed by pulling the tube (32) over a cylindrical mandrel of like diameter and applying a compression force to the tube (32) along its longitudinal axis (22). The compressed portion(s) is(are) secured against movement upon the mandrel, and a coating (38) of liquified polyurethane or other biocompatible elastomer is then applied over at least the compressed portion(s) of the tube (32). The elastomeric coating (38) may be applied by dip coating or spray coating techniques. After the elastomeric coating (38) has dried, the completed graft (20) is removed from the mandrel.

DELLA CORNA Linda V.; FARNAN Robert Charles; COLONE William Michael; KOWLIGI Rajagopal R.

 
 
 
 
341

[Treatment by fat tissue transfer for radiation injury in childhood facial cancer].  

UK PubMed Central (United Kingdom)

The radiation treatment of malignant facial tumors in children may induce major functional and cosmetic sequelae, mainly due to uneven growth of the bones and soft tissues, resulting in facial asymmetry and hemihypotrophy at adult age. Although fat transfer has proven effective for facial cosmetic treatment, few studies have demonstrated the benefit of the technique in heavily irradiated tissues. The techniques generally used for the treatment of facial asymmetry or hypotrophy are ill-adapted to irradiated patients. Indeed, procedures such as skin detachment, osteotomy and vascular suture are risky because of radiation-induced damage. The aim of the present study was to investigate the potential benefits of fat transfer for the correction of sequelae of facial irradiation. Four patients (two males and two females) aged 27, 25, 16 and 13 years underwent fat grafting for the correction of facial asymmetry or hypotrophy induced by cancer radiation treatment during childhood (radiation dose of more than 50Gy). One to three grafting sessions were required, depending on the cases. After a median follow-up of 3.9 years, cosmetic results were considered satisfactory by both the patient and the surgeon in all four cases. Fat transfer remarkably improved the cosmetic appearance of the patients, without deleterious consequences for the vitality of tissues. In addition, a restoration of skin trophicity was observed, thus confirming the benefit of grafting adipocytes into the irradiated integument. In conclusion, fat grafting appears to be a simple and easily reusable technique which makes it possible to obtain the best morphological and cosmetic results in irradiated patients, whereas avoiding complex and potentially hazardous procedures.

Faghahati S; Delaporte T; Toussoun G; Gleizal A; Morel F; Delay E

2010-06-01

342

Autologous fat injection to face and neck: from soft tissue augmentation to regenerative medicine.  

UK PubMed Central (United Kingdom)

Minimally-invasive autologous fat injection of the head and neck region can be considered a valid alternative to major invasive surgical procedures both for aesthetic and functional purposes. The favourable outcomes of autologous fat injection in otolaryngological practice are due to the filling of soft tissue and, mainly, to the potential regenerative effect of adipose-derived mesenchymal stem cells. Herewith, some important biological preliminary remarks are described underlying the potential of autologous fat injection in regenerative medicine, and personal experience in using it for both consolidated clinical applications, such as fat grafting to the face and vocal fold augmentation in the treatment of glottic incompetence, and more recent applications including the treatment of post-parotidectomy Frey syndrome and velopharyngeal insufficiency.

Mazzola RF; Cantarella G; Torretta S; Sbarbati A; Lazzari L; Pignataro L

2011-04-01

343

Autologous fat transplantation in the craniofacial patient: the UCLA experience.  

UK PubMed Central (United Kingdom)

Patients with congenital craniofacial malformations present with complex challenges for reconstruction. Successful management requires individualized treatment often involving rebuilding the facial skeleton de novo, as well as correcting the overlying soft-tissue deficiencies in the final stages. At the University of California, Los Angeles (UCLA) Craniofacial Clinic, serial autologous fat transplantation performed during staged reconstruction is the preferred method.A total of 27 patients with a diagnosis of either craniofacial microsomia/Goldenhar (CM) (n = 19) or Treacher Collins syndrome (TC) (n = 8) were treated at the UCLA Craniofacial Clinic by autologous fat transfer between July 1999 and February 2009. Two-dimensional analysis was conducted on standardized preoperative and postoperative photographs to determine facial symmetry for every patient. Results was grouped based on pathology and analyzed by comparing adipocyte donor site (abdomen vs other).The mean ages at the time of first fat transfer were 17 years for the CM group and 15 years for the TC group. The average numbers of fat transfers per patient were 2.05 (CM) and 2.12 (TC). A mean of 3.74 procedures other than fat grafting was performed in each CM patient, whereas 4.38 other procedures were performed in each TC patient. In CM patients, less than 10.5 months between procedures resulted in improved symmetry. There was an average 6.63% improvement in facial symmetry in the CM group, and a 7.67% improvement in the TC group.Based on the UCLA experience, the durability of facial asymmetry and contour correction with fat transplantation is attainable in the craniofacial patient but may also require concomitant skeletal correction in the most severe cases.

Lim AA; Fan K; Allam KA; Wan D; Tabit C; Liao E; Kawamoto HK; Bradley JP

2012-07-01

344

Autologous fat transplantation in the craniofacial patient: the UCLA experience.  

Science.gov (United States)

Patients with congenital craniofacial malformations present with complex challenges for reconstruction. Successful management requires individualized treatment often involving rebuilding the facial skeleton de novo, as well as correcting the overlying soft-tissue deficiencies in the final stages. At the University of California, Los Angeles (UCLA) Craniofacial Clinic, serial autologous fat transplantation performed during staged reconstruction is the preferred method.A total of 27 patients with a diagnosis of either craniofacial microsomia/Goldenhar (CM) (n = 19) or Treacher Collins syndrome (TC) (n = 8) were treated at the UCLA Craniofacial Clinic by autologous fat transfer between July 1999 and February 2009. Two-dimensional analysis was conducted on standardized preoperative and postoperative photographs to determine facial symmetry for every patient. Results was grouped based on pathology and analyzed by comparing adipocyte donor site (abdomen vs other).The mean ages at the time of first fat transfer were 17 years for the CM group and 15 years for the TC group. The average numbers of fat transfers per patient were 2.05 (CM) and 2.12 (TC). A mean of 3.74 procedures other than fat grafting was performed in each CM patient, whereas 4.38 other procedures were performed in each TC patient. In CM patients, less than 10.5 months between procedures resulted in improved symmetry. There was an average 6.63% improvement in facial symmetry in the CM group, and a 7.67% improvement in the TC group.Based on the UCLA experience, the durability of facial asymmetry and contour correction with fat transplantation is attainable in the craniofacial patient but may also require concomitant skeletal correction in the most severe cases. PMID:22777454

Lim, Alan A; Fan, Kenneth; Allam, Karam A; Wan, Derrick; Tabit, Christina; Liao, Eileen; Kawamoto, Henry K; Bradley, James P

2012-07-01

345

Edible fat-containing products  

UK PubMed Central (United Kingdom)

The present invention is concerned with an edible fat-containing product comprising less than 35 wt.% of a fat-continuous phase comprising one or more indigestible polyol fatty acid polyesters and optionally triglycerides, and at least 65 wt.% of an aqueous phase, the fat-continuous phase containing from 5-24% by weight of said fat-continuous phase of polyol fatty acid polyester(s) having a slip melting point of more than 30°C and from 95-60% by weight of the fat-continuous phase of an oil having a slip melting point of less than 20°C, the fat-continuous phase having an N5-value of at most 14 and an N20-value of at most 8. The products according to the invention exhibit a very good stability against water-loss in combination with a good oral response.

Cain Frederick William; De Jong Frederik Roelof

346

High efficiency deep fat fryer  

Energy Technology Data Exchange (ETDEWEB)

Disclosed is a high efficiency deep-fat fryer from whose fry tank fat is continuously withdrawn for heating and filteration. A pump circulates part of this fat through a helical- or serpentine-shaped finned-tube heat exchanger positioned between a gas-fired burner and the bottom of the fry tank. The remaining portion of fat is directed through a filter located in the bottom zone of the fry tank. The fryer includes a control system with sensors such as pressure switches for preventing damage to the fat at low flow rates and devices for expelling moisture trapped in the pump. The filter has an element of material such as carbon-impregnated cloth which may be quickly replaced without draining fat from the tank. Using the heating systems as described in the invention. The fryer provides a calorimetric efficiency of about 75-80% and flue losses of about 20% or less. 14 figs.

Hurley, J.R.; Shukla, K.C.; Searight, E.F.; Panora, R.A.

1988-01-12

347

Distinguishing fat from extracellular methemoglobin  

International Nuclear Information System (INIS)

This paper to analyze how effective chemical shift selective techniques are in the suppression of fat so that fat can be easily distinguished from methemoglobin. A phantom was constructed so that fat and extracellular methemoglobin could be imaged in juxtaposition with one another. Five pulse sequences were tested for their ability to suppress fat while not diminishing the signal intensity from the methemoglobin. The pulse sequences tested where short time inversion recovery, spectral presaturation, spin-echo chopper fat averaging in the time domain, the Dixon technique (opposed phase), and a combination of the Dixon technique and spectral presaturation. Signal-to-noise measurements were made over portions of the phantom that contained fat, water, and methemoglobin, respectively

1990-01-01

348

The Supersymmetric Fat Higgs  

Energy Technology Data Exchange (ETDEWEB)

Supersymmetric models have traditionally been assumed to be perturbative up to high scales due to the requirement of calculable unification. In this note I review the recently proposed `Fat Higgs' model which relaxes the requirement of perturbativity. In this framework, an NMSSM-like trilinear coupling becomes strong at some intermediate scale. The NMSSM Higgses are meson composites of an asymptotically-free gauge theory. This allows us to raise the mass of the Higgs, thus alleviating the MSSM of its fine tuning problem. Despite the strong coupling at an intermediate scale, the UV completion allows us to maintain gauge coupling unification.

Harnik, Roni

2004-10-27

349

Edible fat-containing composition  

UK PubMed Central (United Kingdom)

The present invention is concerned with an edible composition containing from 10 to 100 wt.% fat essentially consisting of a mixture of polyol fatty acid polyester having a slip melting point of at least 25°C and digestible fat having a lower slip melting point, wherein the average molecular weight of the molecules comprised by the digestible fat is below 710. We have found that the negative influence of the inclusion of relatively high melting polyol fatty acid polyester can be reduced substantially by using digestible fat composed of molecules having a low average molecular weight.

De Bruijne Dirk Willem; Lucassen-Reynders Emmie Helena

350

Graft healing in anterior cruciate ligament reconstruction.  

UK PubMed Central (United Kingdom)

Graft healing within the bone tunnel after anterior cruciate ligament (ACL) reconstruction is still a complex, poorly understood biological process that is influenced by multiple surgical and postoperative variables. However, remarkable advances in knowledge of this process have been made based primarly on animal models. According to the findings of this review, some surgical and postoperative variables are known to directly affect time-course and quality of graft-tunnel healing. The type of graft, graft motion, and fixation methods have shown to directly affect time-course and quality of graft-tunnel healing. Therefore, the application of early and aggressive rehabilitation protocols should be cautious when using soft-tissue graft, allografts, and direct or aperture type of fixation for ACL reconstruction. With regard to graft placement, several cadaveric models showed biomechanical advantages of a more anatomical graft location; however, there are no studies that explore the relationship between graft placement and healing process. The precise effect of graft tensioning, graft/tunnel diameter disparity, and graft length within the bone tunnel in the graft healing process remains unclear and requires more research. To enhance graft-tunnel healing, tissue-engineering approaches, including the use of growth factors, mesenchymal stem cells, and periosteum graft augmentation, have been tested on animal models. These have shown promising results in terms of enhancement of bone-graft healing rate.

Ekdahl M; Wang JH; Ronga M; Fu FH

2008-10-01

351

Preirradiation grafting VBTAC onto HDPE films  

International Nuclear Information System (INIS)

HDPE films irradiated to 200 kGy in N2 were grafted with vinyl benzyltrimethylammonium chloride (VBTAC) to synthesize a strong base anion-exchange membrane. Comonomer grafting technique was used owing to the difficulty of direct graft polymerization of VBTAC onto polyethylene. Dimethylaminoethyl methacrylate (DMAEMA), a relative weak acid monomer, was selected as a co-monomer to promote graft polymerization of VBTAC. The grafting conditions, as well as the compositions of grafted films were investigated. The distribution of grafted basic group in polymer substrate was measured by an X-ray microanalyzer. (authors)

2008-01-01

352

Autologous fat transfer with in-situ mediation (AIM): a novel and compliant method of adult mesenchymal stem cell therapy.  

Science.gov (United States)

BACKGROUND: In an attempt to engineer a regulatory compliant form of cell assisted lipotransfer in the U.S., the authors developed Autologous Fat Transfer with In-situ Mediation (AIM) for reconstruction of a refractory surgical scar. METHODS: This method incorporates use of accepted standard procedures like autologous fat grafting and intradermal injection of NB6 collagenase to release adipose stem cells from a naturally occurring high concentration stromal vascular fraction (SVF) fat graft. To prevent off-target effects of collagenase, a hyaluronic acid and serum deactivation barrier is placed circumferentially around the operative site. FINDINGS: This novel protocol was well tolerated by the patient and improved scar appearance, mobility and texture. Deepest scar contour defect correction was 80% and 77% at 4 and 12 weeks respectively. CONCLUSION: AIM appears to be a practical and viable option for scar reconstruction requiring small to moderate volume correction. PMID:23725573

Wu, Allan Y; Morrow, David M

2013-05-31

353

Autologous fat transfer with in-situ mediation (AIM): a novel and compliant method of adult mesenchymal stem cell therapy.  

UK PubMed Central (United Kingdom)

BACKGROUND: In an attempt to engineer a regulatory compliant form of cell assisted lipotransfer in the U.S., the authors developed Autologous Fat Transfer with In-situ Mediation (AIM) for reconstruction of a refractory surgical scar. METHODS: This method incorporates use of accepted standard procedures like autologous fat grafting and intradermal injection of NB6 collagenase to release adipose stem cells from a naturally occurring high concentration stromal vascular fraction (SVF) fat graft. To prevent off-target effects of collagenase, a hyaluronic acid and serum deactivation barrier is placed circumferentially around the operative site. FINDINGS: This novel protocol was well tolerated by the patient and improved scar appearance, mobility and texture. Deepest scar contour defect correction was 80% and 77% at 4 and 12 weeks respectively. CONCLUSION: AIM appears to be a practical and viable option for scar reconstruction requiring small to moderate volume correction.

Wu AY; Morrow DM

2013-05-01

354

Fat Replacers in Meat Products  

Digital Repository Infrastructure Vision for European Research (DRIVER)

There is a great interest regarding demand for foods with health enhancing properties as low-fat meat products due to the human health and nutrition correlation. Various aspects of interest relating to product design and fat reducing strategy has been reported. These aspects concerning nutritional, ...

Ozlem Tokusoglu; M. Kemal Unal

355

Bone Grafts (Periodontal Regenerative Surgery)  

Science.gov (United States)

Bone Grafts (Periodontal Regenerative Surgery) What Is It? What It's Used For Preparation How It's Done Follow-Up Risks When To ... Before your surgery, you need to have basic periodontal treatment called scaling and root planing. You also ...

356

Bone grafting options in children.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Retrospective review of the literature. OBJECTIVE: To review the current literature as well as recent trends in bone grafting techniques available for children. SUMMARY OF BACKGROUND DATA: The currently accepted gold standard in bone grafting for adolescent idiopathic scoliosis (AIS) is autogenous iliac crest. Due to questions concerning complications such as donor site pain, other options have been explored, including various allograft sources, demineralized bone matrix, and bone morphogenetic protein. METHODS: A review of the current medical literature was completed and additional case examples are presented. RESULTS: A review of the literature reveals that up to 31% of patients have persistent pain at 2 years post surgery when autogenous iliac crest bone graft is harvested. Allograft supplementation of local autograft has been demonstrated in the literature to be as effective as autogenous iliac crest bone grafting in contributing to a successful posterior spinal fusion in patients with AIS. Modern demineralized bone matrix formulations have been found in both animal models as well as in a recent retrospective clinical review to contribute to a successful posterior spinal fusion in AIS. Bone morphogenetic protein has been shown to contribute to a successful posterior spinal fusion in complex pediatric spinal deformity patients. At 2 years follow-up, patients who underwent a posterior instrumented spinal fusion that was not augmented with any bone graft appear to have successful spinal fusions. CONCLUSION: Although autogenous iliac bone graft remains the benchmark to which bone grafting materials are compared, other options including the placement of no bone graft at all provides similar fusion rates in patients with AIS.

Betz RR; Lavelle WF; Samdani AF

2010-08-01

357

Process for grafted vine cultivation  

UK PubMed Central (United Kingdom)

The invention refers to agriculture, in particular to viticulture and may be applied in the production of planting material. The process includes carrying out of plantage plowing at a depth of 30 cm and planting in the constant place of the unrooted shortened cuttings. The result of the invention consists in increasing the yield of the grafted material and in reducing the expenses in the creation of grafted vine mother material nurseries. Claims: 1

BUCATARU PETRU

358

ANIMAL FAT SUBSTITUTE  

UK PubMed Central (United Kingdom)

The invention relates to an animal fat substitute comprising a mixture of semi-solid palm oil representing 70 - 80 % of the total mass of the substitute and at least one vegetable oil which is fluid at ambient temperature, has taste and/or nutritional qualities and represents 20 - 30 % of the total mass of the substitute. In one embodiment of the invention, fully or partially hydrogenated palm oil represents 70 - 80 % of the total mass of the substitute and vegetable oil fluid at ambient temperature represents 20 - 30 % of the total mass of the substitute. When the palm oil is partially hydrogenated it can include a refined palm oil and a hydrogenated palm oil.The invention also relates to a method for producing said substitute and to the use thereof in a food preparation for cured sausages, fresh sausages or mortadella sausages, as well as to a food preparation containing at least one substitute and to the production method of same.

GAUD BERNARD; ALFOS CARINE

359

Radiation Induced Graft Copolymerization of Polyvinyl Alcohol  

International Nuclear Information System (INIS)

In order to improve the properties of polyvinyl alcohol films and fibres, the graft copolymerization of various vinyl monomers to polyvinyl alcohol films by gamma ray irradiation was investigated. When thin films of polyvinyl alcohol were irradiated in a large excess of styrene no graft copolymerization was observed. With films containing more than 5% water the grafting proceeded smoothly. The highest value of styrene grafted was about 1,000% at a dose of 7X106r. The presence of water in the monomer solution was found to increase considerably the amount of grafted monomer. Methyl methacrylate behaved similarly to styrene in the grafting to polyvinyl alcohol films, the presence of a certain amount of water being essential. The efficiency of the grafting of methyl methacrylate was generally larger than that of the grafting of styrene. The highest value of the grafted methyl methacrylate was 4,000% and obtained at a dose of 5 X 105 r. Some experiments were carried out with acrylonitrile and vinyl acetate but compared with styrene and methyl methacrylate the efficiencies of the grafting of these monomers were not so high. The degree of swelling of the graft copolymers of polyvinyl-alcohol-styrene or methyl methacrylate in organic solvents was measured at 30oC. The relation between the degree of swelling and the percentage of monomer grafted was given by (degree of swelling %) = k (monomer grafted %)n. For polymers grafted with styrene n = 1, but for those grafted with methyl methacrylate n

1960-01-01

360

Advanced cranial reconstruction using intracranial free flaps and cranial bone grafts: an algorithmic approach developed from the modern battlefield.  

UK PubMed Central (United Kingdom)

BACKGROUND: The objective of this study was to report outcomes after initiation of an algorithmic approach (Bethesda protocol) using intracranial free flaps, cranial bone autografts, and dermal/fat grafts to treat warfare-related cranial frontofacial defects after war-related decompressive craniectomy. METHODS: A retrospective review of personnel undergoing complex cranial defect reconstruction that required free flap interpositions for dead space obliteration, cranial bone grafting, or dermal/fat grafting for orbital defects was performed over a 52-month period. RESULTS: From March of 2003 to July of 2011, 13 patients were identified who underwent complex craniofacial defect reconstruction. All patients were male (average age, 25 years). Average follow-up was 3.6 years. Glasgow Coma Scale score was 7 initially and 9 on arrival to the continental United States. Average evacuation time was 4.2 days. Forty-six percent of injuries were blast injuries. Nine patients (69 percent) underwent hemicraniectomies and four (31 percent) underwent bifrontal craniectomies. Two patients required free flaps and four required free flaps and cranial bone grafts for skull base reconstruction. Five patients required cranial bone grafts and two required cranial bone grafts with dermal fat grafts for reconstruction. All patients were complication free at conclusion of the study. The initial free flap success rate was 86 percent (six of seven flaps). Successful frontal bar/free flap reconstruction was present in 100 percent and the secondary cranioplasty rate was 77 percent. CONCLUSION: Decompressive craniectomy defects associated with orbital, sinus, and skull base defects can be successfully reconstructed using an algorithmic approach with low morbidity and high secondary cranioplasty retention rates. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Kumar AR; Tantawi D; Armonda R; Valerio I

2012-11-01

 
 
 
 
361

Bilateral internal thoracic artery grafting.  

UK PubMed Central (United Kingdom)

The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years.

Lytle BW

2013-07-01

362

Grafting machine for vine cuttings or other vegetable varieties and a grafting method  

UK PubMed Central (United Kingdom)

Grafting machine (10) and relative grafting method for vine cuttings or other vegetable varieties (13) obtained by coupling together through grafting a first wood, or graft (11), provided with at least a bud (11a) at one end, and a second wood or vine (12), wherein said grafting machine (10) comprises at least a grafting group (16), able to automatically perform the grafting of at least one graft (11) and at least one vine (12), a first automatic feed and separation group (14), able to position at least one graft (11) at a time in correspondence with a zone predisposed for grafting associated with the grafting group (16), and a second automatic feed and separation group (15) able to position at least one vine (12) at a time in correspondence with said zone predisposed for grafting.

D'Andrea Giancarlo Via Pietro Zorutti 21; Bisutti Alessandro Via Trieste 19/B; Ronzani Giuseppe Via Luchini 1

363

Mammographic changes after fat transfer to the breast compared with changes after breast reduction: a blinded study.  

UK PubMed Central (United Kingdom)

BACKGROUND: : One issue in the adoption of autologous fat transfer to the breast is concern over mammographic changes that may obscure cancer detection. The authors compared mammographic changes following fat grafting to the breast with changes seen after breast reduction. METHODS: : Twenty-seven women who had normal preoperative mammograms were treated with fat grafting to the breast, including admixing of autologous adipose stem cells with the fat graft, for cosmetic augmentation. Repeated mammograms were performed 12 months after surgery. As a control group, postsurgical mammograms from 23 reduction mammaplasty patients were compared. Eight academic breast imaging radiologists reviewed each mammogram in a blinded fashion. Outcomes analysis accounting for individual radiologist's tendencies was performed using generalized estimating equations. RESULTS: : The average volume of fat injected per patient was 526.5 cc. Fifty mammograms (27 lipotransfer, 23 breast reduction) were assessed. Differences in interpretation among individual radiologists were consistently observed (p < 0.10). Differences in abnormality rates were nonsignificant for oil cysts, benign calcifications, and calcifications warranting biopsy. Scarring (p < 0.001) and masses requiring biopsy (p < 0.001) were more common in the reduction cohort. Breast Imaging Reporting and Data System scores were higher after breast reduction (p < 0.001). Significant differences in the recommended follow-up time were also seen (p < 0.01). CONCLUSIONS: : Compared with reduction mammaplasty, a widely accepted procedure, fat grafting to the breast produces fewer radiographic abnormalities with a more favorable Breast Imaging Reporting and Data System score and less aggressive follow-up recommendations by breast radiologists. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, III.

Rubin JP; Coon D; Zuley M; Toy J; Asano Y; Kurita M; Aoi N; Harii K; Yoshimura K

2012-05-01

364

Fat burners: nutrition supplements that increase fat metabolism.  

UK PubMed Central (United Kingdom)

The term 'fat burner' is used to describe nutrition supplements that are claimed to acutely increase fat metabolism or energy expenditure, impair fat absorption, increase weight loss, increase fat oxidation during exercise, or somehow cause long-term adaptations that promote fat metabolism. Often, these supplements contain a number of ingredients, each with its own proposed mechanism of action and it is often claimed that the combination of these substances will have additive effects. The list of supplements that are claimed to increase or improve fat metabolism is long; the most popular supplements include caffeine, carnitine, green tea, conjugated linoleic acid, forskolin, chromium, kelp and fucoxanthin. In this review the evidence for some of these supplements is briefly summarized. Based on the available literature, caffeine and green tea have data to back up its fat metabolism-enhancing properties. For many other supplements, although some show some promise, evidence is lacking. The list of supplements is industry-driven and is likely to grow at a rate that is not matched by a similar increase in scientific underpinning.

Jeukendrup AE; Randell R

2011-10-01

365

Fat preserving by laser 1210-nm.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The 1210-nm wavelength has absorption-affinity for Lipid-Rich Tissue and has demonstrated to stimulate adipocytes and mesenchymal cells of the subcutaneous tissue, with a new concept: Selective Photothermostimulation (SPS). The application in Liposuction of this wavelength is determined by its preservation of the integrity of adipocytes, making possible the use of these materials for fat grafting in Liposculpture, Breast Reconstruction or as filler in Face Rejuvenation, proven that this technique is less traumatic. MATERIALS AND METHODS: 102 patients diagnosed with lipodystrophy either associated to skin flaccidity or not were applied the 1210-nm diode laser (ORlight®) between June 2010 and August 2011. The protocol was followed and verified through ultrasound imaging. Intraoperative and subcutaneous cellular tissue temperatures were measured. Samples of the aspirated tissue were sent for histological analysis to prove alteration/preservation of adipocytes and connective tissues, including mitochondrial activity. RESULTS: Histological analyses revealed 98% preservation of aspirated adipocytes. The 1210-nm diode laser shows affinity for adipose tissue. In addition, the technique poses a reduced trauma level on tissues, allowing for the performance of associated procedures for the body or face. No major complications were observed; and only minor complications, mainly ecchymosis on 2% of the total body surface area, have been recorded. The recovery period is 24 hours. The Liposuction Diode Laser (LSDL) 1210-nm is ideal for Liposculpture.

Centurion P; Noriega A

2013-02-01

366

Patency of femoropopliteal and femorotibial grafts after outflow revascularization (jump grafts) to bypass distal disease.  

UK PubMed Central (United Kingdom)

Repair of failing femorodistal bypass grafts with secondary distal "jump" grafts was performed 34 times in 33 patients. Indication for operation was limb salvage for all distal jump grafts and for 85% of the initial femorodistal bypass grafts. Autogenous vein bypass grafts were used in 28 of 33 initial femorodistal grafts (85%) and in 29 of 34 secondary jump grafts (85%). Sixteen of the 33 initial grafts in jeopardy extended to the infrapopliteal level (48%) and 19 of the jump grafts terminated in foot or ankle arteries (56%). The 12 jump grafts performed in the first 2 months of the initial graft were associated with high rates (9%) of graft thrombosis and amputation. Early loss of viability of initial grafts probably resulted from technical and judgment errors or underestimation of distal disease. Progression of distal disease produced late failure after 1 year of implantation of the initial grafts. The 1-year patency rate of the initial femorodistal grafts was 63% but only 32% of these grafted limbs were viable and were not at risk of amputation. Distal jump grafts produced a 49% improvement in limb viability (to an 81% limb salvage rate) and an 11% increase in the initial graft patency rate (to 74%) at 1 year.

Andros G; Harris RW; Dulawa LB; Oblath RW; Salles-Cunha SX

1984-11-01

367

Mesotherapy for local fat reduction.  

UK PubMed Central (United Kingdom)

Mesotherapy, which is the injection of substances locally into mesodermally derived subcutaneous tissue, developed from empirical observations of a French physician in the 1950s. Although popular in Europe for many medical purposes, it is used for local cosmetic fat reduction in the United States. This paper reviews manuscripts indexed in PubMed/MEDLINE under 'mesotherapy', which pertains to local fat reduction. The history of lipolytic mesotherapy, the physiology of body fat distribution, the mechanism of action of different lipolytic stimulators and their increased efficacy in combination are reviewed. Mesotherapy falls into two categories. Lipolytic mesotherapy using lipolytic stimulators requires more frequent treatments as the fat cells are not destroyed and can refill over time. Ablative mesotherapy destroys fat cells with a detergent, causes inflammation and scarring from the fat necrosis, but requires fewer treatments. The historic and empiric mixing of sodium channel blocking local anaesthetics in mesotherapy solutions inhibits the intended lipolysis. Major mesotherapy safety concerns include injection site infections from poor sterile technique. Cosmetic mesotherapy directs the area from which fat is lost to improve self-image. Studies were of relatively small number, many with limited sample sizes. Future research should be directed towards achieving a Food and Drug Administration indication rather than continuing expansion of off-label use.

Jayasinghe S; Guillot T; Bissoon L; Greenway F

2013-06-01

368

Management of an infected aortic graft with endovascular stent grafting.  

UK PubMed Central (United Kingdom)

Aortic graft infection, one of the most common fatal complications of aortovascular surgery, is managed mainly by the removal of infected graft material and re-establishment of vascular continuity using an extra-anatomical bypass or in situ graft replacement. Despite significant progress in perioperative, surgical, and medical treatments, the mortality and morbidity for this condition remain high. Here, we report the use of endograft implantation and prolonged intravenous antibiotics to successfully treat a life-threatening Dacron aortic tube graft infection and anastomotic leak. Although the gold standard is surgical removal of infected material and repair with a homograft, in certain extremely high-risk patients such as ours, an alternate strategy may be warranted when the risks associated with surgery are prohibitive. Endovascular repair of a surgical Dacron graft leak may provide a novel temporizing measure in the acute setting, allowing for delayed semi-urgent surgical intervention, or it may provide a definitive treatment, as in our case. At the four-year follow-up, our patient was well with a good quality of life and with no clinical, radiological, or biochemical evidence of infection.

Jamel S; Attia R; Young C

2013-01-01

369

Management of an infected aortic graft with endovascular stent grafting.  

Science.gov (United States)

Aortic graft infection, one of the most common fatal complications of aortovascular surgery, is managed mainly by the removal of infected graft material and re-establishment of vascular continuity using an extra-anatomical bypass or in situ graft replacement. Despite significant progress in perioperative, surgical, and medical treatments, the mortality and morbidity for this condition remain high. Here, we report the use of endograft implantation and prolonged intravenous antibiotics to successfully treat a life-threatening Dacron aortic tube graft infection and anastomotic leak. Although the gold standard is surgical removal of infected material and repair with a homograft, in certain extremely high-risk patients such as ours, an alternate strategy may be warranted when the risks associated with surgery are prohibitive. Endovascular repair of a surgical Dacron graft leak may provide a novel temporizing measure in the acute setting, allowing for delayed semi-urgent surgical intervention, or it may provide a definitive treatment, as in our case. At the four-year follow-up, our patient was well with a good quality of life and with no clinical, radiological, or biochemical evidence of infection. PMID:22641467

Jamel, Sara; Attia, Rizwan; Young, Christopher

2012-05-29

370

[Dietary fats and cardiovascular health].  

UK PubMed Central (United Kingdom)

Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an ever-expanding research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended to substitute complex carbohydrates or unsaturated fat for unsaturated and trans fats with the aim of reducing saturated and trans fat intake to <10% and <1%, respectively, of the total calorie intake. Recent population studies, particularly that conducted in Kuopio, Finland, and those on Mediterranean diet, stress the important role of monounsaturated and polyunsaturated fats as key nutrients in preventing cardiovascular disease in modern societies. Furthermore, a special type of polyunsaturated fatty acids, i.e. those of the omega-3 (n-3) series, is increasingly becoming essential nutrients for a healthy diet, especially in the case of children. Therefore, there is a rationale for four the Scientific Societies that are strongly committed to disseminate the benefits of a healthy diet in preventing cardiovascular disease, and to prepare a joint statement with the purpose of spreading improved knowledge on the importance of changing to a healthy diet with a well-balanced fat intake for industrialized populations. Accordingly, a multidisciplinary panel of experts from the following institutions has developed the present joint statement targeted at both adults and children of different ages: Spanish Society of Arteriosclerosis, Spanish Society of Family and Community Medicine, Spanish Association of Paediatrics, Spanish Society of Gastroenterology, Hepatology and Paediatric Nutrition and Dietetics, and Spanish Society for Food Sciences.

Fernández LC; Serra JD; Álvarez JR; Alberich RS; Jiménez FP

2011-03-01

371

How should we preclot knitted Dacron grafts?  

Science.gov (United States)

We studied the change in water porosity over time of 10 Sauvage Bionit-II and 10 DeBakey Vasculour-II knitted velour Dacron grafts throughout the four stages of the Sauvage preclotting technique. Graft porosity decreased significantly (p less than 0.001) at the ends of stages 1 and 2 for both types of grafts, but stages 3 and 4 did not further reduce graft porosity. These results demonstrate that a two-stage preclotting technique is adequate for the preclotting of knitted velour Dacron grafts. A final rinse with heparinized blood is recommended as this may reduce graft thrombogenicity. PMID:2965256

Snooks, S J; Croft, R J; Wagner, C

1988-04-01

372

How should we preclot knitted Dacron grafts?  

UK PubMed Central (United Kingdom)

We studied the change in water porosity over time of 10 Sauvage Bionit-II and 10 DeBakey Vasculour-II knitted velour Dacron grafts throughout the four stages of the Sauvage preclotting technique. Graft porosity decreased significantly (p less than 0.001) at the ends of stages 1 and 2 for both types of grafts, but stages 3 and 4 did not further reduce graft porosity. These results demonstrate that a two-stage preclotting technique is adequate for the preclotting of knitted velour Dacron grafts. A final rinse with heparinized blood is recommended as this may reduce graft thrombogenicity.

Snooks SJ; Croft RJ; Wagner C

1988-04-01

373

[Plaque surgery for Peyronie's disease: heterologous grafts].  

Science.gov (United States)

Surgical treatment of Induratio Penis Plastica includes conservative procedures (phalloplasty), substitutive procedures (prosthesis) and combined procedures (phalloplasty plus prosthesis). Our policy for conservative treatment is based on radical removal of the plaque and replacement with biological patches. During a 15 year experience we employed lyophilized dura mater, autologous dermal graft, preputial skin, cadaveric dermal graft (AlloDerm), venous graft and porcine SIS (Small Intestine Submucosa) graft. Our experience confirms the superiority of venous grafts, but preliminary results with SIS grafts are encouraging. PMID:12868152

Paradiso, Matteo; Sedigh, Omid; Milan, Gian Luca

2003-06-01

374

The cellular biology of tendon grafting.  

UK PubMed Central (United Kingdom)

We investigated the cellular biology of tendon grafting in a mouse model using green fluorescent protein mismatch grafting and quantitative immunohistochemistry of molecular markers for inflammation, proliferation, collagen synthesis, cell death, and myofibroblast/pericyte expression. We provide a detailed analysis of the healing characteristics during the phases of inflammation, synthesis, and remodelling. Our findings indicated that survival of the cells in the grafted tendon was finite. Syngenic and autologous grafts provoked a similar cellular reaction and all grafts healed. Cells in the graft contributed significantly to collagen synthesis and do have a role in healing.

Alam N; McGrouther DA; Wong JK

2013-01-01

375

Natural triglyceride fats  

UK PubMed Central (United Kingdom)

Glyceride fat which comprises a mixture of glycerides originating from seed oils which have not substantially been subjected to chemical modification, which glycerides are derived from fatty acids which comprise (a) at least 10 wt. % of C18-C24 saturated fatty acids (b) which comprise stearic and/or arachidic and/or behenic acid and/or lignoceric acid (c) oleic and/or linoleic acid, while (d) the ratio of saturated C18-acid /saturated (C20+C22+C24)-acids > /=1, preferably > /=5, more preferably > /=10, which glycerides contain calculated on total fatty acid weight (e) < /=5 wt. % of linolenic acid (f) < /=5 wt. % of trans fatty acids (g) < /=75 wt. %, preferably < /=60 wt. % of oleic acid on total fatty acids on position 2 of the glyceride molecule which glycerides contain calculated on total glycerides weight (h) > /=8 wt. % HOH+HHO triglycerides (i) < /=5 wt. % of trisaturated triglycerides (j) which glycerides have a solids content comprising N10> 10 and N35< /=15 and which is characterised in that the ratio of (HOH+HHO) and (HLH+HHL) triglycerides > 1, where H is a saturated C18-C24 fatty acid residue, O is an oleic acid residue and L is a linoleic acid residue.

SASSEN CORNELIS LAURENTIUS; SCHIJF ROBERT; JURIAANSE ADRIAAN CORNELIS

376

NATURAL TRIGLYCERIDE FATS  

UK PubMed Central (United Kingdom)

Glyceride fat which comprises a mixture of glycerides originating from seed oils which have not substantially been subjected to chemical modification, which glycerides are derived from fatty acids which comprise: (a) at least 10 wt.% of C18-C24 saturated fatty acids; (b) which comprise stearic and/or arachidic and/or behenic acid and/or lignoceric acid; (c) oleic and/or linoleic acid, while (d) the ratio of saturated C18-acid/saturated (C20+C22+C24)-acids 1, preferably 5, more preferably 10, which glycerides contain calculated on total fatty acid weight; (e) 5 wt.% of linolenic acid; (f) 5 wt.% of trans fatty acids; (g) 75 wt.%, preferably 60 wt.% of oleic acid on total fatty acids on position 2 of the glyceride molecule which glycerides contain calculated on total glycerides weight; (h) 8 wt.% HOH + HHO triglycerides; (i) 5 wt.% of trisaturated triglycerides; (j) which glycerides have a solids content comprising N10 > 10 and N35 15 and which is characterised in that the ratio of (HOH + HHO) and (HLH + HHL) triglycerides > 1, where H is a saturated C18-C24 fatty acid residue, O is an oleic acid residue and L is a linoleic acid residue.

SASSEN Carlo L.; SCHIJF Robert; JURIAANSE Adriaan Cornelis

377

Impaction grafting of the acetabulum with ceramic bone graft substitute  

Science.gov (United States)

Background and purpose Loss of bone stock remains a challenge in revision hip surgery. Grafting with allograft is well established, but there are problems with availability, cost, infection, antigenicity, reproducibility, and stability of the created construct. BoneSave is a biphasic porous ceramic consisting of sintered 80% tricalcium phosphate and 20% hydroxyapatite. In vitro and in vivo studies, including its use mixed with allograft, have shown good results in impaction grafting. This is the first reported series of its use alone in impaction grafting of the acetabulum. Methods Methods We conducted a retrospective review of a cohort of 43 consecutive patients undergoing impaction grafting of contained acetabular defects by multiple surgeons at a single centre. All patients received uncemented acetabular components. They were followed up radiographically, together with self-reported satisfaction scale (SAPS), Oxford hip score (OHS), and Short-Form 12 (SF12) health survey. Kaplan-Meier survivorship analysis was performed with revision of the acetabular component, revision of any part of the construct, and reoperation as endpoints. Results The fate of all cases was known. Mean follow-up was 4 years. 5 patients died during follow-up, with their constructs in situ. The survivorship of the acetabular component was 98% (95% CI: 85–100) at 7 years. 1 acetabular component was revised for infection and there was 1 radiographic acetabular failure. The median OHS was 36 (6–48), the median SF12 PCS was 36 (14–57), the median SAPS was 75 (0–100), and the median SF12 MCS was 50 (23–64). The graft material had incorporated in all 3 zones of the acetabulum in 33 out of 37 cases with complete radiographic follow-up. Interpretation Medium-term results show that BoneSave alone is a reliable material for impaction grafting of contained defects in the acetabulum at revision surgery.

Dacombe, Peter J; Webb, Jason C J; Blom, Ashley W

2013-01-01

378

Body fat, abdominal fat and body fat distribution related to VO(2PEAK) in young children  

DEFF Research Database (Denmark)

Abstract Objective. Aerobic fitness, defined as maximum oxygen uptake (VO(2PEAK)), and body fat measurements represent two known risk factors for disease. The purpose of this study was to investigate the relationship between VO(2PEAK) and body fat measurements in young children at a population-based level. Methods. Cross-sectional study of 225 children (128 boys and 97 girls) aged 8-11 years, recruited from a population-based cohort. Total lean body mass (LBM), total fat mass (TBF), and abdominal fat mass (AFM) were measured by dual-energy x-ray absorptiometry. Body fat was also calculated as a percentage of body mass (BF%) and body fat distribution as AFM/TBF. VO(2PEAK) was assessed by indirect calorimetry during maximal exercise test. Results. Significant relationships existed between body fat measurements and VO(2PEAK) in both boys and girls, with Pearson correlation coefficients for absolute values of VO(2PEAK) (0.22-0.36, P<0.05), and for VO(2PEAK) scaled by body mass (-0.38 - -0.70, P

Dencker, Magnus; Wollmer, Per

2011-01-01

379

MRI of Hoffa's fat pad  

International Nuclear Information System (INIS)

The infrapatellar fat pad of Hoffa is commonly injured but rarely discussed in the radiological literature. Abnormalities within it most commonly are the consequences of trauma and degeneration, but inflammatory and neoplastic diseases of the synovium can be confined to the fat pad. The commonest traumatic lesions follow arthroscopy, but intrinsic signal abnormalities can also be due to posterior and superior impingements syndromes and following patellar dislocation. Infrapatellar plica syndrome may also be traumatic in aetiology. The precise aetiology of ganglion cysts is not understood; the principal differential diagnosis is a meniscal or cruciate cyst. Hoffa's fat pad contains residual synovial tissue, meaning that primary neoplastic conditions of synovium may originate and be confined to the fat pad. Inflammatory changes along the posterior border of the pad may also be used to help differentiate effusion from acute synovitis on unenhanced MR examinations. (orig.)

2004-01-01

380

Causes of corneal graft failure in India  

Directory of Open Access Journals (Sweden)

Full Text Available The success of corneal grafting in visual rehabilitation of the corneal blind in India depends on survival of the grafts. Understanding the causes of graft failure may help reduce the risk of failure. We studied these causes in a series of 638 graft failures at our institution. Multivariate logistic regression analysis was used to evaluate the association of particular causes of graft failure with indications for grafting, socioeconomic status, age, sex, host corneal vascularization, donor corneal quality, and experience of surgeon. The major causes of graft failure were allograft rejection (29.2%), increased intraocular pressure (16.9%), infection excluding endophthalmitis (15.4%), and surface problems (12.7%). The odds of infection causing graft failure were significantly higher in patients of lower socioeconomic status (odds ratio 2.45, 95% CI 1.45-4.15). Surface problems as a cause of graft failure was significantly associated with grafts done for corneal scarring or for regrafts (odds ratio 3.36, 95% CI 1.80-6.30). Increased intraocular pressure as a cause of graft failure had significant association with grafts done for aphakic or pseudophakic bullous keratopathy, congenital conditions or glaucoma, or regrafts (odds ratio 2.19, 95% CI 1.25-3.84). Corneal dystrophy was the indication for grafting in 12 of the 13 cases of graft failure due to recurrence of host disease. Surface problems, increased intraocular pressure, and infection are modifiable risk factors that are more likely to cause graft failure in certain categories of patients in India. Knowledge about these associations can be helpful in looking for and aggressively treating these modifiable risk factors in the at-risk categories of corneal graft patients. This can possibly reduce the chance of graft failure.

Dandona Lalit; Naduvilath Thomas; Janarthanan M; Rao Gullapalli

1998-01-01