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Sample records for surgery integrating cephalometry

  1. An orthognathic simulation system integrating teeth, jaw and face data using 3D cephalometry.

    Science.gov (United States)

    Noguchi, N; Tsuji, M; Shigematsu, M; Goto, M

    2007-07-01

    A method for simulating the movement of teeth, jaw and face caused by orthognathic surgery is proposed, characterized by the use of 3D cephalometric data for 3D simulation. Computed tomography data are not required. The teeth and facial data are obtained by a laser scanner and the data for the patient's mandible are reconstructed and integrated according to 3D cephalometry using a projection-matching technique. The mandibular form is simulated by transforming a generic model to match the patient's cephalometric data. This system permits analysis of bone movement at each individual part, while also helping in the choice of optimal osteotomy design considering the influences on facial soft-tissue form.

  2. Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry.

    Science.gov (United States)

    Rustemeyer, Jan; Martin, Alice

    2013-03-01

    Since improvement of facial aesthetics after orthognathic surgery moves increasingly into the focus of patients, prediction of soft tissue response to hard tissue movement becomes essential for planning. The aim of this study was to assess the facial soft tissue response in skeletal class II and III patients undergoing orthognathic surgery and to compare the potentials of cephalometry and two-dimensional (2-D) photogrammetry for predicting soft tissue changes. Twenty-eight patients with class II relationship and 33 with class III underwent bimaxillary surgery. All subjects had available both a traced lateral cephalogram and a traced lateral photogram taken pre- and postsurgery in natural head position (median follow-up, 9.4 ± 0.6 months). Facial convexity and lower lip length were highly correlated with hard tissue movements cephalometrically in class III patients and 2-D photogrammetrically in both classes. In comparison, cephalometric correlations for class II patients were weak. Correlations of hard and soft tissue movements between pre- and postoperative corresponding landmarks in horizontal and vertical planes were significant for cephalometry and 2-D photogrammetry. No significant difference was found between cephalometry and 2-D photogrammetry with respect to soft to hard tissue movement ratios. This study revealed that cephalometry is still a feasible standard for evaluating and predicting outcomes in routine orthognathic surgery cases. Accuracy could be enhanced with 2-D photogrammetry, especially in class II patients.

  3. Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry

    OpenAIRE

    Rustemeyer, Jan; Martin, Alice

    2012-01-01

    Purpose Since improvement of facial aesthetics after orthognathic surgery moves increasingly into the focus of patients, prediction of soft tissue response to hard tissue movement becomes essential for planning. The aim of this study was to assess the facial soft tissue response in skeletal class II and III patients undergoing orthognathic surgery and to compare the potentials of cephalometry and two-dimensional (2-D) photogrammetry for predicting soft tissue changes. Material and methods Twe...

  4. Volumetric, planar, and linear analyses of pharyngeal airway change on computed tomography and cephalometry after mandibular setback surgery.

    Science.gov (United States)

    Park, Jae-Woo; Kim, Nam-Kug; Kim, Jong-Wan; Kim, Myung-Jin; Chang, Young-Il

    2010-09-01

    The purpose of this study was to use lateral cephalometry and computed tomography (CT) to examine the volumetric, planar, and linear changes in the pharyngeal airway after mandibular setback surgery. The pharyngeal airways of 12 subjects who underwent mandibular setback surgery at Seoul National University Dental Hospital were assessed linearly and volumetrically on lateral cephalometric radiographs and CT before surgery and 6 months after surgery. The pharynx, nasopharynx, and oropharynx were evaluated by volumetric analysis. Pharyngeal depth, airway space, pharyngeal soft-tissue thickness, and hyoid bone position were measured by linear analysis. The axial section area of the airway was measured by area analysis. From the linear analysis, a significant decrease in pharyngeal depth and a significant posterior movement of the hyoid bone (P 0.05). Although the structures around the mandible inevitably moved backward after mandibular setback surgery on linear analysis, physiologic deformation could occur to preserve the airway capacity after sagittal compression. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  5. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 2: three-dimensional cephalometry.

    Science.gov (United States)

    Xia, J J; Gateno, J; Teichgraeber, J F; Yuan, P; Li, J; Chen, K-C; Jajoo, A; Nicol, M; Alfi, D M

    2015-12-01

    Three-dimensional (3D) cephalometry is not as simple as just adding a 'third' dimension to a traditional two-dimensional cephalometric analysis. There are more complex issues in 3D analysis. These include how reference frames are created, how size, position, orientation and shape are measured, and how symmetry is assessed. The main purpose of this article is to present the geometric principles of 3D cephalometry. In addition, the Gateno-Xia cephalometric analysis is presented; this is the first 3D cephalometric analysis to observe these principles. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Cephalometry in orthodontic practice

    International Nuclear Information System (INIS)

    Theunissen, J.J.W.; Terlingen, P.J.A.M.

    1980-01-01

    Cephalometry is applied in orthodontic practice to: - obtain information on the growth of the skull - assist diagnosis of the relationship between the jaws and abnormalities in dentition - evaluate the results of treatment. The course of the diagnostic procedure with the aid of the Ricketts analysis and evaluation of the treatment results using five superimpositions is demonstrated by means of two examples. (Auth.)

  7. [Cephalometry of Li people through 3-dimensional CT].

    Science.gov (United States)

    You, Wen-Jian; Huang, Lü-Ping; Li, Jian-Jun; Wu, Nian; Zhan, Wang; Liu, Yun

    2008-09-01

    To investigate the skull characteristics of the Li people in Hainan through 3-D CT. CT scan and 3-D reconstruction are very helpful for the cephalometry including the distance and angle measurement. The image can also be enlarged to make the measurement more precisely. 80 Li volunteers underwent the cephalometry through 3-D CT. The data were analyzed and compared with those an people. The results showed difference between the genders of Li people. Compared with Han people, Li people has their own facial characteristics, such as wider face and wider orbital distance. Cephalometry through 3-D CT can show the skull characteristics precisely. The data in this study has great significance in craniomaxillofacial surgery and ethnology.

  8. Noninvasive computerized scanning method for the correlation between the facial soft and hard tissues for an integrated three-dimensional anthropometry and cephalometry.

    Science.gov (United States)

    Galantucci, Luigi Maria; Percoco, Gianluca; Lavecchia, Fulvio; Di Gioia, Eliana

    2013-05-01

    The article describes a new methodology to scan and integrate facial soft tissue surface with dental hard tissue models in a three-dimensional (3D) virtual environment, for a novel diagnostic approach.The facial and the dental scans can be acquired using any optical scanning systems: the models are then aligned and integrated to obtain a full virtual navigable representation of the head of the patient. In this article, we report in detail and further implemented a method for integrating 3D digital cast models into a 3D facial image, to visualize the anatomic position of the dentition. This system uses several 3D technologies to scan and digitize, integrating them with traditional dentistry records. The acquisitions were mainly performed using photogrammetric scanners, suitable for clinics or hospitals, able to obtain high mesh resolution and optimal surface texture for the photorealistic rendering of the face. To increase the quality and the resolution of the photogrammetric scanning of the dental elements, the authors propose a new technique to enhance the texture of the dental surface. Three examples of the application of the proposed procedure are reported in this article, using first laser scanning and photogrammetry and then only photogrammetry. Using cheek retractors, it is possible to scan directly a great number of dental elements. The final results are good navigable 3D models that integrate facial soft tissue and dental hard tissues. The method is characterized by the complete absence of ionizing radiation, portability and simplicity, fast acquisition, easy alignment of the 3D models, and wide angle of view of the scanner. This method is completely noninvasive and can be repeated any time the physician needs new clinical records. The 3D virtual model is a precise representation both of the soft and the hard tissue scanned, and it is possible to make any dimensional measure directly in the virtual space, for a full integrated 3D anthropometry and

  9. Fully automated quantitative cephalometry using convolutional neural networks.

    Science.gov (United States)

    Arık, Sercan Ö; Ibragimov, Bulat; Xing, Lei

    2017-01-01

    Quantitative cephalometry plays an essential role in clinical diagnosis, treatment, and surgery. Development of fully automated techniques for these procedures is important to enable consistently accurate computerized analyses. We study the application of deep convolutional neural networks (CNNs) for fully automated quantitative cephalometry for the first time. The proposed framework utilizes CNNs for detection of landmarks that describe the anatomy of the depicted patient and yield quantitative estimation of pathologies in the jaws and skull base regions. We use a publicly available cephalometric x-ray image dataset to train CNNs for recognition of landmark appearance patterns. CNNs are trained to output probabilistic estimations of different landmark locations, which are combined using a shape-based model. We evaluate the overall framework on the test set and compare with other proposed techniques. We use the estimated landmark locations to assess anatomically relevant measurements and classify them into different anatomical types. Overall, our results demonstrate high anatomical landmark detection accuracy ([Formula: see text] to 2% higher success detection rate for a 2-mm range compared with the top benchmarks in the literature) and high anatomical type classification accuracy ([Formula: see text] average classification accuracy for test set). We demonstrate that CNNs, which merely input raw image patches, are promising for accurate quantitative cephalometry.

  10. Surgical correction of nasal obstruction in the treatment of mild sleep apnoea: importance of cephalometry in predicting outcome.

    Science.gov (United States)

    Sériès, F; St Pierre, S; Carrier, G

    1993-01-01

    BACKGROUND--A study was undertaken to determine if cephalometric radiographs could identify those who will benefit from nasal surgery in patients with a sleep apnoea hypopnoea syndrome (SAHS) and chronic nasal obstruction. METHODS--Fourteen patients with SAHS were enrolled. Those with normal posterior airway space and mandibular plane to hyoid bone distances on preoperative cephalometric radiographs were matched with those with abnormal cephalometry for the frequency of sleep disordered breathing and body mass index. Polysomnographic studies (all subjects) and nasal resistance measurements (n = 10) were performed one to three months before and two to three months after surgery (septoplasty, turbinectomy, and polypectomy). RESULTS--There was no difference in the baseline results of the polysomnographic studies between the two groups of patients. Nasal resistance decreased from a mean (SE) value of 2.9 (0.3) cm H2O/l/s before surgery to 1.4 (0.1) cm H2O/l/s after surgery in the normal cephalometry group and from 2.7 (0.3) cm H2O/l/s to 1.3 (0.3) cm H2O/l/s in the other group. The apnoea + hypopnoea index returned to normal (cephalometry. CONCLUSIONS--Normal cephalometry is helpful in identifying patients with mild SAHS and nasal obstruction who will benefit from nasal surgery. The presence of craniomandibular abnormalities makes it unlikely that nasal surgery will improve sleep related breathing abnormalities. PMID:8511733

  11. Optimizing Hybrid Occlusion in Face-Jaw-Teeth Transplantation: A Preliminary Assessment of Real-Time Cephalometry as Part of the Computer-Assisted Planning and Execution Workstation for Craniomaxillofacial Surgery.

    Science.gov (United States)

    Murphy, Ryan J; Basafa, Ehsan; Hashemi, Sepehr; Grant, Gerald T; Liacouras, Peter; Susarla, Srinivas M; Otake, Yoshito; Santiago, Gabriel; Armand, Mehran; Gordon, Chad R

    2015-08-01

    The aesthetic and functional outcomes surrounding Le Fort-based, face-jaw-teeth transplantation have been suboptimal, often leading to posttransplant class II/III skeletal profiles, palatal defects, and "hybrid malocclusion." Therefore, a novel technology-real-time cephalometry-was developed to provide the surgical team instantaneous, intraoperative knowledge of three-dimensional dentoskeletal parameters. Mock face-jaw-teeth transplantation operations were performed on plastic and cadaveric human donor/recipient pairs (n = 2). Preoperatively, cephalometric landmarks were identified on donor/recipient skeletons using segmented computed tomographic scans. The computer-assisted planning and execution workstation tracked the position of the donor face-jaw-teeth segment in real time during the placement/inset onto recipient, reporting pertinent hybrid cephalometric parameters from any movement of donor tissue. The intraoperative data measured through real-time cephalometry were compared to posttransplant measurements for accuracy assessment. In addition, posttransplant cephalometric relationships were compared to planned outcomes to determine face-jaw-teeth transplantation success. Compared with postoperative data, the real-time cephalometry-calculated intraoperative measurement errors were 1.37 ± 1.11 mm and 0.45 ± 0.28 degrees for the plastic skull and 2.99 ± 2.24 mm and 2.63 ± 1.33 degrees for the human cadaver experiments. These results were comparable to the posttransplant relations to planned outcome (human cadaver experiment, 1.39 ± 1.81 mm and 2.18 ± 1.88 degrees; plastic skull experiment, 1.06 ± 0.63 mm and 0.53 ± 0.39 degrees). Based on this preliminary testing, real-time cephalometry may be a valuable adjunct for adjusting and measuring "hybrid occlusion" in face-jaw-teeth transplantation and other orthognathic surgical procedures.

  12. Experimental and clinical assessment of three-dimensional cephalometry: a systematic review.

    Science.gov (United States)

    Smektała, T; Jędrzejewski, M; Szyndel, J; Sporniak-Tutak, K; Olszewski, R

    2014-12-01

    This study provides a systematic review of the current scientific literature on three-dimensional (3D) cephalometry. The null hypothesis was that 3D cephalometry is an accurate and reproducible diagnostic technique. To examine this hypothesis, the following three research questions were proposed: 1) What is the accuracy of 3D cephalometric measurements compared to in vitro measurements? 2) What is the intra- and inter-observer reliability of the selection of 3D cephalometric landmarks? 3) What is the reproducibility of the linear and angular measurements? A comprehensive database search was performed, using Medline, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar. The titles and abstracts obtained from the search were screened and evaluated by two observers according to the inclusion and exclusion criteria. The evaluation process yielded 21 articles. A high level of agreement (cephalometry was observed and some landmarks provided highly reproducible results. However, the linear (0.04-7.49 mm) and angular (0.99-9.30°) measurements differed greatly. The null hypothesis was rejected. This study indicates critical points regarding 3D cephalometry and provides guidance for future research in this field. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Usefulness of cephalometry in sparing polysomnography of patients with suspected obstructive sleep apnea.

    Science.gov (United States)

    Julià-Serdà, Gabriel; Pérez-Peñate, Gregorio; Saavedra-Santana, Pedro; Ponce-González, Miguel; Valencia-Gallardo, José Manuel; Rodríguez-Delgado, Raquel; Cabrera-Navarro, Pedro

    2006-12-01

    The aim of this investigation was to evaluate the contribution of cephalometry to a statistical model integrating clinical, physical, and oximetric variables, to reduce demands for polysomnographies. Two hundred and twenty-five consecutive patients that had been referred to the sleep clinic for suspected obstructive sleep apnea (OSA) were studied. The clinical assessment of all patients consisted of a sleep related questionnaire, the Epworth sleepiness scale, and a physical examination. In addition, they all underwent spirometry, cephalometry, and a full polysomnography. The clinical variables related with OSA were questions concerning witnessing of apneas by bed partners, intensity of snoring, a history of hypertension, and nocturia. A significant relation was also found with score on the Epworth scale, sex, age, body mass index, neck and waist circumferences, total number and frequency of oxygen desaturations, and the lowest oxygen saturation value. Significant cephalometric measurements were: the linear distance from gonion to gnathion, from the hyoid bone to the mandibular plane, and from the posterior nasal spine to the tip of the soft palate, and the thickness of the uvula as well. A statistical model was built to estimate a patient's probability of having OSA based on clinical variables, physical examination, pulse oximetry, and cephalometry. The validation of this model demonstrated a remarkable ability in reducing the number of polysomnographic studies. We conclude that cephalometry combined with clinical variables, physical examination, and nocturnal oximetry is useful in the diagnosis of OSA and enables the sparing of a considerable number of polysomnographies.

  14. Cephalometry.

    Science.gov (United States)

    Taub, Peter J

    2007-07-01

    With the development of x-ray technology and its application to the craniofacial skeleton, numerous landmarks have been described and studied to better diagnose and plan treatment options for anomalies related to facial architecture. The following text serves to highlight the important landmarks and illustrate how they may be used to plan successful orthognathic reconstruction.

  15. The evaluation of a novel haptic-enabled virtual reality approach for computer-aided cephalometry.

    Science.gov (United States)

    Medellín-Castillo, H I; Govea-Valladares, E H; Pérez-Guerrero, C N; Gil-Valladares, J; Lim, Theodore; Ritchie, James M

    2016-07-01

    In oral and maxillofacial surgery, conventional radiographic cephalometry is one of the standard auxiliary tools for diagnosis and surgical planning. While contemporary computer-assisted cephalometric systems and methodologies support cephalometric analysis, they tend neither to be practical nor intuitive for practitioners. This is particularly the case for 3D methods since the associated landmarking process is difficult and time consuming. In addition to this, there are no 3D cephalometry norms or standards defined; therefore new landmark selection methods are required which will help facilitate their establishment. This paper presents and evaluates a novel haptic-enabled landmarking approach to overcome some of the difficulties and disadvantages of the current landmarking processes used in 2D and 3D cephalometry. In order to evaluate this new system's feasibility and performance, 21 dental surgeons (comprising 7 Novices, 7 Semi-experts and 7 Experts) performed a range of case studies using a haptic-enabled 2D, 2½D and 3D digital cephalometric analyses. The results compared the 2D, 2½D and 3D cephalometric values, errors and standard deviations for each case study and associated group of participants and revealed that 3D cephalometry significantly reduced landmarking errors and variability compared to 2D methods. Through enhancing the process by providing a sense of touch, the haptic-enabled 3D digital cephalometric approach was found to be feasible and more intuitive than its counterparts as well effective at reducing errors, the variability of the measurements taken and associated task completion times. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Impact of integrated programs on general surgery operative volume.

    Science.gov (United States)

    Jensen, Amanda R; Nickel, Brianne L; Dolejs, Scott C; Canal, David F; Torbeck, Laura; Choi, Jennifer N

    2017-03-01

    Integrated residencies are now commonplace, co-existing with categorical general surgery residencies. The purpose of this study was to define the impact of integrated programs on categorical general surgery operative volume. Case logs from categorical general, integrated plastics, vascular, and thoracic surgery residents from a single institution from 2008 to 2016 were collected and analyzed. Integrated residents have increased the number of cases they perform that would have previously been general surgery resident cases from 11 in 2009-2010 to 1392 in 2015-2016. Despite this, there was no detrimental effect on total major cases of graduating chief residents. Multiple integrated programs can co-exist with a general surgery program through careful collaboration and thoughtful consideration to longitudinal needs of individual trainees. As additional programs continue to be created, both integrated and categorical program directors must continue to collaborate to insure the integrity of training for all residents. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Comparison of Ultrasound Cephalometry, Radiology, and Liquor Studies in Patients with Unknown Confinement Dates*

    Science.gov (United States)

    Underhill, Rosemary A.; Beazley, John M.; Campbell, Stuart

    1971-01-01

    The accuracy of predicting fetal maturity by ultrasound cephalometry, radiology, and liquor studies in patients with unknown confinement dates has been compared. The best prediction was given by ultrasound cephalometry. Liquor studies were least helpful. PMID:4106479

  18. Lateral cephalometry changes after SARPE.

    Science.gov (United States)

    Parhiz, A; Schepers, S; Lambrichts, I; Vrielinck, L; Sun, Y; Politis, C

    2011-07-01

    Surgically assisted rapid palatal expansion (SARPE) is associated with postoperative cephalometric changes. In this study we analyse these changes in the sagittal plane in orthognathic patients undergoing SARPE followed by orthodontic treatment and Le Fort I, bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery. This is a retrospective review of 50 patients (20 males, 30 females) undergoing orthognathic treatment with SARPE to correct transversal deficiency of the maxilla as part of a comprehensive treatment plan. PP-SN, SNA, and ANB angles were increased and U1-SN and U1-PP angles were decreased. All changes were statistically significant. Changes of SNB, PP-Mand plane angle, and SN-Mand. plane angle were not statistically significant. Surgically assisted rapid palatal expansion using a bone-borne appliance as a preparative step for later orthognathic surgery results in clockwise rotation of the maxilla. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Contribution of postero-anterior cephalometry in obstructive sleep apnea.

    Science.gov (United States)

    Poirrier, Anne-Lise; Pire, Sylvie; Raskin, Sylviane; Limme, Michel; Poirrier, Robert

    2012-10-01

    Lateral cephalometry has been widely used to characterize facial and maxillary morphology in obstructive sleep apnea (OSA) patients. It is a useful tool to assess orthodontic and maxillofacial procedures, but transverse dimensions of the airway (e.g., nasal framework) have not been well described yet by cephalometry. We explored whether postero-anterior cephalometry could refine the analysis of the facial morphology, with a special attention paid to nasal morphology. We validated cephalometric measurements relevant to the diagnosis of OSA. Controlled study. We explored postero-anterior and lateral cephalometric bony structures in OSA patients and in control subjects to determine which were predictive of an association with OSA. Healthy volunteers paired for age and sex to OSA patients underwent polysomnography and cephalometry. Data were analyzed by Shapiro-Wilk, Fisher, Wilcoxon, and paired t tests where appropriate. Nasal fossae and maxillary bone proportions were positively and independently associated with the absence of OSA. Measurements of maxillary width, nasal fossae angle, and anterior skull base contributed to the characterization of OSA patients. Postero-anterior cephalometry is an easy, rapid, informative, and reliable technique, which is complementary to the lateral cephalometry in the assessment of OSA patients. Our study may also suggest the negative impact of the nasal resistance on the upper airway resistance in sleep disorders. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  20. [Development of an analysis system for X-ray cephalometry by Windows platform].

    Science.gov (United States)

    Wang, Hai-bin; Zhang, Yang; Chen, Shi-pei; Hu, Wei; Wang, Jian-qi; Yang, Bo; Duan, Yin-zhong

    2002-07-01

    Here in this paper introduced is an analysis system for X-ray cephalometry developed through Windows platform,which includes three parts: data input, cephalometry analysis & calculation, and display & printing of diagnostic results. It has been applied in orthodontic department of Stomatological Hospital of the Fourth Military Medical University, and it is quite convenient for doctors' cephalometry diagnosis.

  1. Virtual reality simulator for vitreoretinal surgery using integrated OCT data.

    Science.gov (United States)

    Kozak, Igor; Banerjee, Pat; Luo, Jia; Luciano, Cristian

    2014-01-01

    Operative practice using surgical simulators has become a part of training in many surgical specialties, including ophthalmology. We introduce a virtual reality retina surgery simulator capable of integrating optical coherence tomography (OCT) scans from real patients for practicing vitreoretinal surgery using different pathologic scenarios.

  2. Evolving Perceptions of the Plastic Surgery Integrated Residency Training Program.

    Science.gov (United States)

    Pace, Elizabeth; Mast, Bruce; Pierson, Justine M; Leavitt, Adam; Reintgen, Christian

    2016-01-01

    In recent years, there has been a transition in plastic surgery residency training. Many programs across the country are now using integrated training modalities vs. independent training programs. This change in residency training has brought into question the effectiveness of integrated residency programs, in which medical students immediately enter the plastic surgery specialty upon graduation. This study assessed plastic surgery residency program directors and faculty members׳ viewpoints on the transition to integrated training programs and the effect this transition has had on the training of plastic surgery residents. An anonymous 13-question survey was formulated using a pilot survey sent to members of the plastic surgery department at the University of Florida. The final survey was then electronically sent via SurveyMonkey.com to 92 current plastic surgery residency program directors. Program directors were identified via program lists provided by the American Council of Academic Surgeons. Program directors were then asked to forward the survey to faculty members of their respective institutions. Responses collected were analyzed via SurveyMonkey.com and Microsoft Excel. University of Florida College of Medicine, Department of Plastic Surgery. Plastic surgery residency program directors as identified by the American Council of Academic Surgeons. A response rate of 40.2% was achieved via 37 of the 92 plastic surgery program directors responding to the electronic survey. An additional 6 anonymous faculty members also responded to the survey, 13.9% of all responses. Institutions indicated that the majority was using integrated residency programs, with some institutions using both integrated and independent training programs simultaneously. Most respondents indicated that they supported the transition to the integrated residency program at their respective institutions. Respondents indicated several reasons as to why or why not programs have transitioned to the

  3. Role of magnetic resonance imaging cephalometry in obstructive sleep apnoea.

    Science.gov (United States)

    Moorthy, N L N; Reddy, P Navaneeth Sagar; Aruna, T; Chander, D Mahesh

    2014-01-01

    Obstructive sleep apnoea (OSA) is one of the most common public health problems in adults. Patients with OSA are prone for excessive adipose tissue deposition in the neck, which in turn, increases the upper airway narrowing. Of the imaging modalities available for assessing the upper airway, magnetic resonance imaging (MRI) is found to be useful technique for defining soft tissue abnormalities. We prospectively studied 50 patients presenting with OSA and 50 normal controls to evaluate the role of MRI cephalometry in the diagnosis of OSA and compared the cross-sectional area and antero-posterior diameter of the upper airway in the retro-palatal airway and retro-glossal areas by MRI cephalometry. In comparison with controls, cases had a significantly lower cross-sectional area and antero-posterior diameter of the upper airway in the retro-palatal airway and retro-glossal areas. Our observations suggest that MRI cephalometry is a sensitive technique for the diagnosis of OSA.

  4. A comparative study of computed radiographic cephalometry and conventional cephalometry in reliability of head film measurements

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Done; Kim, Kee Deog; Park, Chang Seo [Dept. of Dental Radiology, College of Dentistry, Yensei University, Seoul(Korea, Republic of)

    1997-02-15

    The purpose of this study was to compare and to find out the variability of head film measurements (landmarks identification) between Fuji computed radiographic cephalometry and conventional cephalometry. 28 Korean adults were selected. Lateral cephalometric FCR film and conventional cephalometric film of each subject was taken. Four investigators identified 24 cephalometric landmarks on lateral cephalometric FCR film and conventional cephalometric film were statistically analysed. The results were as follows : 1. In FCR film and conventional film, coefficient of variation (C.V.) of 24 landmarks was taken horizontally and vertically. 2. In comparison of significant differences of landmarks variability between FCR film and conventional film, horizontal l value of coefficient of variation showed significant differences in four landmarks among twenty-four landmarks, but vertical a value of coefficient of variation showed significant differences in sixteen landmarks among twenty-four landmarks. FCR film showed significantly less variability than conventional film in 17 subjects among 20 (4+16) subjects that sho wed significant difference.

  5. A comparative study of computed radiographic cephalometry and conventional cephalometry in reliability of head film measurements

    International Nuclear Information System (INIS)

    Kim, Hyung Done; Kim, Kee Deog; Park, Chang Seo

    1997-01-01

    The purpose of this study was to compare and to find out the variability of head film measurements (landmarks identification) between Fuji computed radiographic cephalometry and conventional cephalometry. 28 Korean adults were selected. Lateral cephalometric FCR film and conventional cephalometric film of each subject was taken. Four investigators identified 24 cephalometric landmarks on lateral cephalometric FCR film and conventional cephalometric film were statistically analysed. The results were as follows : 1. In FCR film and conventional film, coefficient of variation (C.V.) of 24 landmarks was taken horizontally and vertically. 2. In comparison of significant differences of landmarks variability between FCR film and conventional film, horizontal l value of coefficient of variation showed significant differences in four landmarks among twenty-four landmarks, but vertical a value of coefficient of variation showed significant differences in sixteen landmarks among twenty-four landmarks. FCR film showed significantly less variability than conventional film in 17 subjects among 20 (4+16) subjects that sho wed significant difference.

  6. Evaluation of vertical parameters in cephalometry.

    Science.gov (United States)

    Bock, Jens Johannes; Fuhrmann, Robert A W

    2007-05-01

    The aim of this study was to determine the validity of different vertical parameters in cephalometry. The cephalograms of 94 patients were used in this study. The inclusion criteria were as follows: skeletal Class I, completion of maximum skeletal growth, and no history of orthodontic therapy. The control group consisted of 34 subjects with very good occlusion (overbite 2-4 mm). The patients were classified with the help of dental casts: Group 1 (n = 31) patients with cover-bite (overbite > 5.5 mm) and Group 2 (n = 29) patients with anterior open bite (overbite < -0.5 mm). In addition to the 24 standard cephalometric measurements (Bergen-Analysis), we included individualized norm values (Segner & Hasund), the Overbite Depth Indicator (ODI) described by Kim, the Denture Frame Analysis (DFA) described by Sato, and facial-type evaluations according to Schopf. We observed significant differences among the three study groups in all the vertical parameters tested. We demonstrated statistically-significant classification results for the Segner & Hasund harmony box's individualized norm values (83.8%), and those of the ODI (77.7%) and ML-AB angle (76.6%). Based on the vertical cephalometric parameters, we succeeded in statistically differentiating among the groups with open bite, cover-bite and the control group. Various measurements must be taken to ensure that the cephalometric vertical relationships are reliably evaluated.

  7. An Updated View of the Integrated Plastic Surgery Match.

    Science.gov (United States)

    Borsting, Emily A; Chim, Jimmy H; Thaller, Seth R

    2015-11-01

    Plastic surgery is one the most competitive residency programs. Data on match trends for plastic surgery residencies and traits of successful applicants are necessary for individuals applying into this highly desirable specialty. Analyze recent trends in the independent and integrated match as well as to describe attributes of successful applicants. Data from National Resident Matching Program and San Francisco Match Program for 2007 to 2014 were compiled and analyzed. Statistical analysis and figure creation were performed using the R software package. For bivariate associations, χ or Fisher's exact test was used. The number of available integrated plastic surgery positions through National Resident Matching Program has increased since 2007, whereas the number of independent residencies offered through the SF Match has steadily decreased. The average Step 2 scores, The number of research presentations, publications, abstracts, and the percent of students ranking plastic surgery only have increased. In a break from previous trends, percent of applicants with Alpha Omega Alpha (AOA) membership and mean Step 1 board scores decreased. United States medical school applicants who matched were more likely to be AOA members and graduates from a top 40 medical school. There was no significant association between having an additional academic degree and successfully matching into integrated plastic surgery. Integrated plastic surgery residency programs continue to be highly competitive, with overall increasing research experience, but slightly lower Step 1 scores and AOA membership than that in previous years. If the trend of decreasing independent and increasing integrated positions continues, the applicant only interested in plastic surgery may find the integrated pathway a more feasible option.

  8. 3D cephalometry: a new approach for landmark identification and image orientation

    OpenAIRE

    Van Cauter, Sofie

    2008-01-01

    Cephalometry is the scientific study of the measurement of the head in relation to specific reference points. In 3D CT cephalometry, these points are identified on three-dimensional surface models generated from computed tomography scans. In this study a new approach for 3D cephalometry is presented, which should improve reproducibility of the technique and allow accurate comparison of pre- and postoperative data.

  9. [3-dimensional CT cephalometry before and after mandibular angle osteotomy and its clinical significance].

    Science.gov (United States)

    Li, Hui-Chao; Li, Dong-Mei; Zhang, Zhi-Yong; Lü, Chang-Sheng; Liu, Yu-Feng; Zhang, Ji; Gui, Lai

    2008-05-01

    To investigate the change of skeleton structure and masseter after mandibular angle osteotomy and its clinical significance in preoperative design. 3-dimensional CT cephalometry was performed before and after surgery in 18 cases of prominent mandibular angle. Pre- and post-operative data were compared. Significant differences between the pre- and post-operative data were found in the mandibular angle, the distance between mandibular angle, length of ramus, ectropion angle of mandibular angle, triangle Go-Me-Go, the thickness, width and length of masseter. It indicates the skeleton structure is changed and some kind of atrophy happens in the masseter after operation. So we suggest partial resection of masseter should be unnecessary for mandibular angle osteotomy.

  10. Comparison of the integrated vascular surgery resident operative experience and the traditional vascular surgery fellowship.

    Science.gov (United States)

    Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

    2017-07-01

    After almost 10 years since its approval, residents in integrated vascular surgery training programs now outnumber traditional vascular fellows. We examined the Accreditation Council for Graduate Medical Education (ACGME) case log data to assess whether there is a difference in operative experience between the graduating integrated residents and vascular fellows. We analyzed the total clinical experience of vascular surgery trainees during the academic years between 2012 and 2014 for the 30 graduated integrated vascular surgery residents (VSRs) and the 243 graduated vascular surgery fellows (VSFs). Data were compared on the basis of reported categories defined by the ACGME operation reporting system. VSR case totals were calculated by combining "surgeon chief," "surgeon junior," and "secondary procedures" categories. VSF "surgeon fellow" and "secondary procedures" case totals were combined with all vascular cases done in general surgery residency (using averages of general surgery resident ACGME case log data from the same years) to reflect their total vascular experience. The average total vascular experience reported by VSRs was 1446.0 compared with 1421.8 for VSFs (P = .2086). VSRs performed 694.7 major vascular procedures on average compared with 616.3 major cases for VSFs (P = .0106). Highlighted comparisons include the following: open aortic aneurysm cases, VSRs 20.6 and VSFs 22.2 (P = .320); endovascular aortic aneurysm cases, VSRs 80.0 and VSFs 80.6 (P = .945); cerebrovascular cases, VSRs 78.8 and VSFs 85.0 (P = .1132); and peripheral obstructive cases, VSRs 343.6 and VSFs 293.4 (P = .0032). Integrated VSRs and traditional VSFs graduate with comparable overall vascular surgery clinical experience. VSRs reported, on average, a significantly higher number of major vascular procedures during their tenure as trainees as well as a significantly increased number of cases in six of the other ACGME categories. Copyright © 2017 Society for Vascular Surgery

  11. The role of cephalometry in assessing velopharyngeal dysfunction in velocardiofacial syndrome.

    Science.gov (United States)

    Veerapandiyan, Aravindhan; Blalock, David; Ghosh, Srija; Ip, Edward; Barnes, Craig; Shashi, Vandana

    2011-04-01

    To report our experience with cephalometry in evaluating velopharyngeal dysfunction (VPD) in velocardiofacial syndrome (VCFS) and its utility in assessing the role of cervical spine abnormalities in VPD, prior to surgical correction of VPD. Clinical charts and cephalometric radiographs done prior to surgery for VPD were retrospectively analyzed to ascertain velopharyngeal measurements and cervical spine abnormalities. Twenty-six patients (age: 6-23 years) with molecularly confirmed VCFS. Wake Forest University Health Sciences (1997-2005). Cranial base angle, nasopharyngeal depth, velum length, and Need ratio at rest, velar dimple location, and velopharyngeal length during phonation; information on presence/absence of submucous cleft palate and cervical spine abnormalities were also obtained. The relationship between C1 anterior arch abnormalities and Need ratio was examined. Seventy-three percent of the VCFS patients had excessive nasopharyngeal depth, 80% had an abnormal Need ratio, 50% had a short velum, 81% had a submucous or occult submucous cleft palate, 90.5% had a cervical spine abnormality (C1 anterior arch abnormalities in 38%) and 11.5% had platybasia. There was a significant difference in the Need ratio between patients with and without C1 anterior arch abnormalities. Cephalometry can be used to delineate factors such as C1 vertebral abnormalities, excessive pharyngeal depth, and short velum that contribute to VPD in VCFS. This would help otolaryngologists better understand the anatomy prior to surgical treatment of VPD. This is the first study to highlight the frequent occurrence of C1 anterior arch abnormalities in VCFS. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc., Rhinological, and Otological Society, Inc.

  12. Virtual reality simulator for vitreoretinal surgery using integrated OCT data

    OpenAIRE

    Kozak, Igor; Banerjee, Pat; Luo, Jia; Luciano, Cristian

    2014-01-01

    Igor Kozak,1 Pat Banerjee,2 Jia Luo,2 Cristian Luciano21King Khaled Eye Specialist Hospital, Vitreoretinal Division, Riyadh, Kingdom of Saudi Arabia; 2College of Engineering, University of Illinois at Chicago, Chicago, IL, USAAbstract: Operative practice using surgical simulators has become a part of training in many surgical specialties, including ophthalmology. We introduce a virtual reality retina surgery simulator capable of integrating optical coherence tomography (OCT) scans from real p...

  13. Comparison of drug-induced sleep endoscopy and lateral cephalometry in obstructive sleep apnea.

    Science.gov (United States)

    George, Jonathan R; Chung, Sooyoun; Nielsen, Ib; Goldberg, Andrew N; Miller, Arthur; Kezirian, Eric J

    2012-11-01

    To evaluate the association between findings from drug-induced sleep endoscopy (DISE) and lateral cephalometry in obstructive sleep apnea (OSA) STUDY DESIGN: Cross-sectional. This was a consecutive series of subjects with OSA who underwent DISE and lateral cephalometry. DISE findings were characterized according to the region/degree of obstruction as well as the VOTE classification (velum, oropharyngeal lateral walls, tongue, and epiglottis). The primary measurements from lateral cephalometry images were sella-nasion-point A angle, sella-nasion-point B angle, distance from the posterior nasal spine-tip of palate, posterior airway space, and mandibular plane to hyoid (MPH) distance, although additional airway measurements were taken. Descriptive statistics summarized DISE and lateral cephalometry findings, and χ(2) and t tests examined potential associations between their findings. Among the 55 subjects, most demonstrated velum-related obstruction, although obstruction related to other structures was also common. Lateral cephalometry findings were within population norms with the exception of an increased MPH and decreased airway 4 and airway 5 measurements. There was little association between DISE and lateral cephalometry findings, although significant associations were identified between tongue-related obstruction and airway measurements posterior to the tongue base. DISE and lateral cephalometry are largely distinct airway evaluation techniques in OSA. The use of these techniques remains complementary. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  14. Three-dimensional cephalometry: spiral multi-slice vs cone-beam computed tomography.

    Science.gov (United States)

    Swennen, Gwen R J; Schutyser, Filip

    2006-09-01

    Three-dimensional (3D) craniofacial imaging techniques are becoming increasingly popular and have opened new possibilities for orthodontic assessment, treatment, and follow-up. Recently, a new 3D cephalometric method based on spiral multi-slice (MS) computed tomography (CT) was developed and validated by our research group. This innovative 3D virtual approach is a bridge between conventional cephalometry and modern craniofacial imaging techniques and provides high-quality, accurate, and reliable quantitative 3D data. The aim of this article was to describe the advantages and the disadvantages of spiral MS-CT 3D cephalometry and to discuss the potential of cone-beam CT 3D cephalometry.

  15. James Willocks and the innovation of fetal cephalometry.

    Science.gov (United States)

    Nicolson, M; Fleming, J E E

    2009-11-01

    James Willocks (1928-2004), a Glasgow obstetrician, was an important pioneer of obstetric ultrasound and the originator of the first clinically useful technique of fetal cephalometry. He collaborated with Tom Duggan, an engineer, who designed and built an electronic cephalometer to be used in conjunction with a Kelvin Hughes industrial flaw detector. Working in the Royal Maternity Hospital, Willocks was able to measure the biparietal diameter to an accuracy of better than 2mm. This major innovation enabled fetal growth in the third trimester to be accurately charted and thus greatly improved the detection of placental insufficiency, as well as the management of antepartum haemorrhage, hypertension and other complications of late pregnancy.

  16. 0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.

    Science.gov (United States)

    Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L

    2016-01-01

    Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. A nationwide curriculum analysis of integrated plastic surgery training: is training standardized?

    Science.gov (United States)

    Schneider, Lisa F; Barr, Jason; Saadeh, Pierre B

    2013-12-01

    The integrated model of plastic surgery education, shortly to become the standard for all 6-year programs, has set minimal but no maximal exposure to plastic surgery. The authors hypothesized that the first 3 years of integrated training will show variability among residency programs. Rotation schedules for all 42 integrated programs were analyzed for plastic surgery versus 18 nonplastic surgery rotations for postgraduate years 1, 2, and 3 as well as cumulatively for the first 3 years. Rotations "strongly suggested" by the Residency Review Committee on Plastic Surgery and American Board of Plastic Surgery were also examined. Postgraduate years 1 through 3 spent a wide range of 3 to 19 months (SD ± 4.9 months) on plastic surgery (mean, 9.1 months). General surgery also varied dramatically, with 8 to 21 months (SD ± 4.0 months) of exposure (mean, 16.3 months). Surgical subspecialty rotations ranged substantially from 1 to 6 months (SD ± 1.0 months). Plastic surgery exposure was greater in programs based within plastic surgery departments than within divisions (13.8 versus 8.3 months, p plastic surgery experience in the first 3 years of residency training varies by a greater than 6-fold difference among integrated programs. This was also found in the 2.5-fold and 6-fold differences in general surgery and subspecialty surgery experiences. Since standardized residency training is an expectation by both accrediting bodies and the public, this variability may warrant closer attention.

  18. A comparison between two lateral cephalometry techniques (standard and natural head position

    Directory of Open Access Journals (Sweden)

    Hedayati Z. Assistant Professor. Sang S. DMD

    2003-06-01

    Full Text Available Statement of Problem: Cephalometric findings are of high importance in making decision about orthodontic treatment plans and orthognathic surgeries. Natural head position (NHP is considered as a useful and exact radiographic technique."nAim: The aim of the present study was to compare two techniques, namely Standard and NHP, in lateral"ncephalometry."nMaterials and Methods: In this cross- sectional study, performed in Shiraz. 138 randomly selected students {70 males .and 68 females, age ranging from (13-15. were evaluated clinically and radiographically. None of them had a history of orthodontic treatment, head and face fracture or surgical operations. Lateral cephalograms were taken in both standard and natural head position techniques, for each student. For statistical analysis, l-lest for paired samples, was done."nResults: This study showed that in anterior-posterior dimension, among angles with significant differences in two techniques, those of standard one were more reliable, whereas in vertical dimension."nstatistical differences showed natural technique as more useful one."nConclusion: Due to the fact that natural cephalometry requires more patient cooperation, more time and a higher complex technique, it is not suggested, except when different clinical and cepholomeiric findings are observed.

  19. An Advocacy for the Integration of Bloodless Medicine and Surgery

    African Journals Online (AJOL)

    Alasia Datonye

    increasingly difficult in recent times in these populations. It has thus become imperative for clinicians to begin to .... bloodless medicine and surgery. Today the practice of bloodless medicine and surgery is accepted and consolidated ..... J Bone Joint Surg Am 1989; 71:823-. 827. 15. Ward WF. The development of a hospital ...

  20. Diagnostic accuracy of three-dimensional CT reconstruction and cephalometry for lateral skull base tumors.

    Science.gov (United States)

    Xie, X Z; Huo, X K

    2015-10-01

    To explore the diagnostic accuracy of three-dimensional CT reconstruction and cephalometry in lateral skull base tumors. Fifty-eight patients with lateral skull base tumors were randomly divided into control group (n = 29, examined with conventional diagnostic technique) or study group (n = 29, examined with three-dimensional CT reconstruction and cephalometry). The diagnostic accuracy, tumor distribution and image characteristics were compared between both patient groups. In control group, preoperative tumor diagnosis was consistent with intraoperative diagnosis in 20 patients, similar in 7 patients and discrepant in 2 patients. In study group, there were 24 consistent, 4 similar, and 1 discrepant diagnoses (p cephalometry provides accurate diagnosis of lateral skull base tumors, which is helpful for subsequent surgical treatment.

  1. Comparison between Urinary Oestrogen Assay and Serial Ultrasonic Cephalometry in Assessment of Fetal Growth Retardation

    Science.gov (United States)

    Campbell, Stuart; Kurjak, Asim

    1972-01-01

    Urinary oestrogen assay and serial ultrasonic cephalometry were performed on 284 patients who were considered on clinical grounds to be at risk of having a growth-retarded fetus. It was found that ultrasonic cephalometry was significantly better than oestrogens in diagnosing the small-for-dates baby, but that there was no significant difference between the two methods in predicting perinatal asphyxia. Of the 14 stillbirths, three were in the normal ultrasonic growth rate group and five had normal oestrogen excretion. Both methods were found to be of value in the diagnosis of fetal growth-retardation, although cephalometry would seem to have some advantages, especially in distinguishing between fetal growth-retardation and mistaken maturity. PMID:4673993

  2. Evaluation of the influence of patient positioning on the reliability of lateral cephalometry.

    Science.gov (United States)

    David, Ovidiu-Tiberiu; Tuce, Robert-Angelo; Munteanu, Oana; Neagu, Adrian; Panainte, Irinel

    2017-07-01

    Two-dimensional cephalometry is widely used for monitoring orthodontic treatments and for quantifying the outcome of maxillofacial surgery. Despite careful use of a cephalostat, successive radiographs might differ due to slight differences in patient posture. This study evaluates the reliability of lateral cephalometric measurements and estimates the impact of patient positioning on this reliability. We studied cephalograms of 104 patients; 31 of them had two radiographs because the first was deemed unsuitable for cephalometric analysis. Using AudaxCeph 3.0 (Audax, Ljubljana, Slovenia), two observers traced each cephalogram twice, one month apart. We evaluated intra- and interobserver agreement via Bland-Altman analysis, intraclass correlation coefficient (ICC), standard error of measurement, and smallest detectable difference (SDD). First, we studied the reliability of the hard tissue part of the Tweed-Merrifield analysis for 73 single cephalograms and for the better ones of patients with two exposures. Then, we studied 31 unsatisfactory cephalograms, and the ones recorded at improved patient posture. Although intraobserver bias was less than 0.5° or 0.3 mm, interobserver bias was significant for most measurements. Intraobserver reliability was high (ICC > 0.9), whereas interobserver reliability was good (ICC > 0.83) except for FMPA, FMIA and OP. Head rotations and inclinations had little impact on reliability (e.g., interobserver SDD decreased for 3 of 11 measurements). We conclude that averaging the positions of bilateral structures enables a reliable cephalometric analysis in spite of imprecise patient posture. Retaking cephalograms is ethically questionable in such cases.

  3. Veterans Affairs general surgery service: the last bastion of integrated specialty care.

    Science.gov (United States)

    Poteet, Stephen; Tarpley, Margaret; Tarpley, John L; Pearson, A Scott

    2011-11-01

    In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients. Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to 2009 at the Nashville VA. Over a 5-year span general surgery residents spent an average of 5 months on the VA general surgery service, which includes a postgraduate year (PGY)-5, PGY-3, and 2 PGY-1 residents. Surgeries involved the following specialties: surgical oncology, endocrine, colorectal, hepatobiliary, transplant, gastrointestinal laparoscopy, and elective and emergency general surgery. The surgeries were categorized according to ACGME index requirements. A total of 2,956 surgeries were performed during the 5-year period from 2005 through 2009. Residents participated in an average of 246 surgeries during their experience at the VA; approximately 50 cases are completed during the chief year. On the VA surgery service alone, 100% of the ACGME requirement was met for the following categories: endocrine (8 cases); skin, soft tissue, and breast (33 cases); alimentary tract (78 cases); and abdominal (88 cases). Approximately 50% of the ACGME requirement was met for liver, pancreas, and basic laparoscopic categories. The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training

  4. Bone age estimation by cervical vertebral dimensions in lateral cephalometry.

    Science.gov (United States)

    Varshosaz, Masoud; Ehsani, Sara; Nouri, Mahtab; Tavakoli, Mohammad A

    2012-09-01

    A critical issue in contemporary orthodontics is bone age estimation. The most reliable method for skeletal age evaluation is hand-wrist radiography; but it requires further radiation. There is an increasing attention for evaluating cervical vertebrae to reduce the radiation to the patients. The aim of this study was to estimate bone age by measuring 3rd and 4th cervical vertebrae (C3, C4) dimensions. We conducted a correlational study on 91 Iranian individuals aged 8-18 years. After taking lateral cephalometry and hand-wrist radiographs, C3 and C4 were measured using Vixwin 2000 software. Hand-wrist bone age, determined on Greulich Atlas, was the reference test. Stepwise multiple linear regression model demonstrated the correlation between the two measurements. Anterior height of the fourth cervical vertebrae (AH4) had the strongest simple correlation with hand-wrist bone age (r=0.831, P<0.001) and was the only variable that remained in stepwise multivariate regression model. The regression model was: Bone age=0.989×AH4+3.308. Adjusted R2 was 0.686 (p<0.001). Lateral cephalometric radiographs are useful for bone age estimation, and might be an alternative for hand-wrist radiography, with the advantage of radiation reduction. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  5. Classification of anterior open bite using individualized cephalometry.

    Science.gov (United States)

    Bock, Jens Johannes; Bock, Franziska; Böhm, Bernhard; Fuhrmann, Robert A

    2005-09-01

    The objective of this study was to describe the cephalometric characteristics of the open bite, and to classify the open bite according to individualized norms. The lateral cephalograms of 134 patients with an anterior open bite (min -0.5 mm) were analyzed. Patients were classified according to the inclination of the jaws, applying the principles of individualized cephalometry. The harmony box described by Hasund was used to define individualized norms for the inclination of the upper and lower jaws in each patient. The open bite was classified into four sub-types: (1) dental, (2) skeletal with enlarged ML-NSL angle, (3) skeletal with reduced ML-NSL angle, and (4) skeletal with deviations in upper and lower jaws. A skeletal open bite was found in 89 patients (66.4%). A dental open bite was found in 45 patients (33.6%). A number of significant differences were found between these four groups using single-factor variance analysis and the Bonferroni a posteriori test, (p < or = 0.05, p < or = 0.01, p < or = 0.001). The most prominent variables were index value of anterior facial hight, total facial height ratio, gonial angle, and Y-axis. No significant differences were found for overbite, however. It was possible to use individualized norms to classify the open bite into four sub-types. The demarcation between the four groups was supported statistically. The extent of the anterior open bite does not allow any conclusions as to the craniofacial pattern.

  6. Lower face cephalometry based on quadrilateral analysis with cone-beam computed tomography: a clinical pilot study.

    Science.gov (United States)

    Dobai, Adrienn; Vizkelety, Tamás; Markella, Zsolt; Rosta, Adrienne; Kucsera, Ágnes; Barabás, József

    2017-06-01

    As most orthognathic surgeries focus on the lower face, the aim of this study was to transfer previously developed two-dimensional cephalometry-which is useful for surgeons in the orthognathic surgery of the lower face-to three-dimensional (3D) cephalometry by using cone-beam computed tomography (CBCT). We selected the quadrilateral lower face analysis developed by the surgeon Di Paolo, who focused only for the lower face and mentioned that data in millimeters are more easy to use than angles for surgeons. Additionally, we wanted to create a 3D lower face analysis approach based on quadrilateral analysis and establish a reference table for surgical planning. Three investigators assigned 16 landmarks on CBCT images from 30 patients with normocclusion. Intra-class correlation coefficients (ICCs) and standard deviations (SDs) were calculated according to each landmark. The maxillary and mandibular lengths and widths and the anterior and posterior lower facial heights (ALFH and PLFH) are presented as means and SDs. The asymmetry of the face was calculated with paired t test, and the coherence of the lower face was assessed with correlation coefficients (r) and regression models. The ICCs were ≥0.90, and the SDs of the landmarks were lower than 1.00 mm, except for the J-point, which was located at the junction of the anterior border of the ramus and the corpus of the mandible. The SDs of linear measurements were 3.06-5.20 mm, and there was no significant facial asymmetry. The r among the structures was greater than 0.3 in 13 of 15 assessments. Based on these values, we could establish a floating norm of the lower face using the following five regressions: one linear regression for the mandibular length, two quadratic models for the ALFH and PLFH, and two multivariate regressions for the posterior widths of the maxillae and mandible. The adaptation of quadrilateral analysis can provide accurate 3D characterization of the morphology of the lower face and the floating

  7. Evaluation of the radiographic cephalometry learning process by a learning virtual object.

    Science.gov (United States)

    Silveira, Heraldo Luis Dias; Gomes, Maria João; Silveira, Heloísa Emilia Dias; Dalla-Bona, Reni Raymundo

    2009-07-01

    Radiographic cephalometry is a complex area of study. The literature shows a lack of interobserver reproducibility in the definition and identification of cephalometric landmarks. The aim of this study was to test a learning virtual object (LVO) called ceph learning used in the teaching of radiographic cephalometry and to verify whether it improves performance of the landmarking process. A total of 40 undergraduate students were divided into 2 groups. Group A was taught according to the conventional teaching method of theory and practical classes, and group B was taught with an LVO. The students' learning performance was tested by using a multiple-choice questionnaire that covered the knowledge and understanding of cephalometry and by the index of correct landmark identification. The Student t test was used to check statistical differences between the 2 groups. LVO usability was evaluated with a questionnaire based on the system usability scale. In the first posttest, the Student t test showed no significant differences (P >0.05). However, in the second posttest 15 days later, a decrease was observed in the scores of group A, with significant differences (P cephalometry.

  8. Open abdominal surgical training differences experienced by integrated vascular and general surgery residents.

    Science.gov (United States)

    Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

    2017-10-01

    As the integrated vascular residency program reaches almost a decade of maturity, a common area of concern among trainees is the adequacy of open abdominal surgical training. It is our belief that although their overall exposure to open abdominal procedures has decreased, integrated vascular residents have an adequate and focused exposure to open aortic surgery during training. National operative case log data supplied by the Accreditation Council for Graduate Medical Education were compiled for both graduating integrated vascular surgery residents (IVSRs) and graduating categorical general surgery residents (GSRs) for the years 2012 to 2014. Mean total and open abdominal case numbers were compared between the IVSRs and GSRs, with more in-depth exploration into open abdominal procedures by organ system. Overall, the mean total 5-year case volume of IVSRs was 1168 compared with 980 for GSRs during the same time frame (P surgery, representing 57% of all open abdominal cases. GSRs completed an average of 116 open alimentary tract surgeries during their training. Open abdominal surgery represented an average of 7.1% of the total vascular case volume for the vascular residents, whereas open abdominal surgery represented 21% of a GSR's total surgical experience. IVSRs reported almost double the number of total cases during their training, with double chief-level cases. Sixty-five percent of open abdominal surgeries performed by IVSRs involved the aorta or its renovisceral branches. Whereas open abdominal surgery represented 7.1% of an IVSR's surgical training, GSRs had a far broader scope of open abdominal procedures, completing nearly double those of IVSRs. The differences in open abdominal procedures pertain to the differing diseases treated by GSRs and IVSRs. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  9. A reflection on radiographic cephalometry: the evaluation of sagittal discrepancy.

    Science.gov (United States)

    Duterloo, Herman S

    2014-09-01

    A critical review is presented of the basic properties and applications of cephalometry as a clinical tool with a focus on the evaluation of sagittal discrepancy. Diagnostic cephalometric assessments are subjective and not based on evidence. To assess individual skeletal and/or facial soft tissue form subjectively, selected norms are used. Norms have been developed for various ethnical groups to improve clinical applicability, but subjectivity remains. That subjectivity precludes application of a modern review system, making the present review a personal account. The cephalometric evaluation of sagittal discrepancy finds its historic origin in the Angle classification. Recent publications try to improve accuracy in classifying sagittal discrepancy. It remains unclear in what sense such efforts influence treatment decisions and/or treatment effect. Almost all selected landmarks are located on or dependent upon periosteal/endosteal bone image contours. Their homology is based on circumstantial reasoning and stability over time, which is implicitly assumed. However, implant growth studies and histological investigations show most landmarks to be unstable, as they are involved in displacement and bone remodelling. These landmarks are therefore heterologous when used for individual evaluation of change over time. Notwithstanding the above-indicated limitations, diagnostic cephalometric assessments are clinically useful and help to develop perceptions of balance and harmony and communication between colleagues and patients. There is no evidence-based method to prefer one particular diagnostic method. Landmark location accuracy and geometric issues do not play a decisive role. The subjective characteristic of diagnostic evaluations limits their power to size/shape comparisons. Structural superimposition is the valid biologically evidence-based method to provide advanced insight in individual growth and/or treatment changes and their variations. © 2014 British Orthodontic

  10. Microscope-integrated optical coherence tomography for image-aided positioning of glaucoma surgery.

    Science.gov (United States)

    Li, Xiqi; Wei, Ling; Dong, Xuechuan; Huang, Ping; Zhang, Chun; He, Yi; Shi, Guohua; Zhang, Yudong

    2015-07-01

    Most glaucoma surgeries involve creating new aqueous outflow pathways with the use of a small surgical instrument. This article reported a microscope-integrated, real-time, high-speed, swept-source optical coherence tomography system (SS-OCT) with a 1310-nm light source for glaucoma surgery. A special mechanism was designed to produce an adjustable system suitable for use in surgery. A two-graphic processing unit architecture was used to speed up the data processing and real-time volumetric rendering. The position of the surgical instrument can be monitored and measured using the microscope and a grid-inserted image of the SS-OCT. Finally, experiments were simulated to assess the effectiveness of this integrated system. Experimental results show that this system is a suitable positioning tool for glaucoma surgery.

  11. Microscope Integrated Intraoperative Spectral Domain Optical Coherence Tomography for Cataract Surgery: Uses and Applications.

    Science.gov (United States)

    Das, Sudeep; Kummelil, Mathew Kurian; Kharbanda, Varun; Arora, Vishal; Nagappa, Somshekar; Shetty, Rohit; Shetty, Bhujang K

    2016-05-01

    To demonstrate the uses and applications of a microscope integrated intraoperative Optical Coherence Tomography in Micro Incision Cataract Surgery (MICS) and Femtosecond Laser Assisted Cataract Surgery (FLACS). Intraoperative real time imaging using the RESCAN™ 700 (Carl Zeiss Meditec, Oberkochen, Germany) was done for patients undergoing MICS as well as FLACS. The OCT videos were reviewed at each step of the procedure and the findings were noted and analyzed. Microscope Integrated Intraoperative Optical Coherence Tomography was found to be beneficial during all the critical steps of cataract surgery. We were able to qualitatively assess wound morphology in clear corneal incisions, in terms of subclinical Descemet's detachments, tears in the inner or outer wound lips, wound gaping at the end of surgery and in identifying the adequacy of stromal hydration, for both FLACS as well as MICS. It also enabled us to segregate true posterior polar cataracts from suspected cases intraoperatively. Deciding the adequate depth of trenching was made simpler with direct visualization. The final position of the intraocular lens in the capsular bag and the lack of bioadhesivity of hydrophobic acrylic lenses were also observed. Even though Microscope Integrated Intraoperative Optical Coherence Tomography is in its early stages for its application in cataract surgery, this initial assessment does show a very promising role for this technology in the future for cataract surgery both in intraoperative decision making as well as for training purposes.

  12. Essential surgery: Integral to the right to health.

    Science.gov (United States)

    McQueen, K A Kelly; Ozgediz, Doruk; Riviello, Robert; Hsia, Renee Y; Jayaraman, Sudha; Sullivan, Stephen R; Meara, John G

    2010-06-15

    In a rights-based approach to health, the provision of essential surgical services is not a luxury, but a critical component of the "highest attainable standard of health." Yet while access to select basic health care interventions has increasingly been discussed as part of the human right to health, essential surgical services have generally not been part of this discussion. This is despite the substantial global burden of surgical conditions in low- and middle-income countries, extreme global disparities in access to surgical care, and the fact that relatively simple, cost-effective, and curative surgical procedures can avert disability and premature death from many life-threatening emergencies and other conditions. Many barriers, both supply and demand-related, such as constraints in human resources, infrastructure, and access to care, have limited the ability of health systems to deliver surgical services. In this paper, the authors share their experience - as a group of surgeons, anesthesiologists, emergency physicians, and public health experts working with colleagues in varied resource-constrained settings to provide basic surgical care - in addressing the challenge of realizing the right to surgery in resource-poor settings. We argue that essential surgical care should be included in the basic human right to health, and that the current emphasis on "vertical" disease-specific models of health service delivery should be broadened to include systems needed to provide surgical services. We outline the global burden of surgical conditions, discuss the public health importance of surgery, identify the most significant global disparities in access to surgical care, and provide economic arguments for surgical delivery.

  13. Integrative Medicine as an Adjunct to Orthopaedic Surgery.

    Science.gov (United States)

    Ficke, James R; Moroski, Nathan M; Ross, Steven D; Gupta, Ranjan

    2018-01-15

    Patients often seek nontraditional forms of treatment, including alternative/complementary medical options, such as chiropractic care and acupuncture, to meet their personal needs. In the United States, interest has grown in methods to reduce pain and improve function through Ayurvedic medicine, which uses plant-based supplements, such as turmeric. Traditional allopathic medicine attempts to provide patients with evidence-based therapeutic regimens for their musculoskeletal conditions. Integrative medicine often is used to prevent and manage the sequelae associated with injuries and illnesses; however, competitive athletes and military personnel use complementary medicine for performance enhancement. Thus, physicians should be aware of the evolving field of integrative medicine, including the reported benefits as well as any potential drawbacks, to facilitate an educated discussion with their patients.

  14. Comparison of landmark identification and linear and angular measurements in conventional and digital cephalometry.

    Science.gov (United States)

    Akhare, Pankaj J; Dagab, Akshay M; Alle, Rajkumar S; Shenoyd, Usha; Garla, Venkatesh

    2013-01-01

    The purpose was to compare the reliability of landmark identification and linear and angular measurements in conventional versus digital cephalometry. Using 50 cephalometric radiographs, four orthodontic residents identified 19 cephalometric landmarks followed by 18 linear and angular measurements of the same radiographs. The values of 18 measurements were compared to quantify the measurement difference and interobserver errors between these two methods. Multivariate analysis of variance showed that the "cephalometric radiograph" and "landmark" variation had greater influence than that of "method" (landmark identification on original radiograph/on digital). A statistically significant difference for interobserver errors between the two methods was noted only for 5 out of 19 cephalometric landmarks. The most accurately identified landmark in conventional and digitized method was Sella (S), followed by Nasion (N). Landmarks requiring further scrutiny in digital images were Porion (P) Articulare, ANS, UM, and LM. The advantages of digital cephalometry were also substantiated.

  15. A new method for improved standardisation in three-dimensional computed tomography cephalometry.

    Science.gov (United States)

    Van Cauter, S; Okkerse, W; Brijs, G; De Beule, M; Braem, M; Verhegghe, B

    2010-02-01

    Interest for three-dimensional computed tomography cephalometry has risen over the last two decades. Current methods commonly rely on the examiner to manually point-pick the landmarks and/or orientate the skull. In this study, a new approach is presented, in which landmarks are calculated after selection of the landmark region on a triangular model and in which the skull is automatically orientated in a standardised way. Two examiners each performed five analyses on three skull models. Landmark reproducibility was tested by calculating the standard deviation for each observer and the difference between the mean values of both observers. The variation can be limited to 0.1 mm for most landmarks. However, some landmarks perform less well and require further investigation. With the proposed reference system, a symmetrical orientation of the skulls is obtained. The presented methods contribute to standardisation in cephalometry and could therefore allow improved comparison of patient data.

  16. Correlation between nasopharyngoscopy and cephalometry in the diagnosis of hyperplasia of the pharyngeal tonsils.

    Science.gov (United States)

    Ritzel, Rodrigo Agne; Berwig, Luana Cristina; da Silva, Ana Maria Toniolo; Corrêa, Eliane Castilhos Rodrigues; Serpa, Eliane Oliveira

    2012-04-01

     Hyperplasia of the pharyngeal tonsil is one of the main causes of mouth breathing, and accurate diagnosis of this alteration is important for proper therapeutic planning. Therefore, studies have been conducted in order to provide information regarding the procedures that can be used for the diagnosis of pharyngeal obstruction.  To verify the correlation between nasopharyngoscopy and cephalometric examinations in the diagnosis of pharyngeal tonsil hyperplasia.  This was a cross-sectional, clinical, experimental, and quantitative study. Fifty-five children took part in this study, 30 girls and 25 boys, aged between 7 and 11 years. The children underwent nasofibropharyngoscopic and cephalometric evaluation to determine the grade of nasopharyngeal obstruction. The Spearman's rank correlation coefficient at the 5% significance level was used to verify the correlation between these exams.  In the nasopharyngoscopy evaluation, most children showed grade 2 and 3 hyperplasia of the pharyngeal tonsil, which was followed by grade 1. In the cephalometry assessment, most children showed grade 1 hyperplasia of the pharyngeal tonsil, which was followed by grade 2. A statistically significant regular positive correlation was observed between the exams.  It was concluded that the evaluation of the pharyngeal tonsil hyperplasia could be carried out by fiber optic nasopharyngoscopy and cephalometry, as these examinations were regularly correlated. However, it was found that cephalometry tended to underestimate the size of the pharyngeal tonsil relative to nasopharyngoscopy.

  17. Parental craniofacial morphology in cleft lip with or without cleft palate as determined by cephalometry: a meta-analysis.

    Science.gov (United States)

    Weinberg, S M; Maher, B S; Marazita, M L

    2006-02-01

    To integrate findings from previous cephalometric studies comparing the craniofacial complex of unaffected parents with cleft lip with or without cleft palate (CL/P) children to controls with no history of the disease. Meta-analysis of case-control cephalometric data. Studies were selected if the unaffected parents of children with CL/P were included and were not combined with parents of children with isolated CP; quantitative data were obtained through cephalometry; the cephalometric variables used were not unique to a study; a case-control design was used; and the means and standard deviations for all variables were reported or could be calculated for both the experimental and the control group. Using raw data obtained from nine studies, mean weighted effect sizes with 95% confidence intervals were calculated for 28 cephalometric variables (mothers and fathers combined) or 18 variables (mothers and fathers separately). Heterogeneity statistics for the effect sizes were also calculated. In general, unaffected parents of children with CL/P possessed significantly wider interorbital, nasal cavity and upper facial dimensions, narrower cranial vaults, longer cranial bases, longer and more protrusive mandibles, shorter upper faces and longer lower faces compared with controls. Increased width of the nasal cavity was the most robust finding. Significant effect size heterogeneity was observed in roughly half of the variables examined. Unaffected parents of children with CL/P are characterized by a suite of consistent, yet subtle, craniofacial differences, which could indicate an underlying genetic liability.

  18. From 200 BC to 2015 AD: an integration of robotic surgery and Ayurveda/Yoga.

    Science.gov (United States)

    Khan, Ali Zamir; Pillai, Geethakrishnan Gopalakrishna

    2016-02-01

    Among the traditional systems of medicine practiced all over the world, Ayurveda and Yoga has a documented history dating back to beyond 200 BC. Robotic and video assisted thoracic surgery (VATS) is an invention of the 21(st) century. We aim to quantify the effects of integration of Ayurveda and Yoga on patients undergoing minimally invasive robotic and VATS. Four hundred and fifty-four patients undergoing VATS and robotic thoracic surgery were introduced to a pre and postoperative protocol of Yoga therapy, mediation and oil massages. Yoga exercises included Pranayam, Anulom Vilom, and Oil Massages included Urotarpan. Preoperative and postoperative respiratory functions were recorded. Patient satisfaction questionnaire were noted. Statistical comparison was made to control group undergoing minimally invasive thoracic surgery without integrative medicine. Only one patient refused to undergo Ayurveda therapy and was deleted from the group. Acceptability was high among all patients. Preoperative training led to implementation as early as 6 hours post surgery. Pulmonary function test showed significant improvement. All patients suggested an improvement in satisfaction score. Pain score were less in study patients. Quicker mobilization led to early discharge and drain removal. Chronic pain was prevented in patients having oil massages over the healed wound sites. Integration of Ayurveda, Yoga and minimally invasive robotic and VATS is acceptable to Indian patients and gives better clinical results and higher patient satisfaction.

  19. Surgery

    Science.gov (United States)

    ... and sterile gloves. Before the surgery begins, a time out is held during which the surgical team confirms ... the Consumer Version. DOCTORS: Click here for the Professional Version What Participants Need to Know About Clinical ...

  20. Utilizing integrated facility design to improve the quality of a pediatric ambulatory surgery center.

    Science.gov (United States)

    Pelly, Nicole; Zeallear, Brian; Reed, Mark; Martin, Lynn

    2013-07-01

    The aim was to use Integrated Facility Design (IFD) to design a surgery center that enhances the delivery of health care by developing processes that provide highly efficient patient, family, and provider flows while adding value and utilizing costly resources effectively. Integrated Facility Design is an adaptation of the Toyota 3P (Production, Preparation, Process) Program. The goal of IFD is to accelerate development time and lower start-up costs. The use of IFD produced a savings of $30 million in project costs and enabled a completion date 3.5 months ahead of schedule. The designed patient flow processes resulted in dramatic improvements in patient, family, and provider throughput. The use of IFD in the design of a pediatric ambulatory clinic and surgery resulted in significant cost savings and improved clinical efficiency. © 2013 John Wiley & Sons Ltd.

  1. Aesthetic Surgery Training during Residency in the United States: A Comparison of the Integrated, Combined, and Independent Training Models

    Science.gov (United States)

    Momeni, Arash; Kim, Rebecca Y.; Wan, Derrick C.; Izadpanah, Ali; Lee, Gordon K.

    2014-01-01

    Background. Three educational models for plastic surgery training exist in the United States, the integrated, combined, and independent model. The present study is a comparative analysis of aesthetic surgery training, to assess whether one model is particularly suitable to provide for high-quality training in aesthetic surgery. Methods. An 18-item online survey was developed to assess residents' perceptions regarding the quality of training in aesthetic surgery in the US. The survey had three distinct sections: demographic information, current state of aesthetic surgery training, and residents' perception regarding the quality of aesthetic surgery training. Results. A total of 86 senior plastic surgery residents completed the survey. Twenty-three, 24, and 39 residents were in integrated, combined, and independent residency programs, respectively. No statistically significant differences were seen with respect to number of aesthetic surgery procedures performed, additional training received in minimal-invasive cosmetic procedures, median level of confidence with index cosmetic surgery procedures, or perceived quality of aesthetic surgery training. Facial aesthetic procedures were felt to be the most challenging procedures. Exposure to minimally invasive aesthetic procedures was limited. Conclusion. While the educational experience in aesthetic surgery appears to be similar, weaknesses still exist with respect to training in minimally invasive/nonsurgical aesthetic procedures. PMID:25225615

  2. Surgery

    Science.gov (United States)

    ... surgery has several common causes, including the following: Infections at the operative site Lung problems such as pneumonia or collapsed lung ... the trauma of an operation. The risk of infections at the operative site, DVTs, and UTIs can be decreased by meticulous ...

  3. Differences of Upper Airway Morphology According to Obesity: Study with Cephalometry and Dynamic MD-CT

    Science.gov (United States)

    Kim, Tae Hoon; Chun, Bum Soo; Lee, Ho Won

    2010-01-01

    Objectives We investigated difference of parameters of polysomnography, cephalometry and dynamic multi-detector computerized tomography (MD-CT) in wake and sleep states according to obesity. Methods We evaluated 93 patients who underwent polysomnography and cephalometry. MD-CT was performed in 68 of these 93 patients. Fifty-nine and 34 patients were classified as obese and non-obese, with obesity defined as BMI ≥25. Cephalometry results were analyzed for 12 variables. Using the MD-CT, we evaluated dynamic upper airway morphology in wake and sleep states and divided the upper airway into four parts named as high retropalatal (HRP), low retropalatal (LRP), high retroglossal (HRG), and low retroglossal (LRG). A minimal cross sectional area (mCSA) and collapsibility index (CI) were calculated for each airway level. Results Diastolic blood pressure (P=0.0005), neck circumference (P<0.0001), and apnea-hypopnea index (P<0.0001) were statistically significantly different between the obese and non-obese group. Among 12 cephalometric variables, there was a significant difference in only the distance from mandibular plane to hyoid bone (P=0.003). There was statistical difference in CI of HRG and LRG in sleep state (P=0.0449, 0.0281) but no difference in mCSA in wake and sleep states. Conclusion The obese group had more severe sleep apnea than the non-obese group. We believe that the increased severity of apnea in the obese group may be have been due to increased collapsibility of the upper airway rather than decreased size of the upper airway. PMID:20978543

  4. Practical limitations of cone-beam computed tomography in 3D cephalometry.

    Science.gov (United States)

    Damstra, Janalt; Fourie, Zacharias; Ren, Yijin

    2011-12-01

    3D cone beam computed tomography (CBCT) images offer a unique and new appreciation of the anatomical structures and underlying anomalies not possible with conventional radiographs. However, in almost all aspects of CBCT imaging, from utilization to application, inherent limitations and pitfalls exist. Importantly, these inherent limitations and pitfalls have practical implications which need to be addressed before the potential of this technology can be fully realized. The purpose of this review was to explore the current limitations and pitfalls associated with CBCT imaging to allow for better and more accurate understanding of the possibilities this imaging modality could offer, particularly pertaining to 3D cephalometry.

  5. [Morphology of the soft palate in normal humans with digital cephalometry].

    Science.gov (United States)

    Niu, Yu-Ming; Wang, Hu; Zheng, Qian; He, Xing; Zhang, Jing; Li, Xiao-Min; Lu, Yong

    2006-08-01

    To study the morphology of the soft palate in normal humans with digital radiography and to provide the references for therapy of the cleft. 106 normal people were involved. The morphology of the soft palate was observed with digital cephalometry. All static images of soft palate could be divided into six types: Shuttle-shaped, crescent-shaped, strip-shaped, S-shaped, hamulus-shaped and anomalous shaped. The dynamic image was knee-shaped. The morphology of the soft palate is varied.

  6. A single-institution experience: the integrated vascular surgery residency's effect on fellowship and general surgery resident case volume and diversity.

    Science.gov (United States)

    Carroll, Megan I; Downes, Kathryne; Miladinovic, Branko; Illig, Karl A; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

    2014-01-01

    To determine whether the formation of an integrated vascular surgery residency (0 + 5) has negatively impacted the case volume and diversity of the vascular surgery fellows (5 + 2) and chief general surgeons at the same institution. Operative data from the vascular integrated (0 + 5), independent (5 + 2), and general surgery residencies at a single institution were retrospectively reviewed and analyzed to determine vascular surgery case volumes from 2006-2012. National operative data (Residency Review Committee) were used for comparison of diversity and volume. Standard statistical methods were applied. During this period, the 5 + 2 fellows at our institution performed on average 741 (range, 554-1002) primary cases and 1091 (range, 844-1479) combined primary and secondary cases for the 2-year fellowship. Our integrated residency began in July 2007. Our fellows' primary case volumes remained relatively stable between 2006 and 2011, with a 4% increase in the number of cases, although their total (primary and secondary) case volumes fell 15%; by comparison, the equivalent national 50th percentile rates rose 16% during this time frame. Our institution's general surgery residents performed an average of 116 (range, 56-221) vascular cases individually during their 5-year residency from 2005-2011. From 2006-2011, the total case volume fell only 5%, while the national 50th percentile rate fell 24%. Across all years, however, resident and fellow volumes both continue to be above Accreditation Council for Graduate Medical Education minimum requirements, and the major vascular case volume at our institution in all groups studied remained statistically greater than or equal to the national 50th percentile of cases. Our first integrated resident to graduate finished in June 2012 with 931 total vascular cases and 249 general surgery cases for a total operative experience of 1180 cases during the 5-year residency. Finally, after an 8-year period (2003-2010) in which none of

  7. Bariatric surgery results: reporting clinical characteristics and adverse outcomes from an integrated healthcare delivery system.

    Science.gov (United States)

    Li, Robert A; Fisher, David P; Dutta, Sanjoy; O'Brien, Rebecca M; Ackerson, Lynn M; Sorel, Michael E; Sidney, Stephen

    2015-01-01

    Limited data have been reported on bariatric surgery within a large, high-volume regional multicenter integrated healthcare delivery system. Review clinical characteristics and short- and intermediate-term outcomes and adverse events from a bariatric surgery program within an integrated healthcare delivery system. Single high-volume, multicenter regional integrated healthcare delivery system. Adult patients who underwent primary bariatric surgery during 2010-2011 were reviewed. Clinical characteristics, outcomes, and weight loss results were extracted from the electronic medical record. A total of 2399 patients were identified within the study period. The 30-day rates of clinical outcomes for Roux-en-Y gastric bypass (RYGB; n = 1313) and sleeve gastrectomy (SG; n = 1018) were 2.9% for readmission, 3.0% for major complications, .8% for reoperation, and 0% for mortality. One-year and 2-year weight loss results were as follows: percent weight loss (%WL) was 31.4 (±SD 8.5) and 34.2±12.0% for SG and 34.1±9.3 and 39.1±11.9 for RYGB; percent excess weight loss (%EBWL) was 64.2±18.0 and 69.8±23.7 for SG and 68.0±19.3 and 77.8±23.7 for RYGB; percent excess body mass index loss (%EBMIL) was 72.9±21.0 and 77.7±22.4 for SG and 76.6±22.1% and 85.6±21.6 for RYGB. Follow-up for each procedure at 1 year was 76% for SG (n = 778) and 80% for RYGB (n = 1052) and at 2 years was 65% for SG (n = 659) and 67% for RYGB (n = 875). A large regional high-volume multicenter bariatric program within an integrated healthcare delivery system can produce excellent short-term results with low rates of short- and intermediate-term adverse outcomes. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  8. [Usefulness of cephalometry and pharyngeal findings in the primary diagnosis of obstructive sleep apnea syndrome].

    Science.gov (United States)

    Kitamura, Takuro; Sakabe, Akiko; Ueda, Narihisa; Shiomori, Teruo; Udaka, Tsuyoshi; Ohbuchi, Toyoaki; Suzuki, Hideaki

    2008-11-01

    We studied the usefulness of cephalometry and pharyngeal findings in determining efficient primary diagnosis of obstructive sleep apnea syndrome (OSAS). Subjects were 171 adult men with sleep-disordered breathing, who underwent cephalometry and polysomnography (PSG) and had pharyngeal findings evaluated by modified Mallampati grade (MMP) and palatine tonsil size. An apnea-hypopnea index (AHI) of > or = 15 in PSG was considered to indicate OSAS. We analyzed the correlation between AHI and other parameters and conducted stepwise multiple regression analysis to predict AHI, and studied the screening performance of prediction equations using a receiver operating characteristic (ROC) curve. Of the 8 cephalometric parameters examined, the length of the soft palate (PNS-P; p = 0.011) and the distance from the mandibular plane to the hyoid bone (MP-H; p (a) > (b). Sensitivity and of equation (c) with a cutoff of 15 were 0.95 and specificity 0.25. These results indicate that both cephalometric parameters and pharyngeal indices should be included in conducting an efficient primary diagnosis for OSAS.

  9. [Predicting of growth tendency with cephalometry. Cephalometric research comparing orthodontic treatment cases with four premolar extraction].

    Science.gov (United States)

    Szabó, Gyula Tamás; Herényi, Gejza; Szabó, Gyula

    2007-02-01

    The Hasund cephalometry gives important information about the position of the mandible and maxilla to each other and to the cranium in horizontal and vertical plane, and about the expecting mandibular growth. The aim of the study was to examine the reliability of the Hasund growth analysis on the basis of cephalogramms. The data of eighteen children having been treated with four premolar extraction in the growing period were compared. At the start of treatments the children's average age was 10 (8.5-11.5) years. Figures from the cephalometry were analysed by an orthodontic diagnostic program. According to our results the predicted growth was justified in 14 cases and contrary mandibular development was found in 4 cases. Beyond the limits of this study we concluded that the Hasund growth analysis gives mainly a reliable prognosis on predicting mandibular development. In diagnostic procedures this analysis should be followed for a successful decision-making in treatment plan. However, during the orthodontic treatment the prognostic results have to be monitored by using further cephalometric evaluations in a time-scales of a year.

  10. Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries.

    Science.gov (United States)

    Pasricha, Neel Dave; Bhullar, Paramjit Kaur; Shieh, Christine; Viehland, Christian; Carrasco-Zevallos, Oscar Mijail; Keller, Brenton; Izatt, Joseph Adam; Toth, Cynthia Ann; Challa, Pratap; Kuo, Anthony Nanlin

    2017-01-01

    We report the first use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT) capable of live four-dimensional (4D) (three-dimensional across time) imaging intraoperatively to directly visualize tube shunt placement and trabeculectomy surgeries in two patients with severe open-angle glaucoma and elevated intraocular pressure (IOP) that was not adequately managed by medical intervention or prior surgery. We performed tube shunt placement and trabeculectomy surgery and used SS-MIOCT to visualize and record surgical steps that benefitted from the enhanced visualization. In the case of tube shunt placement, SS-MIOCT successfully visualized the scleral tunneling, tube shunt positioning in the anterior chamber, and tube shunt suturing. For the trabeculectomy, SS-MIOCT successfully visualized the scleral flap creation, sclerotomy, and iridectomy. Postoperatively, both patients did well, with IOPs decreasing to the target goal. We found the benefit of SS-MIOCT was greatest in surgical steps requiring depth-based assessments. This technology has the potential to improve clinical outcomes.

  11. Instruments used in the assessment of expectation toward a spine surgery: an integrative review

    Directory of Open Access Journals (Sweden)

    Eliane Nepomuceno

    Full Text Available Abstract OBJECTIVE To identify and describe the instruments used to assess patients' expectations toward spine surgery. METHOD An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. RESULTS A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. CONCLUSION The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies.

  12. Multisensor data fusion in an integrated tracking system for endoscopic surgery.

    Science.gov (United States)

    Ren, Hongliang; Rank, Denis; Merdes, Martin; Stallkamp, Jan; Kazanzides, Peter

    2012-01-01

    Surgical planning and navigation systems are vital for minimally invasive endoscopic surgeries but it is challenging to track the position and orientation of intrabody surgical instruments in these procedures. In order to address this problem, we propose a tracking system including multiple-sensor integration and data fusion. The proposed tracking approach is free of the constraints of line-of-sight, less subject to environmental distortion, and with higher update rate. By incorporating electromagnetic and inertial sensors, the system yields continuous 6-DOF information. Based on a system dynamic model and estimation theories, a new multisensor fusion algorithm, cascade orientation and position-estimation algorithm, is proposed for the integrated tracking device. The experimental results show that the proposed algorithms achieve accurate orientation and position tracking with robustness.

  13. Away Rotations and Matching in Integrated Plastic Surgery Residency: Applicant and Program Director Perspectives.

    Science.gov (United States)

    Drolet, Brian C; Brower, Jonathan P; Lifchez, Scott D; Janis, Jeffrey E; Liu, Paul Y

    2016-04-01

    Although nearly all medical students pursuing integrated plastic surgery residency participate in elective rotations away from their home medical school, the value and costs of these "away" rotations have not been well studied. The authors surveyed all integrated plastic surgery program directors and all applicants in the 2015 National Residency Matching Program. Forty-two program directors and 149 applicants (64 percent and 70 percent response rate, respectively) completed the survey. Applicants reported 13.7 weeks spent on plastic surgery rotations during medical school, including a mean of 9.2 weeks on away rotations. Average reported cost for away rotations was $3591 per applicant. Both applicants and program directors most commonly reported "making a good impression" (44.6 percent and 36.6 percent, respectively) or finding a "good-fit" program (27.7 percent and 48.8 percent, respectively) as the primary goal for away rotations. Almost all applicants (91.1 percent) believed an away rotation made them more competitive for matching to a program at which they rotated. Program directors ranked a strong away rotation performance as the most important residency selection criterion. Twenty-seven percent of postgraduate year-1 positions were filled by an away rotatorm and an additional 17 percent were filled by a home medical student. Away rotations appear to be mutually beneficial for applicants and programs in helping to establish a good fit between students and training programs through an extended interaction with the students, residents, and faculty. In addition, making a good impression on a senior elective rotation (home or away) may improve an applicant's chance of matching to a residency program.

  14. Is cricothyroid muscle twitch predictive of the integrity of the EBSLN in Thyroid Surgery?

    Science.gov (United States)

    Sung, Eui-Suk; Chang, Jae Hyeok; Kim, Jia; Cha, Wonjae

    2018-03-24

    Cricothyroid (CT) muscle twitch inspection with neurostimulation is a widely accepted method to identify the external branch of the superior laryngeal nerve (EBSLN) and its integrity in thyroid surgery. However, there has been no large-scale research to evaluate the diagnostic values of CT muscle twitch inspection based on postoperative electromyography (EMG) results, which are considered the gold standard. In this study, we aimed to demonstrate the diagnostic value of CT muscle twitch inspection based on postoperative EMG. Prospective cohort study. A total of 454 patients underwent primary thyroid surgery. Among them, 55 patients were excluded because of preoperative vocal fold palsy, problems with the stimulator, or refusal to participate in the EMG study. Finally, 399 patients were prospectively enrolled in this study. Intraoperatively, CT muscle twitch was inspected with neurostimulation. Bilateral EMG examination of the CT muscle was performed 2 to 3 months postoperatively in all patients. A total of 712 EBSLNs at risk were analyzed in this study. Of these, 21 (2.9%) nerves were visually identified, and positive CT muscle twitch by neurostimulation was observed in 694 (97.5%). Normal results on postoperative EMG of the CT muscle were reported in 657 (92.3%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 97.7%, 5.5%, 92.5%, and 16.7%, respectively. CT muscle twitch inspection could be a useful intraoperative tool to determine EBSLN integrity considering its high sensitivity and PPV. However, the test may not completely replace EMG for evaluating EBSLN integrity due to its low specificity and NPV. 2b. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Do Plastic Surgery Programs with Integrated Residencies or Subspecialty Fellowships Have Increased Academic Productivity?

    Science.gov (United States)

    Duquette, Stephen P.; Valsangkar, Nakul P.; Sood, Rajiv; Socas, Juan; Zimmers, Teresa A.

    2016-01-01

    Background: The aim of this study was to evaluate the effect of different surgical training pathways on the academic performance of plastic surgical divisions. Methods: Eighty-two academic parameters for 338 plastic surgeons (PS), 1737 general surgeons (GS), and 1689 specialist surgeons (SS) from the top 55 National Institutes of Health (NIH)-funded academic departments of surgery were examined using data gathered from websites, SCOPUS, and NIH Research Portfolio Online Reporting Tools. Results: The median size of a PS division was 7 faculty members. PS faculty had lower median publications (P)/citations (C) (ie, P/C) than GS and SS (PS: 25/328, GS: 35/607, and SS: 40/713, P < 0.05). Publication and citation differences were observed at all ranks: assistant professor (PS: 11/101, GS: 13/169, and SS: 19/249), associate professor (PS: 33/342, GS: 40/691, and SS: 44/780), and professor (PS: 57/968, GS: 97/2451, and SS: 101/2376). PS had a lower percentage of faculty with current/former NIH funding (PS: 13.5%, GS: 22.8%, and SS: 25.1%, P < 0.05). Academic productivity for PS faculty was improved in integrated programs. P/C for PS faculty from divisions with traditional 3-year fellowships was 19/153, integrated 6-year residency was 25/329, and both traditional and 6-year programs were 27/344, P < 0.05. Craniofacial and hand fellowships increased productivity within the integrated residency programs. P/C for programs with a craniofacial fellowship were 32/364 and for those that additionally had a hand fellowship were 45/536. PS faculty at divisions with integrated training programs also had a higher frequency of NIH funding. Conclusions: PS divisions vary in degree of academic productivity. Dramatically improved scholarly output is observed with integrated residency training programs and advanced specialty fellowships. PMID:27014543

  16. The effect of an integrated education model on anxiety and uncertainty in patients undergoing cervical disc herniation surgery.

    Science.gov (United States)

    Chuang, Mei-Fang; Tung, Heng-Hsin; Clinciu, Daniel L; Huang, Jing-Shan; Iqbal, Usman; Chang, Chih-Ju; Su, I-Chang; Lai, Fu-Chih; Li, Yu-Chuan

    2016-09-01

    Educating patients about receiving surgical procedures is becoming an important issue, as it can reduce anxiety and uncertainty while helping to hasten decisions for undergoing time sensitive surgeries. We evaluated a new integrated education model for patients undergoing cervical disc herniation surgery using a quasi-experimental design. The participants were grouped into either the new integrated educational model (n = 32) or the standard group (n = 32) on the basis of their ward numbers assigned at admission. Anxiety, uncertainty, and patient satisfaction were measured before (pre-test) and after the educational intervention (post-test-1) and post-surgery (post-test-2) to assess the effectiveness of the model in this intervention. We found that the generalized estimating equation modeling demonstrated this new integrated education model was more effective than the conventional model in reducing patients' anxiety and uncertainty (p approach to individual health. This novel systemic educational model enhances patient's understanding of the medical condition and surgery while promoting patient-caregiver interaction for optimal patient health outcomes. We present a comprehensive and consistent platform for educational purposes in patients undergoing surgery as well as reducing the psychological burden from anxiety and uncertainty. Integrating medicine, nursing, and new technologies into an e-practice and e-learning platform offers the potential of easier understanding and usage. It could revolutionize patient education in the future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review.

    Science.gov (United States)

    Zizzari, Vincenzo Luca; Zara, Susi; Tetè, Giulia; Vinci, Raffaele; Gherlone, Enrico; Cataldi, Amelia

    2016-10-01

    Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Microscope-integrated optical coherence tomography: A new surgical tool in vitreoretinal surgery.

    Science.gov (United States)

    Jayadev, Chaitra; Dabir, Supriya; Vinekar, Anand; Shah, Urmil; Vaid, Tania; Yadav, Naresh Kumar

    2015-05-01

    Optical coherence tomography (OCT) has revolutionized imaging of ocular structures and various disease conditions. Though it has been used in the clinic for some decades, the OCT has only recently found its way into the operating theater. Early attempts at intraoperative OCT, hand-held and microscope mounted, have already improved our understanding of the surgical pathology and the role it might play in surgical decision-making. The microscope-integrated OCT now allows seamless, high-resolution, real-time imaging of surgical maneuvers from the incision to wound closure. Visualization of instruments and intraoperative tissue manipulation are possible with this in vivo modality and, therefore, help improve the outcome of surgery. In this article, we describe the advantages it offers during various vitreoretinal procedures.

  19. [Three-dimensional cephalometry: applications in clinical practice and research].

    Science.gov (United States)

    Faure, Jacques; Oueiss, Arlette; Marchal-Sixou, Christine; Braga, José; Treil, Jacques

    2008-03-01

    A 3D cephalometric analysis method from scanner acquisition has been developed thanks to a long collaboration between Dr Treil and the Department of Orthodontics in Toulouse III University. It allows a perfect knowledge of maxillo-facial architecture using fourteen landmarks related to the neuromatricial axis of facial growth. These landmarks can be identified without ambiguity. The marking of each tooth relative to dental arches (gravity centre coordinates and torque and tipping of each tooth), and the location of arches relative to maxillo-facial frame are given by the analysis. Description and reconstruction of dental and maxillo-facial anatomy are possible with three levels: maxillo-facial frame, maxillar and mandibular bases and dentoalveolar level. The method not only gives more precise information than conventional cephalometrics in anteroposterior and vertical directions, but it allows transversal analysis and asymmetry measurement. Applications are numerous in research as well as in clinical medicine: analyses of cases border line surgery, surgical set-up, facial asymmetry, analysis of dentoalveolar compensations, definition of therapeutic aims, occlusal analysis and set-up, study of evolution in anthropology-primatology, study of growth etc. This method of description using a pattern of landmarks is perfectly adapted to the last developments of modern research techniques: morphometric geometry with Procustes superimpositions, EDMA, TPS, FEM.

  20. Diagnosis of dental deformities in cephalometry images using support vector machine.

    Science.gov (United States)

    Banumathi, Arumugam; Raju, S; Abhaikumar, Varathan

    2011-02-01

    This paper proposes an automated target recognition algorithm using Support Vector Machine (SVM) to extract landmark points for craniofacial features in cephalometry radiograph. The features are extracted by subjecting the radiograph to the Projected Principle Edge Distribution (PPED) algorithm. Edge flags are accumulated in every four columns and spatial distribution of edge flags are represented by a histogram. The resultants are the front end of support vector machine. Vectors, which possess land marks, are separated from all other vectors. The centroid points, automatically determined from PPED vectors, are the location of landmarks. The landmark points which are serving as a guide for construction and measurement of planes, are used to evaluate the dento-facial relationship, study of growth and development, and also for treatment planning.

  1. [Efficiency of cephalometry in orthodontic treatment planning: cephalometric parameters and their age-related changes].

    Science.gov (United States)

    Arsenina, O I; Shishkin, K M; Shishkin, M K; Popova, N V

    The aim of the study was to evaluate the efficiency of cephalometry in orthodontic treatment planning in patients with teeth crowding and Angle Class I molars relation. Cephalometric parameters were analyzed in 70 patients that completed orthodontic treatment in 'Orthodont' dental clinic (Samara). Cephalometric X-rays were taken at baseline examination and after treatment. In patients with crowding and Class I molars relationship treated with extraction of all four first premolars correlation between N-Se and mandibular and maxillary length was disturbed. These patients showed higher N-Se and reduced jaws length than patients with no extraction or extraction of 2 premolars. The observed increase of G angle with reduced mandibular length assumes compensatory changes of mandible position. These disproportions were aggravated by facial growth. In certain cases cephalometric assessment is inefficient for treatment strategy choice.

  2. [Cephalometry efficacy in orthodontic treatment planning: correlations of cephalometric values and their changes in the course of treatment].

    Science.gov (United States)

    Shishkin, K M; Arsenina, O I; Shishkin, M K; Popova, N V

    The aim of the study was to assess the efficacy of cephalometry in planning of orthodontic patients with teeth crowding (TC) and Angle Class I molar relationship (MR). Cephalometric values of 70 patients with TC and class I MR were analyzed before and after orthodontic treatment. Cephalometric study of correlations proved to be more relevant than comparing with mean values. In patients with TC and class I MR statistically significant were correlations with: facial profile (ÐN-A-B) and jaws relationship in anterio-posterior direction (ÐA-N-B); ÐN-A-B and type of maxillary growth (ÐPn-Mp, ÐB); ÐB and maxillary incisors inclination (Ðis-SpP); ÐPn-Mp and mandibular incisors inclination (Ðii-Mp). These correlations depend on age, anomaly severity and orthodontic strategy. Cephalometry proved to be effective tool for orthodontic treatment planning, prognosis and modelling.

  3. Two-Dimensional and Three-Dimensional Cephalometry Using Cone Beam Computed Tomography Scans.

    Science.gov (United States)

    Cassetta, Michele; Michele, Cassetta; Altieri, Federica; Federica, Altieri; Di Giorgio, Roberto; Roberto, Di Giorgio; Silvestri, Alessandro; Alessandro, Silvestri

    2015-06-01

    Lateral cephalometric radiograph produces a two-dimensional image with several drawbacks. Cone beam computed tomography (CBCT) allows obtaining a three-dimensional representation of the craniofacial structures and seems to overcome the problems of superimposition and magnification, providing more precision than two-dimensional methods. The aim of the current study was to test the intraobserver and interobserver reliability of linear and angular measurements performed on two-dimensional conventional cephalometric images and CBCT-generated cephalograms, and to evaluate if there is a statistically significant difference between the 2 methods of measurements. The sample group consisted of 24 adolescents with a pretreatment digital lateral radiograph and a corresponding CBCT image. A total of 16 cephalometric landmarks were identified and 17 widely used measurements (9 angular and 8 linear) were recorded by 2 independent observers. Intraobserver and interobserver reliability were assessed by calculating Pearson correlation coefficient. Student t-test was used to compare the 2 methods. The threshold for significance was set at P ≤ 0.05.Concerning the intraobserver and interobserver reliability, data showed a statistically significant correlation between all two-dimensional and three-dimensional measurements. The linear and angular measurements of two-dimensional and three-dimensional cephalometry were not statistically different. The results of the current study showed the reliability of both conventional two-dimensional and three-dimensional cephalometry. Linear and angular measurements from CBCT were found also to be similar to conventional measurements. Considering that conventional images deliver the lowest radiation doses to patients, the use of CBCT for orthodontic purposes should be limited.

  4. Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.

    Science.gov (United States)

    Pepin, J L; Ferretti, G; Veale, D; Romand, P; Coulomb, M; Brambilla, C; Lévy, P A

    1992-01-01

    BACKGROUND: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different. METHODS: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep. RESULTS: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram. CONCLUSIONS: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea. Images PMID:1519190

  5. Assessment of two e-learning methods teaching undergraduate students cephalometry in orthodontics.

    Science.gov (United States)

    Ludwig, B; Bister, D; Schott, T C; Lisson, J A; Hourfar, J

    2016-02-01

    Cephalometry is important for orthodontic diagnosis and treatment planning and is part of the core curriculum for training dentists. Training involves identifying anatomical landmarks. The aim of this investigation was to assess whether e-learning improves learning efficiency; a programme specifically designed for this purpose was compared to commercially available software. Thirty undergraduate students underwent traditional training of cephalometry consisting of lectures and tutorials. Tracing skills were tested immediately afterwards (T0). The students were then randomly allocated to three groups: 10 students served as control (CF); they were asked to improve their skills using the material provided so far. Ten students were given a program specifically designed for this study that was based on a power point presentation (PPT). The last group was given a commercially available program that included teaching elements (SW). The groups were tested at the end the six week training (T1). The test consisted of tracing 30 points on two radiographs and a point score improvement was calculated. The students were interviewed after the second test. Both e-learning groups improved more than the traditional group. Improvement scores were four for CF; 8.6 for PPT and 2.8 for SW. For PPT all participants improved and the student feedback was the best compared to the other groups. For the other groups some candidates worsened. Blended learning produced better learning outcomes compared to using a traditional teaching method alone. The easy to use Power Point based custom software produced better results than the commercially available software. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. A lateral cephalometry study of patients with neurofibromatosis type 1.

    Science.gov (United States)

    Friedrich, Reinhard E; Lehmann, Jan-Marten; Rother, Jonathan; Christ, Georg; Zu Eulenburg, Christine; Scheuer, Hannah T; Scheuer, Hanna A

    2017-06-01

    Neurofibromatosis type 1 (NF1) is an autosomal dominant transmitted tumour suppressor syndrome and also a bone disease. Osseous dysplasia affecting the craniofacial region is characteristic of NF1. The aim of this study was to analyse the lateral cephalograms of NF1 patients in comparison to individuals who were not affected by this condition in order to describe the skeletal phenotype of NF1 in more detail. The study comprises the lateral cephalograms of 172 patients with established NF1 diagnoses (female = 85, male = 87). NF1 patients were distinguished by radiological and/or histological findings of the facial region suggestive of plexiform neurofibroma (PNF) or disseminated cutaneous NF (DNF). The analysed radiographs of a collection of 29 healthy volunteers with ideal occlusion served as controls. The focus of this analysis was cephalometrically defined angles. Cephalometric analyses of patients with DNF did not differ from those of controls for the vast majority of parameters. However, the measurement results of patients with PNF differed significantly from those of healthy volunteers and patients with DNF. The number of trigeminal nerve branches affected in PNF patients had an effect on the measurement results. Lateral cephalograms revealed no significant alteration of the facial skeleton in NF1 patients as compared to controls. Indeed, the stigma of a so-called 'NF1 facies' cannot be derived from the cephalometric findings presented. Notably, a wide range of deviating readings were recorded for individuals with facial PNF. Clinicians who treat patients with NF1 should be aware of deviations from cephalometric standards on lateral cephalograms in NF1 patients, especially when craniofacial surgical procedures are planned. Some of these findings, particularly asymmetries of the facial skeleton, could be indicators of an associated PNF. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. THE ALCOHOL CONSUMPTION IS AMENDED AFTER BARIATRIC SURGERY? AN INTEGRATIVE REVIEW.

    Science.gov (United States)

    Gregorio, Valeria Duarte; Lucchese, Roselma; Vera, Ivânia; Silva, Graciele C; Silva, Andrecia; Moraes, Rayrane Clarah Chaveiro

    Bariatric surgery has been an alternative when conservative methods of weight loss fail. Patients undergoing bariatric surgery have an increased risk of up to 6.5% of problems related to alcohol. Integrative review out to analyze the change of alcohol consumption in this public. Database was accessed from June of 2015 to January of 2016 by searching "bariatric surgery" AND "alcoholism", and their Portuguese equivalents. ScienceDirect, PubMed, Lilacs and Medline, besides manual search, were searched. To be included, the paper should have been published between 2005-2016 and related to bariatric surgery and alcoholism. Theses, dissertations, unpublished papers, case reports and theoretical studies were excluded, and a database was subsequently composed. In 2005 there was only a review of change in alcohol metabolism in patients undergoing bariatric surgery. There were no publications in 2006. In 2007, only one study was published, and it did not meet the inclusion criteria. In 2010, there was an increase of 13% in publications and of 20% in 2012, reaching 40% in 2013. The prevalence and incidence of alcohol consumption in relation to the postoperative time was six months to three years with higher incidence for follow-up treatment by men. Roux-en-Y gastric bypass showed greater association with increased consumption of alcohol during the postoperative period. Alcohol consumption proved to be essential to be faced in bariatric surgery. A cirurgia bariátrica tem-se mostrado alternativa para o insucesso dos métodos conservadores de emagrecimento. Pacientes submetidos a ela têm 6,5% aumento do risco de terem problemas relacionados ao álcool. Realizar revisão integrativa para verificar alteração do consumo de álcool neste publico. A base de dados Science Direct, PubMed, Lilacs, Medline e busca manual foram acessadas entre os meses de junho de 2015 a janeiro de 2016 com os descritores "cirurgia bariátrica" e "alcoolismo" e equivalentes em inglês Os critérios de

  8. Applicability of the Ricketts’ posteroanterior cephalometry for sex determination using logistic regression analysis in Hispano American Peruvians

    Science.gov (United States)

    Perez, Ivan; Chavez, Allison K.; Ponce, Dario

    2016-01-01

    Background: The Ricketts' posteroanterior (PA) cephalometry seems to be the most widely used and it has not been tested by multivariate statistics for sex determination. Objective: The objective was to determine the applicability of Ricketts' PA cephalometry for sex determination using the logistic regression analysis. Materials and Methods: The logistic models were estimated at distinct age cutoffs (all ages, 11 years, 13 years, and 15 years) in a database from 1,296 Hispano American Peruvians between 5 years and 44 years of age. Results: The logistic models were composed by six cephalometric measurements; the accuracy achieved by resubstitution varied between 60% and 70% and all the variables, with one exception, exhibited a direct relationship with the probability of being classified as male; the nasal width exhibited an indirect relationship. Conclusion: The maxillary and facial widths were present in all models and may represent a sexual dimorphism indicator. The accuracy found was lower than the literature and the Ricketts' PA cephalometry may not be adequate for sex determination. The indirect relationship of the nasal width in models with data from patients of 12 years of age or less may be a trait related to age or a characteristic in the studied population, which could be better studied and confirmed. PMID:27555732

  9. Applicability of the Ricketts' posteroanterior cephalometry for sex determination using logistic regression analysis in Hispano American Peruvians.

    Science.gov (United States)

    Perez, Ivan; Chavez, Allison K; Ponce, Dario

    2016-01-01

    The Ricketts' posteroanterior (PA) cephalometry seems to be the most widely used and it has not been tested by multivariate statistics for sex determination. The objective was to determine the applicability of Ricketts' PA cephalometry for sex determination using the logistic regression analysis. The logistic models were estimated at distinct age cutoffs (all ages, 11 years, 13 years, and 15 years) in a database from 1,296 Hispano American Peruvians between 5 years and 44 years of age. The logistic models were composed by six cephalometric measurements; the accuracy achieved by resubstitution varied between 60% and 70% and all the variables, with one exception, exhibited a direct relationship with the probability of being classified as male; the nasal width exhibited an indirect relationship. The maxillary and facial widths were present in all models and may represent a sexual dimorphism indicator. The accuracy found was lower than the literature and the Ricketts' PA cephalometry may not be adequate for sex determination. The indirect relationship of the nasal width in models with data from patients of 12 years of age or less may be a trait related to age or a characteristic in the studied population, which could be better studied and confirmed.

  10. Vertical palatal bone dimensions on lateral cephalometry and cone-beam computed tomography: implications for palatal implant placement.

    Science.gov (United States)

    Jung, Britta A; Wehrbein, Heinrich; Heuser, Lothar; Kunkel, Martin

    2011-06-01

    To evaluate the necessity of three-dimensional imaging (computed tomography [CT]/cone-beam computed tomography [CBCT]) for paramedian insertion of palatal implants. Lateral radiographs and CBCT scans were performed from 18 human skulls. For lateral cephalometry, the nasal floor (right/left) and the oral hard palate of all skulls were lined with a tin foil for contrast enhancement. The quantity of vertical bone as measured on lateral radiographs was compared with CBCT measurements obtained in median and parasagittal planes and at minimum bone height. Spearman's rank correlation coefficients were determined for bivariate correlation analysis. The median palatal bone height on CBCT (mean 8.98 mm; standard deviation [SD] 3.4) was markedly higher than the vertical height seen on lateral radiographs (mean 6.6 mm; SD 3.2). Comparing lateral cephalometry with CBCT, the strongest association was observed at the minimum palatal bone height (r=0.926; Pcephalometry reflects the minimum bone height rather than maximum bone in the median plane. Therefore, a preoperative CT or CBCT is only indicated when the lateral cephalometry reveals a marginal quantity of bone. © 2010 John Wiley & Sons A/S.

  11. A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

    Science.gov (United States)

    O'Heron, Colette T; Jarman, Benjamin T

    2014-01-01

    To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  12. The influence of simultaneous integrated boost, hypofractionation and oncoplastic surgery on cosmetic outcome and PROMs after breast conserving therapy

    NARCIS (Netherlands)

    Lansu, J.T.; Essers, M.; Voogd, A.C.; Luiten, E.J.; Buijs, C.; Groenendaal, N.; Poortmans, P.M.P.

    2015-01-01

    INTRODUCTION: We retrospectively investigated the possible influence of a simultaneous integrated boost (SIB), hypofractionation and oncoplastic surgery on cosmetic outcome in 125 patients with stage I-II breast cancer treated with breast conserving therapy (BCT). PATIENTS AND METHODS: The boost was

  13. Generation Y and the Integrated Plastic Surgery Residency Match: A Cross-sectional Study of the 2011 Match Outcomes

    Science.gov (United States)

    Narayan, Deepak

    2013-01-01

    Background: Plastic surgery is the most competitive specialty in medicine. We sought to identify factors associated with the successful match of generation Y applicants into integrated plastic surgery residency. Methods: We utilized the most recent data from the Charting Outcomes in the Match published by the National Resident Matching Program in 2011. We had data on US senior or independent applicant status, Alpha Omega Alpha (AOA) status, attendance of top 40 medical schools, advanced degree status, and number of contiguous ranks within plastic surgery. Our main outcome measure was match status. Results: A total of 81 out of 197 applicants (41.1%) successfully matched into integrated plastic surgery in the 2011 main match. US seniors matched at a significantly higher rate compared to independent applicants (44.0% vs 24.1%, P = 0.044). Matched US seniors were more likely to have AOA membership compared to unmatched US seniors (45.9% vs 27.7%, P = 0.014) and attend a top 40 medical school (52.7% vs 35.1%, P = 0.022). There were no differences in terms of advanced degrees between matched and unmatched US seniors. Unmatched US seniors were more likely to have 3 or fewer contiguous ranks of plastic surgery residency programs than matched US seniors (86.2% vs 68.9%, P = 0.007). Conclusions: US senior status, AOA membership, and attendance at a top 40 medical school are predictors of matching into integrated plastic surgery. Program directors need to be aware of the background of the millennial applicants to recruit and maintain top residents. PMID:25289227

  14. Effect of integrated surgery + radiotherapy + chemotherapy treatment on survival status and serum indexes in patients with gallbladder carcinoma

    Directory of Open Access Journals (Sweden)

    Zhi-Li Wei

    2016-12-01

    Full Text Available Objective: To study the effect of integrated surgery + radiotherapy + chemotherapy treatment on the survival status and serum indexes in patients with gallbladder carcinoma. Methods: A total of 68 patients with gallbladder carcinoma were divided into observation group (received integrated surgery + radiotherapy + chemotherapy treatment and control group (received surgery + radiotherapy according to different treatments. Differences in the content of tumor markers, growth factors and adhesion molecules in serum as well as the median survival time and survival rate in 5 years of follow-up were compared between the two groups 1 month after treatment. Results: Tumor markers β2-MG, CA19-9, CA242, CA125, CA724, CEA and AFP content in serum of observation group after treatment were significantly lower than those of control group; growth factors VEGF, FGF, EGFR and HER2 content in serum were significantly lower than those of control group while IGFBP-2 and IGFBP-3 content were significantly higher than those of control group; adhesion molecules E-selectin, ICAM-1, VCAM-1 and sE-Cd content in serum were significantly lower than those of control group; the median survival time of 5-year follow-up as well as 1-, 3- and 5-year survival rate were significantly greater than those of control group. Conclusions: Integrated treatment of surgery + radiotherapy + chemotherapy can optimize the short-term and long-term curative effect in patients with gallbladder carcinoma.

  15. The DISCOVER Study 3-Year Results: Feasibility and Usefulness of Microscope-Integrated Intraoperative OCT during Ophthalmic Surgery.

    Science.gov (United States)

    Ehlers, Justis P; Modi, Yasha S; Pecen, Paula E; Goshe, Jeff; Dupps, William J; Rachitskaya, Aleksandra; Sharma, Sumit; Yuan, Alex; Singh, Rishi; Kaiser, Peter K; Reese, Jamie L; Calabrise, Carmen; Watts, Allison; Srivastava, Sunil K

    2018-02-03

    To report the 3-year assessment of feasibility and usefulness of microscope-integrated intraoperative OCT (iOCT) during ophthalmic surgery. Prospective, consecutive case series. Adult participants undergoing incisional ophthalmic surgery with iOCT imaging who consented to be enrolled in the Determination of Feasibility of Intraoperative Spectral-Domain Microscope Combined/Integrated OCT Visualization during En Face Retinal and Ophthalmic Surgery (DISCOVER) study. The DISCOVER study is a single-site, multisurgeon, institutional review board-approved investigational device prospective study. Participants included patients undergoing anterior or posterior segment surgery who underwent iOCT imaging with 1 of 3 prototype microscope-integrated iOCT systems (i.e., Zeiss Rescan 700, Leica EnFocus, or Cole Eye iOCT systems). Clinical characteristics were documented, iOCT was directed by the operating surgeon at predetermined surgical time points, and each surgeon completed a questionnaire after surgery to evaluate the usefulness of iOCT during surgery. Feasibility of iOCT based ability to obtain an OCT image during surgery and usefulness of iOCT based on surgeon reporting during surgery. Eight hundred thirty-seven eyes (244 anterior segment cases and 593 posterior segment cases) were enrolled in the DISCOVER study. Intraoperative OCT demonstrated feasibility with successful image acquisition in 820 eyes (98.0%; 95% confidence interval [CI], 96.8%-98.8%). In 106 anterior segment cases (43.4%; 95% CI, 37.1%-49.9%), the surgeons indicated that the iOCT information impacted their surgical decision making and altered the procedure. In posterior segment procedures, surgeons reported that iOCT enabled altered surgical decision making during the procedure in 173 cases (29.2%; 95% CI, 25.5%-33.0%). The DISCOVER iOCT study demonstrated both generalized feasibility and usefulness based on the surgeon-reported impact on surgical decision making. This large-scale study confirmed similar

  16. Instruments used in the assessment of expectation toward a spine surgery: an integrative review.

    Science.gov (United States)

    Nepomuceno, Eliane; Silveira, Renata Cristina de Campos Pereira; Dessotte, Carina Aparecida Marosti; Furuya, Rejane Kiyomi; Arantes, Eliana De Cássia; Cunha, Débora Cristine Prévide Teixeira da; Dantas, Rosana Aparecida Spadoti

    2016-01-01

    To identify and describe the instruments used to assess patients' expectations toward spine surgery. An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. Identificar e descrever os instrumentos usados para avaliar a expectativa dos pacientes diante do tratamento cirúrgico da coluna vertebral. Revisão Integrativa realizada nas bases de dados PubMed, CINAHL, LILACS e PsycINFO. Identificamos 4.402 publicações, das quais 25 atenderam aos critérios de seleção. Dos estudos selecionados, apenas em três os autores utilizaram instrumentos que possuíam validade e confiabilidade confirmadas para serem aplicados; em cinco estudos foram utilizados escores clínicos, modificados para a avaliação das expectativas dos pacientes, e em dezessete os pesquisadores elaboraram escalas sem adequada descrição do método usado para o seu desenvolvimento e validação. A avaliação das expectativas dos pacientes tem sido metodologicamente conduzida de diferentes maneiras. Até a finalização desta revisão integrativa, apenas dois instrumentos, válidos e confiáveis, haviam sido utilizados em três dos estudos selecionados.

  17. Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

    Science.gov (United States)

    Alken, Alexander; Luursema, Jan-Maarten; Weenk, Mariska; Yauw, Simon; Fluit, Cornelia; van Goor, Harry

    2017-08-25

    Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Coaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. Surgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. Twelve experienced surgical teachers participated in this study. Coaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. Priming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. Patient care, Practice based learning and improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Recent trends in applicants and the matching process for the integrated plastic surgery match.

    Science.gov (United States)

    Super, Nikki; Tieman, Joshua; Boucher, Kenneth; Rockwell, William Bradford; Agarwal, Jayant P

    2013-10-01

    Matching into a plastic surgery (PS) residency program is a highly competitive process. Selection criteria are very stringent and may influence an applicant's candidacy and application strategy. The purpose of this study was to evaluate recent trends of applicants matching into integrated PS programs using published National Resident Match Program data. Residency match data were gathered for application years 2002 to 2011 using the National Resident Match Program/Association of American Medical Colleges databases. Analyses were limited to the US senior group and excluded the non-US senior group because of the small numbers in the latter group. For all data sets, a logistic regression was performed to analyze the statistical significance of the data. The overall match rate continues to approximately 50%. United States senior applicants were more likely to rank PS only versus PS and others (PS + other) over time (P ranking PS only were more likely to match versus US senior applicants ranking PS + other (odds ratio, 1.71; P rank PS only. The proportion of applicants ranking PS only is steadily rising. The ranking strategy used by US senior applicants is self-selecting into a more competitive (PS only) and less competitive (PS + other) applicant pool. If this continues, nearly 50% of applicants will not match and could be left scrambling for an alternative residency position. These findings therefore suggest that all candidates, regardless of their perceived application strength, should consider having a "backup plan."

  19. Mechatronic design of a fully integrated camera for mini-invasive surgery.

    Science.gov (United States)

    Zazzarini, C C; Patete, P; Baroni, G; Cerveri, P

    2013-06-01

    This paper describes the design features of an innovative fully integrated camera candidate for mini-invasive abdominal surgery with single port or transluminal access. The apparatus includes a CMOS imaging sensor, a light-emitting diode (LED)-based unit for scene illumination, a photodiode for luminance detection, an optical system designed according to the mechanical compensation paradigm, an actuation unit for enabling autofocus and optical zoom, and a control logics based on microcontroller. The bulk of the apparatus is characterized by a tubular shape with a diameter of 10 mm and a length of 35 mm. The optical system, composed of four lens groups, of which two are mobile, has a total length of 13.46 mm and an effective focal length ranging from 1.61 to 4.44 mm with a zoom factor of 2.75×, with a corresponding angular field of view ranging from 16° to 40°. The mechatronics unit, devoted to move the zoom and the focus lens groups, is implemented adopting miniature piezoelectric motors. The control logics implements a closed-loop mechanism, between the LEDs and photodiode, to attain automatic control light. Bottlenecks of the design and some potential issues of the realization are discussed. A potential clinical scenario is introduced.

  20. A survey of demographics, motivations, and backgrounds among applicants to the integrated 0 + 5 vascular surgery residency.

    Science.gov (United States)

    Lee, Jason T; Teshome, Mediget; de Virgilio, Christian; Ishaque, Brandon; Qiu, Mary; Dalman, Ronald L

    2010-02-01

    The 0 + 5 integrated vascular surgery (VS) residency has altered the training paradigm for future vascular specialists. Rising interest in these novel programs highlights our need to better understand the applicant pool. We compared demographics and surveyed recent applicants to our integrated program to gain more insight into their background and motivation for accelerated vascular training. Demographics and objective parameters were determined from all 65 applicants to the integrated VS program at Stanford University Medical Center and compared to 58 applicants interviewed by the general surgery (GS) program at Harbor-UCLA Medical Center by querying the Electronic Residency Application System for the programs in 2009. There was no overlap of applicants between programs. An anonymous, voluntary Web-based survey was sent to these cohorts with a response rate of 82% for VS applicants and 60% for GS applicants. Subjects were queried regarding their background, personal experience, prior exposure to VS, and motivations for residency specialty selection. Applicants to integrated VS programs tended to be older, were less likely to be from a US medical school, had a higher number of publications, and a higher percentage of cardiovascular-related publications than the GS applicants. When stratified by the 27 VS applicants (41%) that were offered an interview, this highly selected and desirable group for training was nearly 40% female, more likely to have an additional degree (PhD, master's), just as likely to be in the top quartile of their medical school class (60%), and score equally well on standardized board examinations (90th percentile) than the top GS applicants offered interviews. Survey data revealed that the majority of career choices (65%) were made during the third and fourth years of medical school. Factors most strongly influencing the decision to choose VS as a career were endovascular technologies/devices, challenging open vascular operations, clinical

  1. A novel dental implant guided surgery based on integration of surgical template and augmented reality.

    Science.gov (United States)

    Lin, Yen-Kun; Yau, Hong-Tzong; Wang, I-Chung; Zheng, Cheng; Chung, Kwok-Hung

    2015-06-01

    Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery. The aim of this study was to develop an augmented reality-based dental implant placement system and evaluate the accuracy of the virtually planned versus the actual prepared implant site created in vitro. Four fully edentulous mandibular and four partially edentulous maxillary duplicated casts were used. Six implants were planned in the mandibular and four in the maxillary casts. A total of 40 osteotomy sites were prepared in the casts using stereolithographic template integrated with augmented reality-based surgical simulation. During the surgery, the dentist could be guided accurately through a head-mounted display by superimposing the virtual auxiliary line and the drill stop. The deviation between planned and prepared positions of the implants was measured via postoperative computer tomography generated scan images. Mean and standard deviation of the discrepancy between planned and prepared sites at the entry point, apex, angle, depth, and lateral locations were 0.50 ± 0.33 mm, 0.96 ± 0.36 mm, 2.70 ± 1.55°, 0.33 ± 0.27 mm, and 0.86 ± 0.34 mm, respectively, for the fully edentulous mandible, and 0.46 ± 0.20 mm, 1.23 ± 0.42 mm, 3.33 ± 1.42°, 0.48 ± 0.37 mm, and 1.1 ± 0.39 mm, respectively, for the partially edentulous maxilla. There was a statistically significant difference in the apical deviation between maxilla and mandible in this surgical simulation (p augmented reality technology. © 2013 Wiley Periodicals, Inc.

  2. [Procuste cephalometry].

    Science.gov (United States)

    Penin, X

    2006-12-01

    Procrustean cephalometrics employs Procrustes's methods to analyze cranio-facial and orthodontic structures. Using this technique, which is structured on a rigorous mathematical base, orthodontists can avoid the biases and limitations of traditional analyses based on index angles and linear measurements. The starting data are the coordinates of the anatomic landmarks discerned on a profile cephalometric X-ray. Employing this data, orthodontists can calculate patients' type and stage of growth. These factors, representative of the normal variability of each patient, make it possible for the orthodontist to calculate an individualized reference base: a harmonious face in good balance of the same type and at the same growth stage as the patient. Finally, orthodontists make the best possible superimposition of this personalized, "ideal" radiographic sketch on the patient's headplate, by using anatomic landmarks, not a reference plane, to determine the areas that are out of balance and identify the anomalies that will need to be corrected during treatment.

  3. A Comparison of Training Experience, Training Satisfaction, and Job Search Experiences between Integrated Vascular Surgery Residency and Traditional Vascular Surgery Fellowship Graduates.

    Science.gov (United States)

    Colvard, Benjamin; Shames, Murray; Schanzer, Andres; Rectenwald, John; Chaer, Rabih; Lee, Jason T

    2015-10-01

    The first 2 integrated vascular residents in the United States graduated in 2012, and in 2013, 11 more entered the job market. The purpose of this study was to compare the job search experiences of the first cohort of integrated 0 + 5 graduates to their counterparts completing traditional 5 + 2 fellowship programs. An anonymous, Web-based, 15-question survey was sent to all 11 graduating integrated residents in 2013 and to the 25 corresponding 5 + 2 graduating fellows within the same institution. Questions focused on the following domains: training experience, job search timelines and outcomes, and overall satisfaction with each training paradigm. Survey response was nearly 81% for the 0 + 5 graduates and 64% for the 5 + 2 graduates. Overall, there was no significant difference between residents and fellows in the operative experience obtained as measured by the number of open and endovascular cases logged. Dedicated research time during the entire training period was similar between residents and fellows. Nearly all graduates were extremely satisfied with their training and had positive experiences during their job searches with respect to starting salaries, numbers of offers, and desired practice type. More 0 + 5 residents chose academic and mixed practices over private practices compared with 5 + 2 fellowship graduates. Although longer term data are needed to understand the impact of the addition of 0 + 5 graduating residents to the vascular surgery work force, preliminary survey results suggest that both training paradigms (0 + 5 and 5 + 2) provide positive training experiences that result in excellent job search experiences. Based on the current and future need for vascular surgeons in the work force, the continued growth and expansion of integrated 0 + 5 vascular surgery residency positions as an alternative to traditional fellowship training is thus far justified. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Integrated Plastic Surgery Residency Applicant Trends and Comparison With Other Surgical Specialties.

    Science.gov (United States)

    Abraham, Jasson T; Nguyen, Anson V; Weber, Robert A

    2018-02-01

    There has been a relatively rapid increase in the number and size of "integrated" residency programs in plastic surgery (PS) over the past decade. The objective of this study is to evaluate trends of US senior applicants of PS compared with other surgical specialties from 2007 to 2016. Data were obtained from "NRMP: Main Residency Match" and from "NRMP: Charting Outcomes in the Match." Frequencies, percentages, and proportions were calculated for categorical variables. Odds ratios with 95% confidence interval were calculated to evaluate the relationship of Alpha Omega Alpha membership and match success. The overall National Resident Matching Program match rate ranged from 93.1% to 95.1%, but rates were lower for surgical specialties, ranging from 74.7% to 86.6% in 2016. From 2008 to 2016, PS had a relatively high growth rate in the number of positions (65.2%) from 2008 to 2016. Matched PS and Otolaryngology applicants routinely had the highest mean United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge scores. Alpha Omega Alpha membership has a significant impact on successfully matching into a surgical specialty (P < 0.1). Matched applicants of surgical subspecialties (PS, Otolaryngology, orthopedics, and neurosurgery) had similar mean number of research, work, and volunteer experiences. However, PS and neurosurgery matched applicants had notably higher mean research productivity. The rapid increase in the number of positions in PS residency training has not resulted in a decrease in caliber of matched applicants, even though match rates have dramatically increased. Currently, PS continues to attract and successfully match highly qualified applicants, but other surgical specialties have increasingly similar board scores and mean number of extracurricular experiences.

  5. Reference values for three-dimensional surface cephalometry in children aged 3-6 years.

    Science.gov (United States)

    Möller, M; Schaupp, E; Massumi-Möller, N; Zeyher, C; Godt, A; Berneburg, M

    2012-05-01

    This prospective cross-sectional study design was performed to define reference values for the facial surfaces of 3-6-year-old boys and girls using three-dimensional surface cephalometry. A total of 2290 standardized three-dimensional facial images from 3 to 6-year-old preschool children were separated by gender and assigned to four age categories. All children were Caucasian and revealed no evidence of dentofacial abnormalities. On each image, 31 cephalometric landmarks were marked, resulting in 35 (19 frontal, six lateral, 10 paired) distances and eight angles. Differences between age groups and genders were calculated and significances detected. A base table with reference values was compiled, which indicated that boys showed higher values than age-matched girls and that measured distances increased with age. The mean values from this study could be compiled as a reference table for three-dimensional facial analysis in Caucasian children aged 3-6 years. Such a reference table could be used in comparative studies with other populations or children with craniofacial malformations. © 2012 John Wiley & Sons A/S.

  6. The effects of differences in landmark identification on the cephalometric measurements in traditional versus digitized cephalometry.

    Science.gov (United States)

    Chen, Yi-Jane; Chen, Ssu-Kuang; Yao, Jane Chung-Chen; Chang, Hsin-Fu

    2004-04-01

    The aim of this study was to explore the effects of differences in landmark identification on the values of cephalometric measurements on digitized cephalograms in comparison with those obtained from original radiographs. Ten cephalometric radiographs were randomly selected from orthodontic patients' records. Seven orthodontic residents identified 19 cephalometric landmarks on the original radiographs and digitized images. Twenty-seven cephalometric measurements were computed with a customized computer-aided program. To assess the concordance between cephalometric measurements derived from landmarks identified on the original radiographs and those from digitized counterparts, the values of 27 cephalometric measurements were compared to quantify the absolute value of measurement difference and the interobserver errors between these two methods. We found that the differences of all cephalometric measurements between original radiographs and their digitized counterparts were statistically significant. The differences in 21 of the 27 cephalometric items were less than two units of measurement (mm or degree), which is generally within one standard deviation of norm values in conventional cephalometric analysis. Moreover, statistically significant differences of interobserver errors between the two methods were noted only for seven of the 27 cephalometric items. In conclusion, the measurement differences between the original cephalograms and the digitized images are statistically significant but clinically acceptable. The interobserver errors for cephalometric measurements on our digitized cephalometric images are generally comparable with those on the original radiographs. The results of our study substantiated the benefits of digital cephalometry in terms of the reliability of cephalometric analysis.

  7. Preliminary evaluation of cone beam computed tomography in three-dimensional cephalometry for clinical application.

    Science.gov (United States)

    Li, Na; Hu, Bo; Mi, Fanglin; Song, Jinlin

    2017-05-01

    The present study was conducted to evaluate the three-dimensional (3D) cephalometry accuracy of cone-beam computed tomography (CBCT). A total of 40 newly diagnosed orthodontic patients (including 18 males and 22 females; age range, 12-18 years) were subjected to CBCT scanning and X-ray imaging in order to obtain lateral cephalograms. The 3D CBCT cephalograms were reconstructed and measured with in vivo 5.1 software, and compared with the results from the conventional 2D lateral cephalograms. Measurements in the two images were performed twice using the Steiner and Tweed standards and a single analyzer paired t-test was used to analyze the differences between the two cephalometric methods. The results indicated that the two methods showed significant differences in all 12 angle and 5 linear measurements (P<0.05). These findings indicated that CBCT is a more accurate technique compared with the conventional 2D method. In conclusion, CBCT may provide diagnostic and treatment information for maxillofacial deformities by using fast computer-aided analysis platform.

  8. Evaluation of surgically assisted maxillary expansion using acoustic rhinometry and postero-anterior cephalometry.

    Science.gov (United States)

    Baraldi, C E; Pretto, S M; Puricelli, E

    2007-04-01

    Correction of maxillary transverse deficiencies is a common procedure in adult patients presenting dentofacial anomalies. Nasal characteristics of these patients, as well as the effects of these procedures upon nasal patency, have not been well described yet. In the present study, measurements performed by acoustic rhinometry and frontal cephalometry in 13 patients presenting maxillary deficiencies, before and after surgically assisted maxillary expansion (SARME), were compared with those of 10 individuals with normal dentofacial characteristics and without nasal symptoms. The variables analysed were minor cross-sectional area (MCA) and nasal volume, maxillomandibular transverse index and nasal and maxillary width. The results showed a smaller transverse width and MCA in the patients as compared with normal controls. All measurements showed a tendency to increase after SARME. The nasal volumes did not differ. The nasal width showed wide variation. There was no correlation among the variables. Patients presenting maxillary transverse deficiency seem to have lower values for nasal MCA, with a tendency to increase after SARME.

  9. Contingencies of Self-Worth and Psychological Distress in Iranian Patients Seeking Cosmetic Surgery: Integrative Self-Knowledge as Mediator.

    Science.gov (United States)

    Valikhani, Ahmad; Goodarzi, Mohammad Ali

    2017-08-01

    Although previous studies have shown that people applying for cosmetic surgery experience high-intensity psychological distress, important variables that function as protective factors have rarely been the subject of study in this population. Therefore, this study aims to investigate the role of low and high self-knowledge in experiencing psychological distress and contingencies of self-worth to appearance and approval from others and to identify the mediatory role of the integrative self-knowledge in patients seeking cosmetic surgery. Eighty-eight patients seeking cosmetic surgery were selected and completed the contingencies of self-worth and integrative self-knowledge scales, as well as the depression, anxiety and stress scale. Data were analyzed using multivariate analysis of variance (MANOVA) and path analysis using 5000 bootstrap resampling. The results of MANOVA showed that patients seeking cosmetic surgery with high self-knowledge had lower levels of depression, anxiety and stress compared to patients with low self-knowledge. They also gained lower scores in contingencies of self-worth to appearance and approval from others. The results of path analysis indicated that self-knowledge is a complete mediator in the relationship between contingencies of self-worth to appearance and approval from others and psychological distress. Based on the results of this study, it can be concluded that self-knowledge as a protective factor plays a major role in relation to the psychological distress experienced by the patients seeking cosmetic surgery. In fact, by increasing self-knowledge among this group of patients, their psychological distress can be decreased. 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 .

  10. Nursing assistance at the hospital discharge after cardiac surgery: integrative review.

    Science.gov (United States)

    Jesus, Daniela Fraga de; Marques, Patrícia Figueiredo

    2013-01-01

    The study aimed to analyze the available evidence in the literature on nursing care in the hospital post-cardiac surgery. Data were collected from electronic databases LILACS, SciELO, MEDLINE, via DeCS thoracic surgery, hospital, nursing care, in the period 2001 to 2011. Ten articles were selected that showed the need to develop a plan of nursing discharge focusing on prevention of complications and coping with physical limitations resulting from heart surgery. Thus, the discharge should be considered from the time of admission, with carefully planned actions involving patient and family.

  11. Comparison of minimally invasive spine surgery using intraoperative computed tomography integrated navigation, fluoroscopy, and conventional open surgery for lumbar spondylolisthesis: a prospective registry-based cohort study.

    Science.gov (United States)

    Wu, Meng-Huang; Dubey, Navneet Kumar; Li, Yen-Yao; Lee, Ching-Yu; Cheng, Chin-Chang; Shi, Chung-Sheng; Huang, Tsung-Jen

    2017-08-01

    To date, the surgical approaches for the treatment of lumbar spondylolisthesis by transforaminal lumbar interbody fusion (TLIF) using minimally invasive spine surgery assisted with intraoperative computed tomography image-integrated navigation (MISS-iCT), fluoroscopy (MISS-FS), and conventional open surgery (OS) are debatable. This study compared TLIF using MISS-iCT, MISS-FS, and OS for treatment of one-level lumbar spondylolisthesis. This is a prospective, registry-based cohort study that compared surgical approaches for patients who underwent surgical treatment for one-level lumbar spondylolisthesis. One hundred twenty-four patients from January 2010 to March 2012 in a medical center were recruited. The outcome measures were clinical assessments, including Short-Form 12, visual analog scale (VAS), Oswestry Disability Index, Core Outcome Measurement Index, and patient satisfaction, and blood loss, hospital stay, operation time, postoperative pedicle screw accuracy, and superior-level facet violation. All surgeries were performed by two senior surgeons together. Ninety-nine patients (40M, 59F) who had at least 2 years' follow-up were divided into three groups according to the operation methods: MISS-iCT (N=24), MISS-FS (N=23), and OS (N=52) groups. Charts and surgical records along with postoperative CT images were assessed. MISS-iCT and MISS-FS demonstrated a significantly lowered blood loss and hospital stay compared with OS group (p2 mm) was found. However, a lower superior-level facet violation rate was observed in the MISS-iCT and OS groups (p=.049). MISS-iCT TLIF demonstrated reduced operation time, blood loss, superior-level facet violation, hospital stay, and improved functional outcomes compared with the MISS-FS and OS approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Current Practices and Barriers to the Integration of Oncoplastic Breast Surgery: A Canadian Perspective.

    Science.gov (United States)

    Maxwell, Jessica; Roberts, Amanda; Cil, Tulin; Somogyi, Ron; Osman, Fahima

    2016-10-01

    Despite the safety and popularity of oncoplastic surgery, there is limited data examining utilization and barriers associated with its incorporation into practice. This study examines the use of oncoplastic techniques in breast conserving surgery and determines the barriers associated with their implementation. A 13-item survey was mailed to all registered general surgeons in Ontario, Canada. The survey assessed surgeon demographics, utilization of specific oncoplastic techniques, and perceived barriers. A total of 234 survey responses were received, representing a response rate of 32.2 % (234 of 725). Of the respondents, 166 surgeons (70.9 %) reported a practice volume of at least 25 % breast surgery. Comparison was made between general surgeons performing oncoplastic breast surgery (N = 79) and those who did not use these techniques (N = 87). Surgeon gender, years in practice, fellowship training, and access to plastic surgery were similar across groups. Both groups rated the importance of breast cosmesis similarly. General surgeons with a practice volume involving >50 % breast surgery were more likely to use oncoplastic techniques (OR 8.82, p breast conserving surgery (OR 2.21, p = .02). For surgeons not performing oncoplastic surgery, a lack of training and access to plastic surgeons were identified as significant barriers. For those using oncoplastic techniques, the absence of specific billing codes was identified as a limiting factor. Lack of training, access to plastic surgeons, and absence of appropriate reimbursement for these cases are significant barriers to the adoption of oncoplastic techniques.

  13. [The third dimension tomography versus cranial X-ray cephalometry to predict maxilla advance by distraction in hypoplastic maxilla].

    Science.gov (United States)

    Rosas-Muñoz, Arturo; Soriano-Padilla, Fernando; Rendón-Macías, Mario Enrique

    2010-01-01

    the osteogenic distraction is the treatment for the correction of the hypoplastic maxilla secondary to the repair of a cleft lip-palate. Its planning is based on articulated models. Our objective was to describe the accuracy of three-dimensional Cephalometry (CT3D) for projecting jaw displacement. three patients with hypoplastic maxilla. Interventions estimation of the advance required of lateral maxilla through Cephalometry of skull (CLC), CT3D and an articulated model (gold standard). Two months after distraction finalized the advance predicted was compared. the error of the advance projection in each patient was smaller with the CT3D versus CLC (+1, +1 and +1 mm versus -10, -14 and -9mm). Corrections post-distraction were of +25 %, +26 % and +38.4 % on the programmed one. CT3D predicted better the correction (+19 %, +10.8 %, +33.4 % versus CLC: -50 %; -60.8 % and -34.6 %). Chewing alterations were not seen in any patient. the planning of the necessary advance for distraction in patients with hypoplastic maxilla by CT3D can shorten the time of studies and should be consider as next to the projection of articulated model.

  14. [Evaluation of upper airway and surrounding structures in patients with obstructive sleep apnea using cephalometry combined with Muller's maneuver].

    Science.gov (United States)

    Zhao, Yan-hui; Zhu, Min; Lu, Xiao-feng; Sun, Hong-xia; Nie, Ping; Xu, Xiao-long; Tao, Li

    2013-12-01

    To evaluate the upper airway and surrounding structures under intraluminal pressure using cephalometry combined with Muller's maneuver in obstructive sleep apnea and hypopnea syndrome (OSAHS) patients with different severity. Thirty-nine male patients were enrolled in our department during June 2011 to February 2012. Polysomnography (PSG) and anthropometric measurements data were recorded prior to the study. The lateral cephalograms of each patient were obtained during both the end-expiration phase and Muller's maneuver phase. The patients enrolled were classified into 3 groups according to the results of apnea-hypopnea index (AHI), including mild group (n=11), moderate group (n=14), and severe group (n=14). Craniofacial and upper airway structures were measured in lateral cephalometry by application of Cassos 2001 computed aided measurement software before and after the patients practicing Muller's maneuver. The data was analysed using SAS 9.13 software package. Muller's maneuver had a great influence on the upper airway and surrounding tissue, including increased thickness of the uvula, reduction in the anteroposterior dimension of retropalatal and increased vertical distance of the hyoid bone to the mandible in all groups (PCephalometry combined with Muller's maneuver can display how the intraluminal pressure function on the upper airway and surrounding tissues, and they also can distinguish some minor differences of the upper airway in patients with different security. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (11140902001).

  15. Validity of 2D lateral cephalometry in orthodontics: a systematic review.

    Science.gov (United States)

    Durão, Ana R; Pittayapat, Pisha; Rockenbach, Maria Ivete B; Olszewski, Raphael; Ng, Suk; Ferreira, Afonso P; Jacobs, Reinhilde

    2013-09-20

    Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.

  16. Systematic analysis of cephalometry in obstructive sleep apnea in Asian children.

    Science.gov (United States)

    Ping-Ying Chiang, Rayleigh; Lin, Chia-Mo; Powell, Nelson; Chiang, Yuh-Chyun; Tsai, Yih-Jeng

    2012-08-01

    This study was designed to systematically analyze the relationship between a cephalometric analysis and the apnea-hypopnea index in a group of Asian children with obstructive sleep apnea. Retrospective study. Data were collected from 56 children with obstructive sleep apnea who were between 3 and 13 years old. Each child underwent attended overnight polysomnography and cephalometry. We measured nine angles, 10 lines, and two ratios as well as adenoid size on each cephalometric film. Data included five segments of the upper airway: nasal cavity (segment 1), nasopharyngeal space (segment 2), retropalatal space (segment 3), retroglossal space and hyoid (segment 4), and oral cavity-related space (segment 5). Four cephalometric anthropomorphic findings (Gn-Go-H, MP-H, MPH/GnGo, Ad/Na) were related to the apnea-hypopnea index. Three of the four parameters belonged to segment 4, indicating the importance of hyoid position in pediatric obstructive sleep apnea. This study showed that segment 4 was the most important segment affecting the apnea-hypopnea index. Most of the cephalometric parameters in segment 4 did not show a difference from the results of Caucasian groups, except that mandibular length and position appeared to have more positive findings in the Caucasian results. In segment 2, the apnea-hypopnea index was less affected by the skull base-related parameters in our data. The reason why the other segments appeared to play a lesser role in pediatric obstructive sleep apnea might due to the limitations of two-dimensional imaging. Further cephalometric studies with anterior-posterior view and on the differences between Caucasian and Asian children are mandatory. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  17. Evaluation of craniofacial morphology in patients with obstructive sleep apnea using lateral cephalometry and dynamic MRI.

    Science.gov (United States)

    Bharadwaj, Rekha; Ravikumar, A; Krishnaswamy, N R

    2011-01-01

    Obstructive sleep apnea (OSA) is a potentially life-threatening disorder, characterized by repeated collapse of the upper airway during sleep with cessation of breathing. The altered mouth breathing produces morphological changes in craniofacial region. This study was designed to compare and validate the craniofacial morphological characteristics in patients with OSA using lateral cephalometry and to investigate the dentofacial characteristics of patients with OSA with respect to the obstructive sites determined by dynamic magnetic resonance imaging (MRI) to more accurately clarify the pathophysiological features. 10 patients with OSA were divided into two groups of five each according to their obstructive site determined by dynamic MRI. (1) Obstruction at the retropalatal and retroglossal region (Rp + Rg group) and (2) obstruction at the retropalatal region (Rp group). Lateral cephalogram both in upright and supine position was taken for all the subjects. In addition, dynamic MRI was performed to identify the sites of obstruction of the upper airway. Independent t-test was performed to evaluate the significant difference in the upright cephalometric variables between the study and control group and between the two groups. The changes in skeletal and soft tissue parameters with change in posture was assessed within the study and control group by paired t test. P value of ≤ 0.05 was considered as statistically significant. The study indicated that the first group of patients with both retropalatal and retroglossal obstruction showed signs of skeletal discrepancy that predisposed to obstruction at the retroglossal level and the soft tissue components like the soft palate and tongue that contributed to retropalatal obstruction. However, the second group of patients with only retropalatal obstruction had primarily soft tissue components associated with increased BMI that contributed to retropalatal obstruction. Evaluation of craniofacial morphology in OSA patients is

  18. Comparison between traditional 2-dimensional cephalometry and a 3-dimensional approach on human dry skulls.

    Science.gov (United States)

    Adams, Gregory L; Gansky, Stuart A; Miller, Arthur J; Harrell, William E; Hatcher, David C

    2004-10-01

    The cephalogram is the standard used by orthodontists to assess skeletal, dental, and soft tissue relationships. This approach, however, is based on 2-dimensional (2D) views used to analyze 3-dimensional (3D) objects. The purpose of this project was to evaluate and compare a 3D imaging system and traditional 2D cephalometry for accuracy in recording the anatomical truth as defined by physical measurements with a calibrated caliper. Thirteen skeletal landmarks were located by both radiographic methods on 9 dry human skulls. Intraclass correlation (0.995), variance (0.054 mm(2)), and standard deviation (SD) (0.237 mm) were averaged over 76 measurements and derived from precision calipers to establish these physical measurements as a reliable gold standard to make comparisons of the 2D and 3D radiographic methods. The results showed great variability of the 2D from the gold standard, with the range varying from -17.68 mm (underestimation of Gn-Zyg R) to +15.52 mm (overestimation of Zyg L-Zyg R). In contrast, the 3D method (Sculptor, Glendora, Calif) indicated a range of the SD from -3.99 (underestimation) mm to +2.96 mm (overestimation). The 3D evaluation was much more precise, within approximately 1 mm of the gold standard. These results indicate that, when the actual distance is measured on a human skull in its true dimensions of 3D space, the Sculptor program, by using a 3D method, is more precise and 4 to 5 times more accurate than the 2D approach. Evaluating distances in 3D space with a 2D image grossly exaggerates the true measure and offers a distorted view of craniofacial growth. There is an inherent problem of representing a linear measure occupying a 3D space with a 2D image.

  19. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

    Science.gov (United States)

    Ehlers, Justis P; Goshe, Jeff; Dupps, William J; Kaiser, Peter K; Singh, Rishi P; Gans, Richard; Eisengart, Jonathan; Srivastava, Sunil K

    2015-10-01

    Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes. To assess the feasibility and effect on surgical decision making of a microscope-integrated intraoperative OCT (iOCT) system. Report highlighting the 1-year results (March 2014-February 2015) of the RESCAN 700 portion of the DISCOVER (Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery) study, a single-site, multisurgeon, prospective consecutive case series regarding this investigational device. Participants included patients undergoing ophthalmic surgery. Data on clinical characteristics were collected, and iOCT was performed during surgical milestones, as directed by the operating surgeon. A surgeon questionnaire was issued to each surgeon and was completed after each case to evaluate the role of iOCT during surgery and its particular role in select surgical procedures. Percentage of cases with successful acquisition of iOCT (ie, feasibility). Percentage of cases in which iOCT altered surgical decision making (ie, utility). During year 1 of the DISCOVER study, a total of 227 eyes (91 anterior segment cases and 136 posterior segment cases) underwent imaging with the RESCAN 700 system. Successful imaging (eg, the ability to acquire an OCT image of the tissue of interest) was obtained for 224 of 227 eyes (99% [95% CI, 98%-100%]). During lamellar keratoplasty, the iOCT data provided information that altered the surgeon's decision making in 38% of the cases (eg, complete graft apposition when the surgeon believed there was interface fluid). In membrane peeling procedures, iOCT information was discordant with the surgeon's impression of membrane peel completeness in 19% of cases (eg, lack of residual membrane or presence of occult membrane), thus

  20. Intraoperative landmarking of vascular anatomy by integration of duplex and Doppler ultrasonography in image-guided surgery. Technical note.

    Science.gov (United States)

    Sure, Ulrich; Benes, Ludwig; Bozinov, Oliver; Woydt, Michael; Tirakotai, Wuttipong; Bertalanffy, Helmut

    2005-02-01

    The integration of ultrasound technology into neuronavigation systems has recently been the subject of reports by several groups. This article describes our preliminary findings with regard to the integration of data derived from intraoperative duplex (color mode) and Doppler ultrasonography into a neuronavigational data set. It was the aim of the study to investigate (1) whether the intraoperative landmarking of vessels that are outlined with ultrasound technology is possible and (2) whether such a technique might be of clinical interest for neurosurgical interventions. The video image of an ultrasound plane (Toshiba, Powervision 6000 SSA-370A, Tokyo, Japan) was integrated into our neuronavigation system (VectorVision2, BrainLab, Heimstetten, Germany). For calibration of the ultrasound plane, an instrument adapter was fixed to the ultrasound probe and then calibrated using a special, predefined calibration phantom. Accordingly, the system supported a combination of the ultrasound plane functionality with the preoperatively acquired neuronavigational data. The duplex and Doppler mode of the ultrasound system displayed the intraoperative vascular anatomy. Once a vessel was outlined during surgery, it could be landmarked by touching the navigation screen. These landmarks were integrated automatically into the neuronavigational data set and could be used to provide intraoperative image updates of the vascular anatomy. This technique was successful in 45 of 47 (95.7%) surgical interventions. Both image-guided ultrasound and duplex-guided integration of vascular anatomy into the neuronavigational data set are technically possible. In the future, this technology may provide useful intraoperative information during surgery of complex cerebral pathologies.

  1. Integration of image guidance and rapid prototyping technology in craniofacial surgery.

    Science.gov (United States)

    Bullock, P; Dunaway, D; McGurk, L; Richards, R

    2013-08-01

    This technical note demonstrates the benefits of preoperative planning, involving the use of rapid prototype models and rehearsal of the surgical procedure, using image-guided navigational surgery. Optimum reconstruction of large defects can be achieved with this technique. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Stressors relating to patient psychological health following stoma surgery: an integrated literature review.

    Science.gov (United States)

    Ang, Seng Giap Marcus; Chen, Hui-Chen; Siah, Rosalind Jiat Chiew; He, Hong-Gu; Klainin-Yobas, Piyanee

    2013-11-01

    To summarize empirical evidence relating to stressors that may affect patients' psychosocial health following colostomy or ileostomy surgery during hospitalization and after discharge. An extensive search was performed on the CINAHL®, Cochrane Library, PubMed, PsycINFO, Scopus, Science Direct, and Web of Science electronic databases. Eight articles were included with three qualitative and five quantitative research designs. Most studies were conducted in Western nations with one other in Taiwan. Following colostomy or ileostomy surgery, common stressors reported by patients during hospitalization included stoma formation, diagnosis of cancer, and preparation for self-care. After discharge, stressors that patients experienced encompassed adapting to body changes, altered sexuality, and impact on social life and activities. This review suggests that patients with stomas experience various stressors during hospitalization and after discharge. Additional research is needed for better understanding of patient postoperative experiences to facilitate the provision of appropriate nursing interventions to the stressors. To help patients deal with stressors following stoma surgery, nurses may provide pre- and postoperative education regarding the treatment and recovery process and encourage patient self-care. Following discharge, nurses may provide long-term ongoing counseling and support, build social networks among patients with stomas, and implement home visit programs. Stoma surgery negatively affects patients' physical, psychological, social, and sexual health. Postoperative education programs in clinical settings mostly focus on physical health and underemphasize psychological issues. More pre- and postoperative education programs are needed to help patients cope with stoma stressors.

  3. Effect of Vagus nerve integrity on short and long-term efficacy of antireflux surgery

    NARCIS (Netherlands)

    Van Rijn, S.; Rinsma, N. F.; Van Herwaarden-Lindeboom, M. Y A; Ringers, J.; Gooszen, H. G.; Van Rijn, P. J J; Veenendaal, R. A.; Conchillo, J. M.; Bouvy, N. D.; Masclee, Adrian A M

    2016-01-01

    OBJECTIVES:Vagus nerve injury is a feared complication of antireflux surgery (ARS) that may negatively affect reflux control. The aim of the present prospective study was to evaluate short-term and long-term impact of vagus nerve injury, evaluated by pancreatic polypeptide response to

  4. Functional integrity and aging of the left internal thoracic artery after coronary artery bypass surgery

    NARCIS (Netherlands)

    Amoroso, G; Tio, RA; Mariani, MA; van Boven, AJ; Jessurun, GAJ; Monnink, SHJ; Grandjean, JG; Boonstra, PW; Crijns, HJGM

    Objective: To study the endothelial function in the left internal thoracic artery after coronary artery bypass surgery and to identify predictors of early dysfunction, we performed a provocative test with acetylcholine in 23 male patients who underwent routine postoperative coronary angiography.

  5. A Closer Look at the 2013 to 2014 Integrated Plastic Surgery Match.

    Science.gov (United States)

    Kling, Russell E; Kling, Rochelle R; Agi, Chika; Toirac, Alexander; Manders, Ernest K

    2016-03-01

    Plastic surgery has become an increasingly competitive, yet limited information is available in the literature on successfully matched plastic surgery applicants. The goal of this study was to analyze which factors predicted a successful National Residency Match Program match during the 2013 to 2014 cycle. An electronic questionnaire was distributed to successfully matched medical students in plastic surgery. Information obtained included (1) academic performance, (2) medical school criteria, (3) visiting subinternship rotation criteria, and (4) research performance. Match "success" was defined as matching into one of the applicant's top three ranked programs Data were available for 127 matched students. Average Step 1 score was 247.93 (95 percent CI, 244.3 to 251.56). Step 1 scores correlated with the number of interviews received (r(2) = 0.355; p = 0.039). An odds ratio of 2.2 was observed for residents who had a plastic surgery residency program affiliated with their medical school and match success. Step 1 score (r(2) = 0.045; p = 0.798), Step 2 score (r(2) = 0.131; p = 0.505), Alpha Omega Alpha membership (r(2) = 0.011; p = 0.905), and number of publications (r(2) = 0.121; p = 0.458) did not correlate significantly with match success. Successful applicants had a Step 1 score that was 1 SD greater than the U.S. mean. Having a plastic surgery residency program affiliated with an applicant's medical school was an important predictor of match success. Objective measures (step scores, Alpha Omega Alpha membership, and number of publications) were not predictive of match success.

  6. The integrated evaluation of the results of oncoplastic surgery for locally advanced breast cancer.

    Science.gov (United States)

    Bogusevicius, Algirdas; Cepuliene, Daiva; Sepetauskiene, Egle

    2014-01-01

    The optimal surgical management of locally advanced breast cancer (LABC) remains undefined. The aim of the study was to obtain long-term results of oncoplastic surgery in terms of overall survival, loco-regional recurrence, and quality of life in case of LABC. Prospective cohort study enrolled 60 patients with stage III breast cancer. Forty-two (70%) patients received neo-adjuvant chemotherapy, 28 patients were considered suitable for surgery as initial treatment option. Type II oncoplastic surgery was performed for all patients: hemimastectomy and breast reconstruction with latissimus dorsi flap - for 29 (48.3%), lumpectomy - 31 (51.7%), and reconstruction with subaxillary flap for four (6.7%), with bilateral reduction mammoplasty - 14 (23.3%) and with J-plastic - 13 (21.7%) patients. Adjuvant chemotherapy and hormonal therapy followed surgery for all, except one, patients. Sequential radiotherapy was administered for all patients. The mean period of follow-up was 86 months. Postoperative morbidity rate was 5%. Local-regional recurrence was detected in six (10%) patients. After reoperation no local relapse was diagnosed. However, three of these patients had systemic dissemination of the disease. Distant metastasis was detected in 23 (38.3%) patients. Distant metastasis-free survival at 5 years was 61.7%. Fourteen patients died (23.3%). A total of 87.2% of the patients had good and excellent esthetic outcome. Oncoplastic breast-conserving surgery can be proposed for selected patients with LABC with acceptable complication, local recurrence rate, and good esthetic results. © 2013 Wiley Periodicals, Inc.

  7. The influence of simultaneous integrated boost, hypofractionation and oncoplastic surgery on cosmetic outcome and PROMs after breast conserving therapy.

    Science.gov (United States)

    Lansu, J T P; Essers, M; Voogd, A C; Luiten, E J T; Buijs, C; Groenendaal, N; Poortmans, P M H

    2015-10-01

    We retrospectively investigated the possible influence of a simultaneous integrated boost (SIB), hypofractionation and oncoplastic surgery on cosmetic outcome in 125 patients with stage I-II breast cancer treated with breast conserving therapy (BCT). The boost was given sequentially (55%) or by SIB (45%); fractionation was conventional (83%) or hypofractionated (17%); the surgical technique was a conventional lumpectomy (74%) or an oncoplastic technique (26%). We compared cosmetic results subjectively using a questionnaire independently completed by the patient and by the physician and objectively with the BCCT.core software. Independent-samples T-tests were used to compare outcome in different groups. Patients also completed the EORTC QLQ C30 and BR23. Univariate analyses indicated no significant differences of the cosmetic results (P ≤ 0.05) for the type of boost or fractionation. However, the conventional lumpectomy group scored significantly better than the oncoplastic group in the BCCT.core evaluation, without a significant difference in the subjective cosmetic evaluation. Quality of life outcome was in favour of SIB, hypofractionation and conventional surgery. Our study indicates that the current RT techniques seem to be safe for cosmetic outcome and quality of life. Further investigation is needed to verify the possible negative influence of oncoplastic surgery on the cosmetic outcome and the quality of life as this technique is especially indicated for patients with an unfavourable tumour/breast volume ratio. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Integrating Social Media and Anterior Cruciate Ligament Surgery: An Analysis of Patient, Surgeon, and Hospital Use.

    Science.gov (United States)

    Ramkumar, Prem N; La, Ton; Fisch, Evan; Fabricant, Peter D; White, Alexander E; Jones, Kristofer J; Taylor, Samuel A

    2017-03-01

    The purpose of this observational study of social media in sports medicine was to investigate and analyze the presence and shared content of anterior cruciate ligament (ACL) patients, sports surgeons, and top orthopaedic hospitals on popular social media streams. A search of 2 public domains (Instagram and Twitter) was performed over a 6-month period. ACL surgery ("#aclsurgery") was selected for the Instagram-based patient analysis after exclusion of veterinary ACL operations. A binary scoring system was used for media format, time (preoperatively or postoperatively), perioperative period (within 1 week of surgery), tone (positive or negative), return-to-work reference, return-to-play reference, rehabilitation reference, surgical-site reference, satisfaction reference, and dissatisfaction reference; perspective of the media was noted as well. A sample of 97 National Football League team surgeons was used for analysis of physician use in social media outlets and quantified by the number of posts. Hospital analysis categorized a sample of the top 50 orthopaedic hospitals by average number of posts and monthly posting rates with regard to orthopaedics, research, education, and personnel focus. In the patient analysis, 3,145 public posts of human subjects were shared on Instagram. Of these, 92% were personal recovery stories, with an emphasis on postoperative photographs (93%) with a positive tone (88%) more than 1 week after surgery (73%). Posts focused on surgical site (25%), return to play (30%), and postoperative rehabilitation (37%). Of the physicians, 16% had Twitter accounts, with an average of 94 posts per surgeon; none had Instagram accounts. Of the hospitals, 96% had Twitter accounts and 32% had Instagram accounts. Most of the hospital-based Instagram content in the sample was centered on patients or celebrities. Orthopaedic surgery has a large social media presence. Patients emphasize wound appearance, the rehabilitation process, and return to play

  9. Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System.

    Science.gov (United States)

    Liu, Vincent X; Rosas, Efren; Hwang, Judith; Cain, Eric; Foss-Durant, Anne; Clopp, Molly; Huang, Mengfei; Lee, Derrick C; Mustille, Alex; Kipnis, Patricia; Parodi, Stephen

    2017-07-19

    Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery). Implementation began in February and March 2014 and concluded by the end of 2014 at 20 medical centers within the Kaiser Permanente Northern California integrated health care delivery system. A multifaceted ERAS program designed with a particular focus on perioperative pain management, mobility, nutrition, and patient engagement. The primary outcome was hospital length of stay. Secondary outcomes included hospital mortality, home discharge, 30-day readmission rates, and complication rates. The study included a total of 3768 patients undergoing elective colorectal resection (mean [SD] age, 62.7 [14.1] years; 1812 [48.1%] male) and 5002 patients undergoing emergency hip fracture repair (mean [SD] age, 79.5 [11.8] years; 1586 [31.7%] male). Comparator surgical patients included 5556 patients undergoing elective gastrointestinal surgery and 1523 patients undergoing emergency orthopedic surgery. Most process metrics had significantly greater changes in the ERAS target populations after implementation compared with comparator surgical populations, including those for ambulation, nutrition, and opioid use. Hospital length of stay and postoperative complication rates were also significantly lower among ERAS target populations after implementation. The rate ratios for postoperative complications were 0.68 (95% CI, 0.46-0.99; P = .04) for patients

  10. Life-quality of orthognathic surgery patients: The search for an integral diagnosis

    Directory of Open Access Journals (Sweden)

    José Augusto Mendes Miguel

    2014-01-01

    Full Text Available The decision on whether starting an orthosurgical treatment depends on the negative esthetic, functional and social impact the dentofacial deformity has on the quality of life of each patient. The objective of this article is to demonstrate the importance of assessing the quality of life of these individuals by means of applying specific questionnaires before treatment onset in order to increase the success rate of orthosurgical treatment. These questionnaires assess not only the esthetic factor, but also the functional conditions that may be affected as well as the psychological issues related to self-esteem and sociability, all of which must be assessed in order to enable the development of an individual treatment plan that meets patient's expectations. Thus, a more predictable level of satisfaction can be achieved at treatment completion, not only from a normative standpoint stated by professionals, but also from a subjective standpoint stated by patients. Although not enough comparable data is available in the literature for us to assess the extent of improvements produced by orthosurgical treatment, a few recent reports conducted by different universities around the world reveal a good response from the majority of patients after surgery, demonstrating great satisfaction with regard to esthetic, functional and psychosocial factors. Therefore, it is reasonable to conclude that the current objective of orthodontic treatment associated with orthognathic surgery consists not only in treating the esthetic functional components of dentofacial deformities, but also in considering patients' psychological factor.

  11. Association of Informal Clinical Integration of Physicians With Cardiac Surgery Payments.

    Science.gov (United States)

    Funk, Russell J; Owen-Smith, Jason; Kaufman, Samuel A; Nallamothu, Brahmajee K; Hollingsworth, John M

    2017-12-27

    To reduce inefficiency and waste associated with care fragmentation, many current programs target greater clinical integration among physicians. However, these programs have led to only modest Medicare spending reductions. Most programs focus on formal integration, which often bears little resemblance to actual physician interaction patterns. To examine how physician interaction patterns vary between health systems and to assess whether variation in informal integration is associated with care delivery payments. National Medicare data from January 1, 2008, through December 31, 2011, identified 253 545 Medicare beneficiaries (aged ≥66 years) from 1186 health systems where Medicare beneficiaries underwent coronary artery bypass grafting (CABG) procedures. Interactions were mapped between all physicians who treated these patients-including primary care physicians and surgical and medical specialists-within a health system during their surgical episode. The level of informal integration was measured in these networks of interacting physicians. Multivariate regression models were fitted to evaluate associations between payments for each surgical episode made on a beneficiary's behalf and the level of informal integration in the health system where the patient was treated. The informal integration level of a health system. Price-standardized total surgical episode and component payments. The total 253 545 study participants included 175 520 men (69.2%; mean [SD] age, 74.51 [5.75] years) and 78 024 women (34.3%; 75.67 [5.91] years). One beneficiary of the 253 545 participants did not have sex information. The low level of informal clinical integration included 84 598 patients (33.4%; mean [SD] age, 75.00 [5.93] years); medium level, 84 442 (33.30%; 74.94 [5.87] years); and high level, 84 505 (33.34%; 74.66 [5.72] years) (P integration levels varied across health systems. After adjusting for patient, health-system, and community factors, higher levels

  12. Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

    Science.gov (United States)

    Martin, Alice

    2011-01-01

    ABSTRACT Objectives We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods. Material and Methods Twenty-six patients (mean age 25.5, standard deviation (SD) 5.2 years) with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years) who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded. Results Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007;) and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043) compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039). Conclusions Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another. PMID:24421994

  13. Assessment of soft tissue changes by cephalometry and two-dimensional photogrammetry in bilateral sagittal split ramus osteotomy cases.

    Science.gov (United States)

    Rustemeyer, Jan; Martin, Alice

    2011-01-01

    We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods. Twenty-six patients (mean age 25.5, standard deviation (SD) 5.2 years) with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years) who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded. Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007;) and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043) compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039). Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

  14. Comparative analysis of assessment of the craniocervical equilibrium through two methods: cephalometry of Rocabado and cervical range of motion.

    Science.gov (United States)

    de Oliveira, Lilian Becerra; Cajaíba, Franklin; Costa, Wesley; Rocabado, Mariano; Lazo-Osório, Rodrigo; Ribeiro, Sanzia

    2012-01-01

    There are several instruments of evaluation of the craniocervical equilibrium; the most reliable are the radiographies. This study used the cephalometric analysis of Rocabado to measure the sensibility and specificity of the Cervical Range of Motion (CROM), a goniometer designed to assess cervical movements in degrees, and measure the forward head position in centimeters. This instrument frequently used, has been tested as a reliable instrument to evaluate the cervical movements but not the forward head. The sample consisted of 30 volunteers, 18 females, 12 males, mean age of 24.63 years. All participants were evaluated with CROM and radiographies in the resting head position and in erect head position. The values considered by the cephalometry consisted in the angle made between the McGregor plane and the vertical line formed by the base of the odontoid process to its apex; the posterior space between C0-C1 and C1-C2 and the hyoid triangle. 30% of the subjects had forward head posture, according to de cephalometry of Rocabado (decreased space between C0-C1, C1-C2) and 43,3% according to CROM. 16,6% had decreased posterior-inferior angle, and 13% had the hyoid triangle facing up. ROC curve of identifying forward head posture yielded area under the curve of 0,778 (95% confidence interval 0,596-0,960). The sensibility of CROM was: 77%. The specificity 71%. This study suggests that CROM has a moderate sensibility and specificity, useful for clinic use, but not for research.

  15. The status of cephalometry in the prediction of non-CPAP treatment outcome in obstructive sleep apnea patients.

    Science.gov (United States)

    Denolf, Petra L; Vanderveken, Olivier M; Marklund, Marie E; Braem, Marc J

    2016-06-01

    Obstructive sleep apnea syndrome (OSAS) is the most common sleep disordered breathing disorder (SDB) in adults and is characterized by a recurrent partial or complete collapse of the upper airway during sleep. This can be caused by many factors, sometimes interacting, such as skeletal malformations, soft tissue crowding, respiratory instability and the various effects of aging, obesity and gender that dictate craniofacial and upper airway anatomy. Research has demonstrated that the majority of patients exhibit at least one anatomical component such as retrognathia or a narrow posterior airway space that predisposes to the development of OSAS. Within the predisposing elements for OSAS many seem to point to anatomical characteristics. A standardized and relatively simple radiologic technique to evaluate anatomical craniofacial relationships is cephalometry. This has been used already for a long time in orthodontics, but is now gradually being introduced in OSAS treatment to envisage optimal treatment selection as well as to predict treatment outcomes. The purpose of the present review is to evaluate the contribution of cephalometry in the prediction of outcomes from OSAS treatments that depend on the upper airway morphology in their mechanisms of action such as oral appliances that advance the mandible as well as various surgical methods. In addition, an overview of imaging modalities and methods that currently are being used in cephalometric analysis in OSAS patients is provided. The findings indicate that isolated cephalometric parameters cannot be used to reliably predict treatment outcomes from mandibular advancement devices and surgical methods for OSAS. Extreme or outlying values of cephalometric parameters may rather be used as contra-indicators or 'red flags' instead of predictors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

    Directory of Open Access Journals (Sweden)

    Jan Rustemeyer

    2011-07-01

    Full Text Available Objectives: We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods.Material and Methods: Twenty-six patients (mean age 25.5, standard deviation (SD 5.2 years with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded.Results: Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007; and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043 compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039.Conclusions: Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

  17. Coping and caring: support resources integral to perioperative nurses during the process of organ procurement surgery.

    Science.gov (United States)

    Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

    2017-11-01

    To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. A qualitative grounded theory method. The study was informed by perioperative nurses (n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment. © 2016

  18. Retention and attrition in bariatric surgery research: an integrative review of the literature.

    Science.gov (United States)

    Gourash, William F; Lockhart, Joan Such; Kalarchian, Melissa A; Courcoulas, Anita P; Nolfi, David

    2016-01-01

    Bariatric surgery research, often longitudinal, bears the challenge of maintaining retention and decreasing attrition of participants to avoid bias. To explore factors influencing the retention and attrition for bariatric surgical research participants. Databases searched included: PubMed, CINAHL, Scopus, and others. As a secondary aim, studies reporting on retention/attrition factors in clinical follow-up visits were included. Of the 1145 articles retrieved, 44 met inclusion criteria, and underwent qualitative analysis. Four descriptive articles focused on longitudinal research participation and 40 on clinical follow-up visits. Willingness to participate in research was high (92%) and decreased with more invasive procedures or extra visits. A large observational longitudinal study presented 24-month retention/attrition data (92% for some data and 66% visit completion) and the retention strategies employed. One study indicated that research follow-up possibly increased clinical follow-up and another demonstrated a higher retention by increasing compensation. No consistent, modifiable demographic or psychosocial variables associated or predictive of retention or attrition in clinical follow-up were identified. Research on factors related to participant retention and attrition is sparse. It is essential for studies to document retention/attrition data. Existing research has demonstrated a patient willingness to participate in research and that retention strategies have been successful in the short term. Further research should explore the motivations, perspectives and attitudes of bariatric surgical research participants regarding participation and explore predictors to develop evidence-based retention strategies. Research has yet to identify consistent and modifiable demographic or psychosocial variables predictive of clinical follow-up, possibly due to the heterogeneity of follow-up across studies. Further investigation into follow-up definition, content

  19. Calibrated integrated backscatter and myocardial fibrosis in patients undergoing cardiac surgery

    NARCIS (Netherlands)

    Prior, David L; Somaratne, Jithendra B; Jenkins, Alicia J; Yii, Michael; Newcomb, Andrew E; Schalkwijk, Casper G; Black, Mary J; Kelly, Darren J; Campbell, Duncan J

    2015-01-01

    OBJECTIVE: The reported association between calibrated integrated backscatter (cIB) and myocardial fibrosis is based on study of patients with dilated or hypertrophic cardiomyopathy and extensive (mean 15-34%) fibrosis. Its association with lesser degrees of fibrosis is unknown. We examined the

  20. The changing paradigm in surgery is system integration: How do we respond?

    Science.gov (United States)

    Zenilman, Michael E; Freischlag, Julie-Ann

    2017-12-08

    With expansion of health care systems across the country, close relationships need to be developed between academic medical centers and their affiliated community hospitals. This creates opportunity to integrate surgical programs across different hospitals. Herein we describe a model of surgical integration at the system level of five large hospitals. We discuss utilizing advantages that both the academic and community hospital bring to the model. A close relationship between an interdisciplinary team, which includes the academic surgical chair, a regional director liaison who was embedded in the community, individual hospital leadership, and practice plan leaders was created. Three pillars as a foundation to success were physician leadership, the use of system infrastructure and development of new processes. This resulted in development of trust, leading to successful recruitments, models of employment and expansion into novel areas of patient safety. Once created, new opportunities for programming for surgical safety across the health care were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery.

    Science.gov (United States)

    Pasricha, Neel D; Bhullar, Paramjit K; Shieh, Christine; Carrasco-Zevallos, Oscar M; Keller, Brenton; Izatt, Joseph A; Toth, Cynthia A; Freedman, Sharon F; Kuo, Anthony N

    2017-02-14

    The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes. [J Pediatr Ophthalmol Strabismus. 2017;54:e1-e5.]. Copyright 2017, SLACK Incorporated.

  2. Restoring integrity--A grounded theory of coping with a fast track surgery programme.

    Science.gov (United States)

    Jørgensen, Lene Bastrup; Fridlund, Bengt

    2016-01-01

    The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. The study design used classical grounded theory. The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients' main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme.

  3. Integration of sparse electrophysiological measurements with preoperative MRI using 3D surface estimation in deep brain stimulation surgery

    Science.gov (United States)

    Husch, Andreas; Gemmar, Peter; Thunberg, Johan; Hertel, Frank

    2017-03-01

    Intraoperative microelectrode recordings (MER) have been used for several decades to guide neurosurgeons during the implantation of Deep Brain Stimulation (DBS) electrodes, especially when targeting the subthalamic nucleus (STN) to suppress the symptoms of Parkinson's Disease. The standard approach is to use an array of up to five MER electrodes in a fixed configuration. Interpretation of the recorded signals yields a spatially very sparse set of information about the morphology of the respective brain structures in the targeted area. However, no aid is currently available for surgeons to intraoperatively integrate this information with other data available on the patient's individual morphology (e.g. MR imaging data used for surgical planning). This integration might allow surgeons to better determine the most probable position of the electrodes within the target structure during surgery. This paper suggests a method for reconstructing a surface patch from the sparse MER dataset utilizing additional a priori knowledge about the geometrical configuration of the measurement electrodes. The conventional representation of MER measurements as intervals of target region/non-target region is therefore transformed into an equivalent boundary set representation, allowing ecient point-based calculations. Subsequently, the problem is to integrate the resulting patch with a preoperative model of the target structure, which can be formulated as registration problem minimizing a distance measure between the two surfaces. When restricting this registration procedure to translations, which is reasonable given certain geometric considerations, the problem can be solved globally by employing an exhaustive search with arbitrary precision in polynomial time. The proposed method is demonstrated using bilateral STN/Substantia Nigra segmentation data from preoperative MRIs of 17 Patients with simulated MER electrode placement. When using simulated data of heavily perturbed electrodes

  4. Integrated and miniaturized endoscopic devices for use during high power infrared fiber laser surgery

    Science.gov (United States)

    Wilson, Christopher Ryan

    The Thulium Fiber Laser (TFL) is currently being studied as a potential alternative to the conventional, solid-state Holmium:YAG laser (Ho:YAG) for the treatment of kidney stones. The TFL is an ideal candidate to replace the Ho:YAG for laser lithotripsy due to a higher absorption coefficient in water of the emitted wavelength, an ability to operate at high pulse rates, and a near single mode, Gaussian spatial beam profile. The higher absorption of the TFL wavelength by water translates to a decrease in ablation threshold by a factor of four. High pulse rate operation allows higher ablation rates than the Ho:YAG, thus decreasing operation time necessary to ablate the urinary stone. The Gaussian spatial beam profile allows the TFL to couple higher laser power into smaller optical fibers than those currently being used for Ho:YAG lithotripsy. This decrease in fiber diameter translates into a potential decrease in the size of ureteroscope working channel, higher saline irrigation rates for improved visibility and safety, and may also extend to a decrease in overall ureteroscope diameter. Furthermore, the improved spatial beam profile reduces the risk of damage to the input end of the fiber. Therefore, the trunk fiber, minus the distal fiber tip, may be preserved and re-used, resulting in significant cost savings. This thesis details rapid TFL lithotripsy at high pulse rates up to 500 Hz, both with and without the aid of a stone retrieval basket, in order to demonstrate the TFL's superior ablation rates over the Ho:YAG. Collateral damage testing of the TFL effect on the ureter wall and Nitinol stone baskets were conducted to ensure patient safety for future clinical use. Proximal fiber end damage testing was conducted to demonstrate fiber preservation, critical for permanent fiber integration. Optical fibers were fitted with fabricated hollow steel tips and integrated with stone retrieval baskets for testing. Ball tipped optical fibers were tested to maintain ablation

  5. Integration of diffusion tensor-based arcuate fasciculus fibre navigation and intraoperative MRI into glioma surgery.

    Science.gov (United States)

    Zhao, Yan; Chen, Xiaolei; Wang, Fei; Sun, Guochen; Wang, Yubo; Song, Zhijun; Xu, Bainan

    2012-02-01

    This study was designed to evaluate the feasibility and efficacy of diffusion tensor-based arcuate fasciculus (AF) fibre navigation in combination with 1.5-Tesla (1.5-T) intraoperative MRI (iMRI) for the resection of gliomas involving eloquent language fibre tracts (AF tracts). Twenty patients with AF tract-involved gliomas in the dominant hemisphere were prospectively enrolled. The patients were divided into two groups. The normal group included nine patients with preoperative intact language function, while the aphasia group consisted of 11 patients who presented with different levels of conduction aphasia. The AF tractography results were integrated into three-dimensional (3D) datasets used for neuronavigation, and their course was superimposed onto the surgical field during glioma resection. The iMRI was used to compensate for the effects of brain shift and to evaluate the extent of resection. Fibre tract visualisation provided a quick and intuitive overview of the displaced course of the AF in 3D space and the surgical field under a microscope. At a 3-month to 6-month follow-up, only two patients from the normal group suffered exacerbated language deficits due to tumour recurrence. Meanwhile, language function in all patients in the aphasia group had improved. Therefore, AF neuronavigation, combined with 1.5 T iMRI, is a feasible method of maximising resection and minimising language deficits when removing gliomas that involve the AF. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Bosquejo histórico de la Cefalometría Radiográfica Historical sketch of radiographic cephalometry

    Directory of Open Access Journals (Sweden)

    Alberto Companioni Bachá

    2008-06-01

    Full Text Available La cefalometría es un elemento importante en la conformación de una documentación ortodóncica para elaborar un diagnóstico y un plan de tratamiento adecuado. Con el descubrimiento de los rayos X, el 8 de noviembre de 1895 por Wilhhelm Conrad Roentgen, y la existencia de técnicas que precedieron a los rayos X, como la craneometría y la antropología, es que los ortodoncistas pueden contar con esta herramienta diagnóstica de inestimable valor. En el perfeccionamiento de la técnica cefalométrica y de sus análisis contemporáneos ha sido importante el concurso de diversos autores entre los que se destacan Broadbent, Bolton, Hofrath, Korkhaus, Ubaldo Carrea, De Nevreze, Paul Simon y Dreyfus, Margolis, Weingart, Thurow, Bjork, Freeman-Rasmussen, Reboul, Steiner, Andrews, Ricketts, Holdaway, McNamara, Interlandi, entre otros. Este trabajo se propone hacer un recuento de los hechos más significativos que acompañaron la evolución y desarrollo de la cefalometríaCephalometry is an important element to take into account at the time of preparing an orthodontic documentation in order to make a diagnosis and an adequate treatment plan. Thanks to the discovery of X-rays on November 8, 1895 by Wilhhelm Conrad Roentgen, and to the existence of techniques that preceded the X-rays, such as craniometry and anthropology, orthodontists may use this diagnostic tool of great value. In the improvement of the cephalometric technique and its contemporary analyses it has been important the collaboration of various authors, among whom Broadbent, Bolton, Hofrath, Korkhaus, Ubaldo Carrea, De Nevreze, Paul Simon and Dreyfus, Margolis, Weingart, Thurow, Bjork, Freeman-Rasmussen, Reboul, Steiner, Andrews, Ricketts, Holdaway, McNamara and Interlandi, stand out. This paper intends to make an account of the most significant events related to the evolution and development of cephalometry

  7. A comparative study between data obtained from conventional lateral cephalometry and reconstructed three-dimensional computed tomography images.

    Science.gov (United States)

    Oh, Suseok; Kim, Ci-Young; Hong, Jongrak

    2014-06-01

    The aim of this study was to verify the concordance of the measurement values when the same cephalometric analysis method was used for two-dimensional (2D) cephalometric radiography and three-dimensional computed tomography (3D CT), and to identify which 3D Frankfort horizontal (FH) plane was the most concordant with FH plane used for cephalometric radiography. Reference horizontal plane was FH plane. Palatal angle and occlusal plane angle was evaluated with FH plane. Gonial angle (GA), palatal angle, upper occlusal plane angle (UOPA), mandibular plane angle (MPA), U1 to occlusal plane angle, U1 to FH plane angle, SNA and SNB were obtained on 2D cephalmetries and reconstructed 3D CT. The values measured eight angles in 2D lateral cephalometry and reconstructed 3D CT were evaluated by intraclass correlation coefficiency (ICC). It also was evaluated to identify 3D FH plane with high degree of concordance to 2D one by studying which one in four FH planes shows the highest degree of concordance with 2D FH plane. ICCs of MPA (0.752), UOPA (0.745), SNA (0.798) and SNB (0.869) were high. On the other hand, ICCs of gonial angle (0.583), palatal angle (0.287), U1 to occlusal plane (0.404), U1 to FH plane (0.617) were low respectively. Additionally GA and MPA acquired from 2D were bigger than those on 3D in all 20 patients included in this study. Concordance between one UOPA from 2D and four UOPAs from 3D CT were evaluated by ICC values. Results showed no significant difference among four FH planes defined on 3D CT. FH plane that can be set on 3D CT does not have difference in concordance from FH plane on lateral cephalometry. However, it is desirable to define FH plane on 3D CT with two orbitales and one porion considering the reproduction of orbitale itself.

  8. A survey of membrane oxygenator heat-exchanger integrity testing at cardiac surgery centres in Great Britain and Ireland.

    Science.gov (United States)

    Carlton, Matthew; Campbell, John

    2013-11-01

    Membrane oxygenator heat exchanger (HE) device failure is reported to be very low for both short- and long-term extracorporeal devices. All oxygenator manufacturers provide instructions for leak testing of their HE devices prior to patient use. In addition to these recommendations, since 2006 at Nottingham University Hospitals (NUH) we have also additionally pressure tested HE devices prior to use. We conducted a national survey of cardiac centers in Great Britain and Ireland to determine the methods undertaken in individual centers for validation of the integrity of HE devices. Furthermore, we also collected information on the routine maintenance techniques utilized within these centers to inhibit microbial growth in the water used in the heater-cooler units (HCUs). In total, 34 responses were collected from the 57 centers performing cardiac surgery, producing a response rate of 60%. Of the responding centers, 71% are adhering to manufacturer's recommended guidelines of circulating the water through the device for 5 minutes. Of these centers, 17% reported detecting a leak between the HE and membrane compartment of the oxygenator. In responding centers, 29% reported using the pressure test technique. In the centers utilizing pressure testing, 60% reported detecting a leak. This survey reports an association of a greater HE leak detection rate using the pressure test technique compared to using water testing in isolation (p = 0.034). We believe the pressure testing method provides the perfusionist with confidence in the integrity of the HE for short- and long-term circulatory support devices prior to use in both elective and emergency situations.

  9. Validation of virtual reality simulators: Key to the successful integration of a novel teaching technology into minimal access surgery

    NARCIS (Netherlands)

    Schijven, Marlies P.; Jakimowicz, Jack J.

    2005-01-01

    Minimal access surgery (MAS) requires additional training in the surgical curriculum, as skills needed to perform MAS are quite different from those used in open surgery. Moreover, residents do not seem to experience ample opportunity to gain such skills in the current surgical curriculum. Virtual

  10. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION.

    Science.gov (United States)

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2009-01-01

    To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 - 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 60(0)/s and 180(0)/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. A significant difference was found between torque peaks at the speed of 60(0)/s for internal (p=0.036) and external (p=0.008) rotation. However, at 180(0)/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated.

  11. Integration of 3D anatomical data obtained by CT imaging and 3D optical scanning for computer aided implant surgery

    Directory of Open Access Journals (Sweden)

    Paoli Alessandro

    2011-02-01

    Full Text Available Abstract Background A precise placement of dental implants is a crucial step to optimize both prosthetic aspects and functional constraints. In this context, the use of virtual guiding systems has been recognized as a fundamental tool to control the ideal implant position. In particular, complex periodontal surgeries can be performed using preoperative planning based on CT data. The critical point of the procedure relies on the lack of accuracy in transferring CT planning information to surgical field through custom-made stereo-lithographic surgical guides. Methods In this work, a novel methodology is proposed for monitoring loss of accuracy in transferring CT dental information into periodontal surgical field. The methodology is based on integrating 3D data of anatomical (impression and cast and preoperative (radiographic template models, obtained by both CT and optical scanning processes. Results A clinical case, relative to a fully edentulous jaw patient, has been used as test case to assess the accuracy of the various steps concurring in manufacturing surgical guides. In particular, a surgical guide has been designed to place implants in the bone structure of the patient. The analysis of the results has allowed the clinician to monitor all the errors, which have been occurring step by step manufacturing the physical templates. Conclusions The use of an optical scanner, which has a higher resolution and accuracy than CT scanning, has demonstrated to be a valid support to control the precision of the various physical models adopted and to point out possible error sources. A case study regarding a fully edentulous patient has confirmed the feasibility of the proposed methodology.

  12. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION

    Science.gov (United States)

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2015-01-01

    Objective: To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. Methods: 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 − 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 600/s and 1800/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. Results: A significant difference was found between torque peaks at the speed of 600/s for internal (p=0.036) and external (p=0.008) rotation. However, at 1800/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Conclusion: Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated. PMID:27004190

  13. Robotic surgery

    Science.gov (United States)

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  14. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m 2 (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  15. Correlation between severity of sleep apnea and upper airway morphology: Cephalometry and MD-CT study during awake and sleep states.

    Science.gov (United States)

    Heo, Jun-Young; Kim, Jung-Soo

    2011-01-01

    The data show that the evaluation of obstruction site in patients with obstructive sleep apnea (OSA) should be performed in the sleep state rather than in wakefulness. The aim of this study was to identify correlation between severity of OSA as measured by the apnea-hypopnea index (AHI) and upper airway morphology examined by cephalometry and dynamic multidetector computed tomography (MD-CT) in awake and sleep states. Polysomnography and cephalometry were performed in 94 patients with snoring or OSA. Among them, 64 patients underwent MD-CT study. Thirteen cephalometric variables were measured. We analyzed the correlations between AHI and MD-CT measurements - minimal cross-sectional area (mCSA) and collapsibility index (CI) in high retropalate (HRP), low retropalate (LRP), high retroglossal (HRG), and low retroglossal (LRG) areas. Statistically significant correlations between the AHI and inferior displacement of the hyoid bone and pharyngeal length were identified in the cephalometric study. In wakefulness, AHI had a negative correlation with mCSA in the LRP area and a significant correlation with CI in LRP and HRG in MD-CT measurements. However, in the sleep state, the AHI had a negative correlation with mCSA in LRP, HRG, and LRG areas and a meaningful correlation with CI for the whole upper airway (HRP, LRP, HRG, and LRG).

  16. Radiographic cephalometry analysis of condylar position after bimaxillary osteotomy in patients with mandibular prognathism.

    Science.gov (United States)

    Miković, Nikola D; Lazarević, Miloš M; Tatić, Zoran; Krejović-Trivić, Sanja; Petrović, Milan; Trivić, Aleksandar

    2016-04-01

    Postoperative condylar position is a substantial concern in surgical correction of mandibular prognathism. Orthognathic surgery may change condylar position and this is considered a contributing factor for early skeletal relapse and the induction of temporomandibular disorders. The purpose of this study was to evaluate changes in condylar position, and to correlate angular skeletal measurements following bimaxillary surgery. On profile teleradiographs of 21 patients with mandibular angular and linear parametres, the changes in condylar position, were measured during preoperative orthodontic treatment and 6 months after the surgical treatment. A statistically significant difference in values between the groups was found. The most distal point on the head of condyle point (DI) moved backward for 1.38 mm (p = 0.02), and the point of center of collum mandibulae point (DC) moved backward for 1.52 mm (p = 0.007). The amount of upward movement of the point DI was 1.62 mm (p = 0.04). In the patients with mandibular prognathism, the condyles tend to migrate upward and forward six months after bimaxillary surgery.

  17. Radiographic cephalometry analysis of condylar position after bimaxillary osteotomy in patients with mandibular prognathism

    Directory of Open Access Journals (Sweden)

    Miković Nikola D.

    2016-01-01

    Full Text Available Background/Aim. Postoperative condylar position is a substantial concern in surgical correction of mandibular prognathism. Orthognathic surgery may change condylar position and this is considered a contributing factor for early skeletal relapse and the induction of temporomandibular disorders. The purpose of this study was to evaluate changes in condylar position, and to correlate angular skeletal measurements following bimaxillary surgery. Methods. On profile teleradiographs of 21 patients with mandibular angular and linear parametres, the changes in condylar position, were measured during preoperative orthodontic treatment and 6 months after the surgical treatment. Results. A statistically significant difference in values between the groups was found. The most distal point on the head of condyle point (DI moved backward for 1.38 mm (p = 0.02, and the point of center of collum mandibulae point (DC moved backward for 1.52 mm (p = 0.007. The amount of upward movement of the point DI was 1.62 mm (p = 0.04. Conclusion. In the patients with mandibular prognathism, the condyles tend to migrate upward and forward six months after bimaxillary surgery.

  18. The reliability of using postero-anterior cephalometry and cone-beam CT to determine transverse dimensions in clinical practice.

    Science.gov (United States)

    Tai, Benjamin; Goonewardene, Mithran Suresh; Murray, Kevin; Koong, Bernard; Islam, Syed Mohammed Shamsul

    2014-11-01

    This study primarily aimed to assess the accuracy of classically-advocated reference points for the measurement of transverse jaw-base and dental relationships using conventional Postero-Anterior Cephalometry (PAC) and Cone-Beam Computed Tomography (CBCT). PAC and CBCT images were collected from 31 randomly selected orthodontic patients (12 males, 19 females), all of whom had a full permanent dentition. The transverse widths of the maxilla, mandible and the dentition were measured using reference points on both image modalities. Confidence intervals, intra-class coefficients and Bland Altman plots were used to assess the measurement differences derived from the two acquirement methods. Measurements on PAC and CBCT images demonstrated statistically significant differences in the majority of the assessed variables. The interjugal (J-J) width was one of only two variables which did not demonstrate a statistically significant difference on image comparison. The mean differences of the antegonial width (Ag-Ag) (-4.44mm, 95% CI -5.38 to -3.51) represented the greatest difference between the imaging techniques. The application of these points to a transverse skeletal analysis (J-J/Ag-Ag ratio) revealed that five of the 31 subjects (16%) recorded 'false positive' readings according to the derived data. It is recommended that clinicians are cautious when interpreting and making decisions related to transverse dimensions derived from a PAC. The PAC has a higher tendency to falsely identify individuals who require maxillary expansion procedures based on conventional clinical criteria. The errors primarily associated with identifying structures which represent the width of the mandible are significant in both PAC and CBCT techniques and require further investigation. It is postulated that the confounding effects of overlying soft tissues have a sianificant impact on a clinician's ability to identify relevant landmarks.

  19. [Hepato-pancreato-biliary (HPB) surgery and abdominal organ transplantation, a defined subspecialty, integrated within the surgical division: professional, operative and educational aspects].

    Science.gov (United States)

    Ben-Haim, Menahem; Nakache, Richard; Klausner, Joseph M

    2009-04-01

    EstabLishment of hepato-pancreato-biliary (HPB) surgery and abdominal organ transplantation as defined subspecialties of general surgery has been boosted over the Last decade. However, the affiliation (independent service vs. integration within the division of surgery), the training course (transplantation vs. surgical oncology) and the referral patterns are still controversial. Dedicated HPB and transplantation units were defined within the surgical division of the Tel Aviv Medical Center. The principles of operation included muttidisciplinary expert teams, unified and standard treatment protocols, exposure and involvement of all residents and attending surgeons of the division to patients, decision-making and perioperative care, peer review and periodic publication of clinical results. Between the years 2003-2007, 870 major HPB procedures were performed: 70 Liver transplants (9 from live donors), 100 organ procurements, 165 kidney and kidney-pancreas transplants (30% from Live donors), 250 hepatic resections of various types and indications, 35 complex biliary reconstructions and 250 pancreatectomies. The short- (morbidity and mortality) and long-term (survival and disease free survival) rates are compatible with the reported results from Centers of Excellence around the world. Operating HPB and transplantation surgery by trained experts and defined professional units, but within an academic surgical division, promotes the achievement of high volume and excellent results together with optimal exposure, education and training of the surgical residents.

  20. Comparison of New Technology Integrated and Nonintegrated Arterial Filters Used in Cardiopulmonary Bypass Surgery: A Randomized, Prospective, and Single Blind Study

    Directory of Open Access Journals (Sweden)

    Özgür Gürsu

    2013-01-01

    Full Text Available Background. Innovative cardiopulmonary bypass (CPB settings have been developed in order to integrate the concepts of “surface-coating,” “blood-filtration,” and “miniaturization.” Objectives. To compare integrated and nonintegrated arterial line filters in terms of peri- and postoperative clinical variables, inflammatory response, and transfusion needs. Material and Methods. Thirty-six patients who underwent coronary bypass surgery were randomized into integrated (Group In and nonintegrated arterial line filter (Group NIn groups. Arterial blood samples for the assessments of complete hemogram, biochemical screening, interleukin-6, interleukin-2R, and C-reactive protein were analyzed before and after surgery. Need for postoperative dialysis, inotropic therapy and transfusion, in addition to extubation time, total amount of drainage (mL, length of intensive care unit, and hospital stay, and mortality rates was also recorded for each patient. Results. Prime volume was significantly higher and mean intraoperative hematocrit value was lower in Group NIn, but need for erythrocyte transfusion was significantly higher in Group NIn. C-reactive protein values did not differ significantly except for postoperative second day's results, which were found significantly lower in Group In than in Group NIn. Conclusion. Intraoperative hematocrit levels were higher and need for postoperative erythrocyte transfusion was decreased in Group In.

  1. Cosmetic Surgery

    Science.gov (United States)

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a number ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face many ...

  2. Long-Term Course of Failed Back Surgery Syndrome (FBSS Patients Receiving Integrative Korean Medicine Treatment: A 1 Year Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Jinho Lee

    Full Text Available With increase of spine surgeries, failed back surgery syndrome (FBSS prevalence is also rising. While complementary and alternative medicine (CAM is commonly used for low back pain (LBP, there are no studies reporting use of integrative Korean medicine in FBSS patients.Patients with pain continuing after back surgery or recurring within 1 year and visual analogue scale (VAS of LBP or leg pain of ≥6 (total n = 120 were recruited at 2 hospital sites from November 2011 to September 2014. Weekly sessions of integrative Korean medicine treatment were conducted for 16 weeks (herbal medicine, acupuncture/electroacupuncture, pharmacopuncture/bee venom pharmacopuncture, and Chuna manual therapy with additional follow-ups at 24 weeks and 1 year. Outcome measures included VAS of LBP and leg pain (primary outcome, Oswestry Disability Index (ODI, Short-Form 36 (SF-36, medical use, and patient global impression of change (PGIC.VAS of LBP and leg pain improved at 6 months (LBP from 6.1±2.0 at baseline to 2.9±2.3; and leg pain from 5.4±2.6 to 2.4±2.5, respectively. Eighty patients (66.7% showed improvement of 50% or more in main pain of LBP or leg pain from baseline. Disability and quality of life also improved at 6 months (ODI from 41.3±12.3 at baseline to 23.6±13.6; and SF-36 from 42.8±14.5 to 62.7±16.8. At 1 year follow-up, conventional medical management use decreased, improvement in pain and disability was maintained, and 79.2% reported improvement of PGIC.Despite limitations as an observational study, integrative Korean medicine treatment showed positive results in pain, function, and quality of life of FBSS patients.

  3. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients.

    Science.gov (United States)

    Parrott, Julie; Frank, Laura; Rabena, Rebecca; Craggs-Dino, Lillian; Isom, Kellene A; Greiman, Laura

    2017-05-01

    Optimizing postoperative patient outcomes and nutritional status begins preoperatively. Patients should be educated before and after weight loss surgery (WLS) on the expected nutrient deficiencies associated with alterations in physiology. Although surgery can exacerbate preexisting nutrient deficiencies, preoperative screening for vitamin deficiencies has not been the norm in the majority of WLS practices. Screening is important because it is common for patients who present for WLS to have at least 1 vitamin or mineral deficiency preoperatively. The focus of this paper is to update the 2008 American Society for Metabolic and Bariatric Surgery Nutrition in Bariatric Surgery Guidelines with key micronutrient research in laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, biliopancreatic diversion, and biliopancreatic diversion/duodenal switch. Four questions regarding recommendations for preoperative and postoperative screening of nutrient deficiencies, preventative supplementation, and repletion of nutrient deficiencies in pre-WLS patients have been applied to specific micronutrients (vitamins B1 and B12; folate; iron; vitamins A, E, and K; calcium; vitamin D; copper; and zinc). Out of the 554 articles identified as meeting preliminary search criteria, 402 were reviewed in detail. There are 92 recommendations in this update, 79 new recommendations and an additional 13 that have not changed since 2008. Each recommendation has a corresponding graded level of evidence, from grade A through D. Data continue to suggest that the prevalence of micronutrient deficiencies is increasing, while monitoring of patients at follow-up is decreasing. This document should be viewed as a guideline for a reasonable approach to patient nutritional care based on the most recent research, scientific evidence, resources, and information available. It is the responsibility of the registered dietitian nutritionist and WLS program to determine

  4. Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

    OpenAIRE

    Al-Dajani, Mahmoud

    2015-01-01

    Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS) teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were as...

  5. Integration

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2004-01-01

    Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration......Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration...

  6. Maze Surgery

    Science.gov (United States)

    ... Center > Maze Surgery Menu Topics Topics FAQs Maze Surgery Article Info En español Electrical impulses in your ... called an arrhythmia. Why do I need Maze surgery? Maze surgery is also called the Maze procedure. ...

  7. Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

    Science.gov (United States)

    Al-Dajani, Mahmoud

    2015-01-01

    Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS) teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were asked to rate 19 items, which represent a student’s confidence in performing routine surgical interventions, using a four-point Likert scale (1=very little confidence, 4=very confident). A multivariate regression was computed between average confidence and the variables: weekly hours devoted to studying oral and maxillofacial surgery, college grade point average, and the total number of teeth extracted. Results: The response rate was 100%. Students revealed the highest level of confidence in giving local anesthesia (96.9%), understanding extraction indications (93.8%), and performing simple extractions (90.6%). Less confidence was shown with handling difficult extractions (50.0%), extracting molars with separation (50.0%) or extracting third molars (56.3%). The average confidence in performing surgical procedures was 2.88 (SD=0.55), ranging from 1.79 to 3.89. A given student’s confidence increased with an increase in the total number of teeth extracted (P=0.003). Conclusion: It reveals a significant impact of undergraduate clinical training on students’ confidence in performing oral and maxillofacial surgery clinical procedures: The more clinical experience the students had, the more confidence they reported. PMID:26442715

  8. Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mahmoud Al-Dajani

    2015-09-01

    Full Text Available Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were asked to rate 19 items, which represent a student’s confidence in performing routine surgical interventions, using a four-point Likert scale (1=very little confidence, 4=very confident. A multivariate regression was computed between average confidence and the variables: weekly hours devoted to studying oral and maxillofacial surgery, college grade point average, and the total number of teeth extracted. Results: The response rate was 100%. Students revealed the highest level of confidence in giving local anesthesia (96.9%, understanding extraction indications (93.8%, and performing simple extractions (90.6%. Less confidence was shown with handling difficult extractions (50.0%, extracting molars with separation (50.0% or extracting third molars (56.3%. The average confidence in performing surgical procedures was 2.88 (SD=0.55, ranging from 1.79 to 3.89. A given student’s confidence increased with an increase in the total number of teeth extracted (P=0.003. Conclusion: It reveals a significant impact of undergraduate clinical training on students’ confidence in performing oral and maxillofacial surgery clinical procedures: The more clinical experience the students had, the more confidence they reported.

  9. Cephalometric radiography and computed tomography in infants undergoing craniofacial surgery. A comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lilja, J.; Friede, H.; Svendsen, P.; Aggeryd, J.; Lauritzen, C.; Moeller, M.; Andersson, H.; Johansson, B. (University of Goeteborg (Sweden))

    1984-01-01

    Craniofacial growth after surgery in children is not completely understood. We have therefore formed a programme for pre- and postoperative studies with both roentgencephalometric- and computed tomographic investigations. This regimen results in overlapping information. Thus, an assessment of the advantages and disadvantages of the two methods was made and exemplified in four patients. In our experience both cephalometry and CT are essential for the diagnosis, surgical planning and follow-up of surgically treated children with craniofacial anomalies. To minimize the radiation doses and the diagnostic procedures which in these cases often includes general anesthesia, patients with isolated, asymmetrical conditions such as plagiocephaly, might be followed with CT only, since roentgencephalometry can not add much information.

  10. Cephalometric radiography and computed tomography in infants undergoing craniofacial surgery. A comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lilja, J.; Friede, H.; Svendsen, P.; Aggeryd, J.; Lauritzen, C.; Moeller, M.; Andersson, H.; Johansson, B. (University of Goeteborg (Sweden))

    1983-01-01

    Craniofacial growth after surgery in children is not completely understood. We have therefore formed a programme for pre- and postoperative studies with both roentgencephalometric- and computed tomographic investigations. This regiment results in overlapping information. Thus, an assessment of the advantages and disadvantages of the two methods was made and exemplified in four patients. In our experience both cephalometry and CT are essential for the diagnosis, surgical planning and follow-up of surgically treated children with craniofacial anomalies. To minimize the radiation doses and the diagnostic procedures which in these cases often includes general anesthesia, patients with isolated, asymmetrical conditions such as plagiocephaly, might be followed with CT only, since roentgencephalometry can not add much information.

  11. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  12. Cephalometry in adults and children with neurofibromatosis type 1: implications for the pathogenesis of sphenoid wing dysplasia and the “NF1 facies”

    Science.gov (United States)

    Cung, Winnie; Friedman, Laura; Khan, Nicholas E.; Romberg, Elaine E.; Gardner, Pamela J.; Bassim, Carol W.; Baldwin, Andrea M.; Widemann, Brigitte C.; Stewart, Douglas R.

    2015-01-01

    Background Neurofibromatosis type 1 (NF1) is a common, autosomal dominant tumor-predisposition disorder that arises secondary to mutations in the tumor suppressor gene NF1. Cephalometry is an inexpensive, readily available and non-invasive technique that is under-utilized in studying the NF1 craniofacial phenotype. An analysis of NF1 cephalometry was first published by Heervä et al. in 2011. We expand here on that first investigation with a larger cohort of adult and pediatric patients affected with NF1 and sought objective insight into the NF1 facies, said to feature hypertelorism and a broad nasal base, from cephalometric analysis. Methods We obtained cephalograms from 101 patients with NF1 (78 adults and 23 children) from two NF1 protocols at the National Institutes of Health. Each subject had an age-, gender- and ethnicity-matched control. We used Dolphin software to make the cephalometric measurements. We assessed the normality of differences between paired samples using the Shapiro-Wilk test and evaluated the significance of mean differences using paired t-tests and adjusted for multiple testing. We explored the relationship between the cephalometric measurements and height, head circumference and interpupillary distance. Results In this dataset of American whites with NF1, we confirmed in a modestly larger sample many of the findings found by Heerva et al. in an NF1 Finnish cohort. We found a shorter maxilla, mandible, cranial base, (especially anteriorly, p = 0.0001) and diminished facial height in adults, but not children, with NF1. Only one adult exhibited hypertelorism. Conclusions The cephalometric differences in adults arise in part from cranial base shortening and thus result in a shorter face, mid-face hypoplasia, reduced facial projection, smaller jaw, and increased braincase globularity. In addition, we suggest that NF1 sphenoid bone shortening, a common event, is consistent with an intrinsic NF1 bone cell defect, which renders the bone more

  13. Cephalometry in adults and children with neurofibromatosis type 1: Implications for the pathogenesis of sphenoid wing dysplasia and the "NF1 facies".

    Science.gov (United States)

    Cung, Winnie; Freedman, Laura A; Khan, Nicholas E; Romberg, Elaine; Gardner, Pamela J; Bassim, Carol W; Baldwin, Andrea M; Widemann, Brigitte C; Stewart, Douglas R

    2015-11-01

    Neurofibromatosis type 1 (NF1) is a common, autosomal dominant tumor-predisposition disorder that arises secondary to mutations in the tumor suppressor gene NF1. Cephalometry is an inexpensive, readily available and non-invasive technique that is under-utilized in studying the NF1 craniofacial phenotype. An analysis of NF1 cephalometry was first published by Heervä et al. in 2011. We expand here on that first investigation with a larger cohort of adult and pediatric patients affected with NF1 and sought objective insight into the NF1 facies, said to feature hypertelorism and a broad nasal base, from cephalometric analysis. We obtained cephalograms from 101 patients with NF1 (78 adults and 23 children) from two NF1 protocols at the National Institutes of Health. Each subject had an age-, gender- and ethnicity-matched control. We used Dolphin software to make the cephalometric measurements. We assessed the normality of differences between paired samples using the Shapiro-Wilk test and evaluated the significance of mean differences using paired t-tests and adjusted for multiple testing. We explored the relationship between the cephalometric measurements and height, head circumference and interpupillary distance. In this dataset of American whites with NF1, we confirmed in a modestly larger sample many of the findings found by Heerva et al. in an NF1 Finnish cohort. We found a shorter maxilla, mandible, cranial base, (especially anteriorly, p = 0.0001) and diminished facial height in adults, but not children, with NF1. Only one adult exhibited hypertelorism. The cephalometric differences in adults arise in part from cranial base shortening and thus result in a shorter face, mid-face hypoplasia, reduced facial projection, smaller jaw, and increased braincase globularity. In addition, we suggest that NF1 sphenoid bone shortening, a common event, is consistent with an intrinsic NF1 bone cell defect, which renders the bone more vulnerable to a random "second hit" in

  14. Metabolic and nutritional status changes after 10% weight loss in severely obese patients treated with laparoscopic surgery vs integrated medical treatment.

    Science.gov (United States)

    del Genio, Federica; Alfonsi, Lucia; Marra, Maurizio; Finelli, Carmine; del Genio, Gianmattia; Rossetti, Gianluca; del Genio, Alberto; Contaldo, Franco; Pasanisi, Fabrizio

    2007-12-01

    Bariatric surgery is considered the most effective treatment for reducing excess body weight and maintaining weight loss (WL) in severely obese patients. There are limited data evaluating metabolic and body composition changes after different treatments in type III obese (body mass index [BMI] > 40 kg/m(2)). Twenty patients (9 males, 11 females; 37.6 +/- 8 years; BMI = 50.1 +/- 8 kg/m(2)) treated with dietary therapy and lifestyle correction (group 1) have been compared with 20 matched patients (41.8 +/- 6 years; BMI = 50.4 +/- 6 kg/m(2)) treated with laparoscopic gastric bypass (LGBP; group 2). Patients have been evaluated before treatment and after >10% WL obtained on average 6 weeks after LGBP and 30 weeks after integrated medical treatment. Metabolic syndrome (MS) was evaluated using the Adult Treatment Panel III/America Heart Association (ATP III/AHA) criteria. Resting metabolic rate (RMR) and respiratory quotient (RQ) was assessed with indirect calorimetry; body composition with bioimpedance analysis. At entry, RMR/fat-free mass (FFM) was 34.2 +/- 7 kcal/24 h.kg in group 1 and 35.1 +/- 8 kcal/24 h.kg in group 2 and did not decrease in both groups after 10% WL (31.8 +/- 6 vs 34.0 +/- 6). Percent FFM and fat mass (FM) was 50.7 +/- 7% and 49.3 +/- 7% in group 1 and 52.1 +/- 6% and 47.9 +/- 6% in group 2, respectively (p = n.s.). After WL, body composition significantly changed only in group 1 (% FFM increased to 55.9 +/- 6 and % FM decreased to 44.1 +/- 6; p = 0.002). After >10% WL, MS prevalence decreases precociously in surgically treated patients; some improvements in body composition are observed in nonsurgically treated patients only. Further investigations are needed to evaluate long-term effects of bariatric surgery on body composition and RMR after stable WL.

  15. 'Integration'

    DEFF Research Database (Denmark)

    Olwig, Karen Fog

    2011-01-01

    , while the countries have adopted disparate policies and ideologies, differences in the actual treatment and attitudes towards immigrants and refugees in everyday life are less clear, due to parallel integration programmes based on strong similarities in the welfare systems and in cultural notions...

  16. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    Directory of Open Access Journals (Sweden)

    Hee Seung Choi

    2014-01-01

    Full Text Available Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%. When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

  17. Three-dimensional fetal cephalometry: an evaluation of the reliability of cephalometric measurements based on three-dimensional CT reconstructions and on dry skulls of sheep fetuses.

    Science.gov (United States)

    Papadopoulos, Moschos A; Jannowitz, Christina; Boettcher, Peter; Henke, Julia; Stolla, Rudolf; Zeilhofer, Hans-Florian; Kovacs, Laszlo; Erhardt, Wolf; Biemer, Edgar; Papadopulos, Nikolaos A

    2005-08-01

    To develop a 3D CT cephalometric analysis for maxillary growth evaluation of sheep fetuses operated in utero, and to evaluate the reliability of this analysis by comparing it with a direct cephalometric analysis on dry skulls. Five skulls of operated sheep fetuses were used, which after preparation were CT scanned and a 3D reconstruction was performed. A cephalometric analysis was performed directly on the dry skulls as well as on the reconstructed 3D CT images. In total, 56 linear distances were measured. In order to access the error of the method, the procedure was repeated after a 2 week interval. The comparison between the direct cephalometric and the 3D CT analysis revealed that only 5 variables were significantly different. The evaluation of the error of method revealed that 7 variables of the direct cephalometric analysis and none of the 3D CT analysis differed significantly. According to the results of this study, it can be concluded that a cephalometric analysis on 3D CT reconstructed images of the skulls includes fewer identification errors and seems to be an accurate and reliable method that could be regarded at least as equivalent to conventional cephalometry.

  18. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  20. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  1. Hemorrhoid surgery

    Science.gov (United States)

    ... surgery. Hemorrhoid surgery may involve: Putting a small rubber band around a hemorrhoid to shrink it by blocking blood flow. Stapling a hemorrhoid to block blood flow, causing it to shrink. Using a ...

  2. Plastic Surgery

    Science.gov (United States)

    ... idea for teens? As with everything, there are right and wrong reasons to have surgery. Cosmetic surgery is unlikely to change your life. Most board-certified plastic surgeons spend a lot of time ... the right reasons. Many plastic surgery procedures are just that — ...

  3. Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

    Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Simultaneous Integrated Boost Irradiation After Breast-Conserving Surgery: Physician-Rated Toxicity and Cosmetic Outcome at 30 Months' Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Bantema-Joppe, Enja J.; Schilstra, Cornelis [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Bock, Geertruida H. de [Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Dolsma, Wil V.; Busz, Dianne M.; Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Maduro, John H., E-mail: j.h.maduro@umcg.nl [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)

    2012-07-15

    Purpose: To evaluate toxicity and cosmetic outcome (CO) in breast cancer survivors treated with three-dimensional conformal radiotherapy with a hypofractionated, simultaneous integrated boost (3D-CRT-SIB) and to identify risk factors for toxicity, with special focus on the impact of age. Methods and Materials: Included were 940 consecutive disease-free patients treated for breast cancer (Stage 0-III) with 3D-CRT-SIB, after breast-conserving surgery, from 2005 to 2010. Physician-rated toxicity (Common Terminology Criteria for Adverse Events version 3.0) and CO were prospectively assessed during yearly follow-up, up to 5 years after radiotherapy. Multivariate logistic regression analyses using a bootstrapping method were performed. Results: At 3 years, toxicity scores of 436 patients were available. Grade {>=}2 fibrosis in the boost area was observed in 8.5%, non-boost fibrosis in 49.4%, pain to the chest wall in 6.7%, and fair/poor CO in 39.7% of cases. Radiotherapy before chemotherapy was significantly associated with grade {>=}2 boost fibrosis at 3 years (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.3-6.0). Non-boost fibrosis was associated with re-resection (OR 2.2, 95% CI 1.2-4.0) and larger tumors (OR 1.1, 95% CI 1.0-1.1). At 1 year, chest wall pain was significantly associated with high boost dosage (OR 2.1, 95% CI 1.2-3.7) and younger age (OR 0.4, 95% CI 0.2-0.7). A fair/poor CO was observed more often after re-resection (OR 4.5, 95% CI 2.4-8.5), after regional radiotherapy (OR 2.9, 95% CI 1.2-7.1), and in larger tumors (OR 1.1, 95% CI 1.0-1.1). Conclusions: Toxicity and CO are not impaired after 3D-CRT-SIB. Fibrosis was not significantly associated with radiotherapy parameters. Independent risk factors for fibrosis were chemotherapy after radiotherapy, re-resection, and larger tumor size. Re-resection was most predictive for worse CO. Age had an impact on chest wall pain occurrence.

  5. Cosmetic Surgery Training in Plastic Surgery Residency Programs.

    Science.gov (United States)

    McNichols, Colton H L; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur; Rasko, Yvonne

    2017-09-01

    Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

  6. Step-wise integration of single-port laparoscopic surgery into routine colorectal surgical practice by use of a surgical glove port.

    Science.gov (United States)

    Hompes, R; Lindsey, I; Jones, O M; Guy, R; Cunningham, C; Mortensen, N J; Cahill, R A

    2011-06-01

    The cost associated with single-port laparoscopic access devices may limit utilisation of single-port laparoscopic surgery by colorectal surgeons. This paper describes a simple and cheap access modality that has facilitated the widespread adoption of single-port technology in our practice both as a stand-alone procedure and as a useful adjunct to traditional multiport techniques. A surgical glove port is constructed by applying a standard glove onto the rim of the wound protector/retractor used during laparoscopic resectional colorectal surgery. To illustrate its usefulness, we present our total experience to date and highlight a selection of patients presenting for a range of elective colorectal surgery procedures. The surgical glove port allowed successful completion of 25 single-port laparoscopic procedures (including laparoscopic adhesiolysis, ileo-rectal anastomosis, right hemicolectomy, total colectomy and low anterior resection) and has been used as an adjunct in over 80 additional multiport procedures (including refashioning of a colorectal anastomosis made after specimen extraction during a standard multiport laparoscopic anterior resection). This simple, efficient device can allow use of single-port laparoscopy in a broader spectrum of patients either in isolation or in combination with multiport surgery than may be otherwise possible for economic reasons. By separating issues of cost from utility, the usefulness of the technical advance inherent within single-port laparoscopy for colorectal surgery can be better appreciated. We endorse the creative innovation inherent in this approach as surgical practice continues to evolve for ever greater patient benefit.

  7. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    3 Department of Paediatric Surgery, Sophia's Children Hospital/Erasmus Medical Centre, Rotterdam, The Netherlands. 4 Department of Paediatric Surgery, Emma's Children Hospital/Academic Medical Centre, Amsterdam, The Netherlands. 5 Department of Radiology, Red Cross War Memorial Children's Hospital, ...

  8. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    Gastroschisis in a developing country: poor resuscitation is a more significant predictor of mortality than postnatal transfer time. PAEDIATRIC SURGERY. P Stevens,1 E Muller,1 P Becker2. 1 Department of Paediatric Surgery, Steve Biko Academic Hospital, University of Pretoria. 2 South African Medical Research Council.

  9. Integration of oncologic margins in three-dimensional virtual planning for head and neck surgery, including a validation of the software pathway

    NARCIS (Netherlands)

    Kraeima, Joep; Schepers, Rutger H.; van Ooijen, Peter M. A.; Steenbakkers, Roel J. H. M.; Roodenburg, Jan L. N.; Witjes, Max J. H.

    2015-01-01

    Purpose: Three-dimensional (3D) virtual planning of reconstructive surgery, after resection, is a frequently used method for improving accuracy and predictability. However, when applied to malignant cases, the planning of the oncologic resection margins is difficult due to visualisation of tumours

  10. Rodding Surgery

    Science.gov (United States)

    ... usually undertaken as a scheduled elective procedure. An optimal age for a first rodding surgery has not ... which may prevent or postpone the need for replacement. The smallest diameter expanding rods are still too ...

  11. Lung surgery

    Science.gov (United States)

    ... the pulmonary artery ( pulmonary embolism ) Treat complications of tuberculosis Video-assisted thoracoscopic surgery can be used to ... Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed ...

  12. Bariatric Surgery

    Science.gov (United States)

    ... action of certain hormones, such as ghrelin —“the hunger hormone.” People have these types of surgery if ... organizations to further patient education on hormone related issues. Network Sponsors The Hormone Health Network is supported ...

  13. Epilepsy Surgery

    Science.gov (United States)

    ... and the portion of your brain that's involved: Memory problems. The temporal lobe handles memory and language functions, so surgery on this part ... computerized tomography (SPECT). The scan image varies in color depending on the amount of blood flow in ...

  14. After Surgery

    Science.gov (United States)

    After any operation, you'll have some side effects. There is usually some pain with surgery. There ... anesthesia, or accidental injury. Some people have a greater risk of complications because of other medical conditions. ...

  15. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... Barnett J, Mohanty A, Desai SK, Patterson JT. Neurosurgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, ...

  16. Bariatric surgery

    Science.gov (United States)

    Karmali, Shahzeer; Stoklossa, Carlene Johnson; Sharma, Arya; Stadnyk, Janet; Christiansen, Sandra; Cottreau, Danielle; Birch, Daniel W.

    2010-01-01

    Abstract OBJECTIVE To review the management of bariatric surgical patients. QUALITY OF EVIDENCE MEDLINE, EMBASE, and Cochrane Library databases were searched, as well as PubMed US National Library, from January 1950 to December 2009. Evidence was levels I, II, and III. MAIN MESSAGE Bariatric surgery should be considered for obese patients at high risk of morbidity and mortality who have not achieved adequate weight loss with lifestyle and medical management and who are suffering from the complications of obesity. Bariatric surgery can result in substantial weight loss, resolution of comorbid conditions, and improved quality of life. The patient’s weight-loss history; his or her personal accountability, responsibility, and comprehension; and the acceptable level of risk must be taken into account. Complications include technical failure, bleeding, abdominal pain, nausea or vomiting, excess loose skin, bowel obstruction, ulcers, and anastomotic stricture. Lifelong monitoring by a multidisciplinary team is essential. CONCLUSION Limited long-term success of behavioural and pharmacologic therapies in severe obesity has led to renewed interest in bariatric surgery. Success with bariatric surgery is more likely when multidisciplinary care providers, in conjunction with primary care providers, assess, treat, monitor, and evaluate patients before and after surgery. Family physicians will play a critical role in counseling patients about bariatric surgery and will need to develop skills in managing these patients in the long-term. PMID:20841586

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  19. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  20. Bariatric surgery

    Directory of Open Access Journals (Sweden)

    Alojz Pleskovič

    2013-07-01

    Full Text Available Background: In almost six decades different surgical techniques have been developed to treat patients with morbid obesity. Various surgical techniques are generally divided with respect to their effect into restrictive, malabsorbtive and humoral and a combination of these. Surgically modified human metabolism ameliorates metabolic diseases, particularly diabetes, even in nonobese patients. The understanding of metabolic effects changed the traditional paradigm of bariatric surgery from simple weight-loss procedure to metabolic surgery affecting whole-body metabolism. Proper surgical technique for individual patient is the most important factor influencing long- term results, comorbidities and quality of life. Recommendations for patient selection, surgical methods and pre- and postoperative patient management are to be respected. Metabolic surgery principles and current concepts are presented.

  1. Integration of oncologic margins in three-dimensional virtual planning for head and neck surgery, including a validation of the software pathway.

    Science.gov (United States)

    Kraeima, Joep; Schepers, Rutger H; van Ooijen, Peter M A; Steenbakkers, Roel J H M; Roodenburg, Jan L N; Witjes, Max J H

    2015-10-01

    Three-dimensional (3D) virtual planning of reconstructive surgery, after resection, is a frequently used method for improving accuracy and predictability. However, when applied to malignant cases, the planning of the oncologic resection margins is difficult due to visualisation of tumours in the current 3D planning. Embedding tumour delineation on a magnetic resonance image, similar to the routinely performed radiotherapeutic contouring of tumours, is expected to provide better margin planning. A new software pathway was developed for embedding tumour delineation on magnetic resonance imaging (MRI) within the 3D virtual surgical planning. The software pathway was validated by the use of five bovine cadavers implanted with phantom tumour objects. MRI and computed tomography (CT) images were fused and the tumour was delineated using radiation oncology software. This data was converted to the 3D virtual planning software by means of a conversion algorithm. Tumour volumes and localization were determined in both software stages for comparison analysis. The approach was applied to three clinical cases. A conversion algorithm was developed to translate the tumour delineation data to the 3D virtual plan environment. The average difference in volume of the tumours was 1.7%. This study reports a validated software pathway, providing multi-modality image fusion for 3D virtual surgical planning. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep

    2009-01-01

    Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

  3. Cosmetic surgery.

    OpenAIRE

    Harris, D. L.

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks.

  4. PLASTIC SURGERY

    African Journals Online (AJOL)

    surgery or subcutaneous mastectomy utilizing a periareolar or circumareolar ... old. Informed consent was obtained. The height of the patients was measured from heel to vertex with a standard height measuring device. The chest circumference was ... The procedure was followed with liposuction 3-6 months later if required.

  5. GENERAL SURGERY

    African Journals Online (AJOL)

    Summary: The multidisciplinary management of Breast Cancer (BC) has evolved over the past 50 years: the patient is offered a choice of .... Choice of procedure. – For women with early BC, there is essentially a choice between 2 procedures: mastectomy or breast conserving surgery with radiation (BCT). The standard.

  6. GENERAL SURGERY

    African Journals Online (AJOL)

    Schwab , using a three-phase approach.5 In 1998, Moore et al. extended the concept and described the five-stage approach.6. The aim of damage control surgery is to prevent severely injured patients from developing the “lethal triad” of hypothermia, coagulopathy and worsening acidosis, as this confers a dismal prognosis ...

  7. GENERAL SURGERY

    African Journals Online (AJOL)

    We plan to protocolise earlier surgery and blood conservation strategies intraoperatively in addition to a restrictive strategy in ..... Marshall JC. Review Transfusion trigger: when to transfuse? Crit Care. 2004;8(Suppl 2):S31-3. 11. Hofmann A, Farmer S, Towler SC. Strategies to preempt and reduce the use of blood products: ...

  8. Cosmetic Surgery

    Science.gov (United States)

    ... http://www.mayoclinic.com/health/cosmetic-surgery/SN00006 Medical Tourism (Copyright © American Society of Plastic Surgeons) — People considering ... in exotic vacation spots. This publication talks about "medical tourism" and whether it's safe. http://www.plasticsurgery.org/ ...

  9. GENERAL SURGERY

    African Journals Online (AJOL)

    Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...

  10. GENERAL SURGERY

    African Journals Online (AJOL)

    after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016;113(2):188-193. http:// dx.doi.org/10.1002/jso.24125. 2. Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): An international study group of pancreatic surgery (ISGPS) definition. Surg. 2007;142(1):20-25. http://.

  11. Metabolic Surgery

    DEFF Research Database (Denmark)

    Pareek, Manan; Schauer, Philip R; Kaplan, Lee M

    2018-01-01

    the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity...

  12. TRAUMA SURGERY

    African Journals Online (AJOL)

    deaths due to other trauma types (gunshot wounds, road traffic fatalities and assault) ... the axillary artery was ligated during surgery. Type of ... Left axillary artery. Ischaemic left upper limb. 3. Fifth intercostal space on the left. Bilateral pneumothorax and haemothorax still present at autopsy. (intercostal drain only inserted on ...

  13. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  14. Impact of surgery and chemotherapy on cellular immunity in pancreatic carcinoma patients in view of an integration of standard cancer treatment with immunotherapy.

    Science.gov (United States)

    Bellone, Graziella; Novarino, Anna; Vizio, Barbara; Brondino, Gabriele; Addeo, Alfredo; Prati, Adriana; Giacobino, Alice; Campra, Donata; Fronda, Gian Ruggero; Ciuffreda, Libero

    2009-06-01

    As surgery and chemotherapy may act as adjuvants providing antitumor immunity benefits, we ran phenotypical and functional immunomonitoring in patients with resectable pancreatic adenocarcinoma and advanced metastatic disease receiving combined treatment (cisplatin, gemcitabine, 5-FU). Blood was taken before/one month after resection; before/during chemotherapy. Controls were age- and gender-matched. Circulating lymphocyte, myeloid and plasmacytoid dendritic cell (MDC and PDC) subsets were examined by flow cytometry; functional activity by mixed lymphocyte reaction (MLR) for DC allostimulation, through 4-h 51Cr-release assay for Natural Killer (NK) and lymphokine-activated-killer (LAK) cell cytotoxicity; ELISA for spontaneous/activated cytokine release by PBMC and T cells. Significant differences occurred in several parameters between pretreatment patient and control values: fewer CD8+ cells and increased apoptosis-prone CD3+/CD95+ lymphocytes, higher frequency of MDC, reduced allostimulatory activity by ex vivo-generated DC, depressed LAK activity, elevated IL-10 and IL-12p40 production; impaired IL-12p70 and IFN-gamma production by stimulated PBMC and T cells. Only IL-12p70 level was correlated with survival. One month after radical, but not palliative surgery, the percentage of T-lymphocytes coexpressing CD3/CD95 decreased significantly, the stimulatory capacity of DC increased, and LPS-induced IL-12p70 release by PBMC rose concomitantly with the anti-CD3 stimulated-IFN-gamma production by T cells. In patients with locally advanced or metastatic disease, one and/or two combined drug cycles increased percentage of CD4+ cells and LAK cell cytotoxicity and decreased PDC frequency and spontaneous/LPS-stimulated IL-10 by PBMC. Results suggest immunological changes induced by surgical resection/combined chemotherapy indicate specific precisely-timed windows of opportunity for introducing immunotherapy in pancreatic cancer, possibly improving survival in this highly

  15. Transition to a novel advanced integrated vitrectomy platform: comparison of the surgical impact of moving from the Accurus vitrectomy platform to the Constellation Vision System for microincisional vitrectomy surgery.

    Science.gov (United States)

    Murray, Timothy G; Layton, Andrew J; Tong, Kuo B; Gittelman, Michael; Latiff, Azeema; Gologorsky, Daniel; Vigoda, Michael M

    2013-01-01

    Microincisional vitrectomy surgery (MIVS) is the current standard surgical approach for pars plana vitrectomy. Historically, the most common surgical platform for vitrectomy surgery, since its introduction in 1997, has been the Accurus vitrectomy system. Recent introduction of the next generation of vitrectomy platforms has generated concerns associated with transitioning to new technology in the operating room environment. This study compared, in a matched fashion, surgical use of the Accurus vitrectomy system and the next generation Constellation Vision System to evaluate surgical efficiencies, complications, and user perceptions of this transition. Electronic health records were abstracted as a hospital quality assurance activity and included all vitreoretinal surgical procedures at the Bascom Palmer Eye Institute, Anne Bates Leach Eye Hospital, during two discrete 12-month time periods. These two periods reflected dedicated usage of the Accurus (June 2008-May 2009) and Constellation Vision (July 2009-June 2010) systems. Data were limited to a single surgeon and evaluated for operating room (OR) total time usage/day, OR case time/case, and OR surgical time/case. Further analysis evaluated all patients undergoing combined MIVS and clear cornea phacoemulsification/intraocular lens (IOL) implantation during each individual time period to determine the impact of the instrumentation on these parameters. All records were evaluated for intraoperative complications. Five hundred and fourteen eligible patients underwent MIVS during the 2-year study windows, with 281 patients undergoing surgery with the Accurus system and 233 patients undergoing surgery with the Constellation system. Combined MIVS and phacoemulsification with IOL implantation was performed 141 times during this period with the Accurus and 158 times during the second study period with the Constellation. Total number of patients operated per day increased from 7.55 with Accurus to 8.53 with Constellation

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ...

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  18. Tennis elbow surgery - discharge

    Science.gov (United States)

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...

  20. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were......The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform...

  1. Social media in vascular surgery.

    Science.gov (United States)

    Indes, Jeffrey E; Gates, Lindsay; Mitchell, Erica L; Muhs, Bart E

    2013-04-01

    There has been a tremendous growth in the use of social media to expand the visibility of various specialties in medicine. The purpose of this paper is to describe the latest updates on some current applications of social media in the practice of vascular surgery as well as existing limitations of use. This investigation demonstrates that the use of social networking sites appears to have a positive impact on vascular practice, as is evident through the incorporation of this technology at the Cleveland Clinic and by the Society for Vascular Surgery into their approach to patient care and physician communication. Overall, integration of social networking technology has current and future potential to be used to promote goals, patient awareness, recruitment for clinical trials, and professionalism within the specialty of vascular surgery. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  2. The Integration of Group Technology and Simulation Optimization to Solve the Flow Shop with Highly Variable Cycle Time Process: A Surgery Scheduling Case Study

    Directory of Open Access Journals (Sweden)

    T. K. Wang

    2014-01-01

    Full Text Available Surgery scheduling must balance capacity utilization and demand so that the arrival rate does not exceed the effective production rate. However, authorized overtime increases because of random patient arrivals and cycle times. This paper proposes an algorithm that allows the estimation of the mean effective process time and the coefficient of variation. The algorithm quantifies patient flow variability. When the parameters are identified, takt time approach gives a solution that minimizes the variability in production rates and workload, as mentioned in the literature. However, this approach has limitations for the problem of a flow shop with an unbalanced, highly variable cycle time process. The main contribution of the paper is to develop a method called takt time, which is based on group technology. A simulation model is combined with the case study, and the capacity buffers are optimized against the remaining variability for each group. The proposed methodology results in a decrease in the waiting time for each operating room from 46 minutes to 5 minutes and a decrease in overtime from 139 minutes to 75 minutes, which represents an improvement of 89% and 46%, respectively.

  3. Ultrasonic Fetal Cephalometry: Percentiles Curve

    Science.gov (United States)

    Flamme, P.

    1972-01-01

    Measurements by ultrasound of the biparietal diameter of the fetal head during pregnancy are a reliable guide to fetal growth. As a ready means of comparison with the normal we constructed from 4,170 measurements in 1,394 cases a curve showing the percentiles distribution of biparietal diameters for each week of gestation. PMID:5070162

  4. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...... to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients....

  5. Integration of computer-assisted fracture reduction system and a hybrid 3-DOF-RPS mechanism for assisting the orthopedic surgery

    Science.gov (United States)

    Irwansyah; Sinh, N. P.; Lai, J. Y.; Essomba, T.; Asbar, R.; Lee, P. Y.

    2018-02-01

    In this paper, we present study to integrate virtual fracture bone reduction simulation tool with a novel hybrid 3-DOF-RPS external fixator to relocate back bone fragments into their anatomically original position. A 3D model of fractured bone was reconstructed and manipulated using 3D design and modeling software, PhysiGuide. The virtual reduction system was applied to reduce a bilateral femoral shaft fracture type 32-A3. Measurement data from fracture reduction and fixation stages were implemented to manipulate the manipulator pose in patient’s clinical case. The experimental result presents that by merging both of those techniques will give more possibilities to reduce virtual bone reduction time, improve facial and shortest healing treatment.

  6. Borromean surgery formula for the Casson invariant

    DEFF Research Database (Denmark)

    Meilhan, Jean-Baptiste Odet Thierry

    2008-01-01

    It is known that every oriented integral homology 3-sphere can be obtained from S3 by a finite sequence of Borromean surgeries. We give an explicit formula for the variation of the Casson invariant under such a surgery move. The formula involves simple classical invariants, namely the framing, li......, linking number and Milnor's triple linking number. A more general statement, for n independent Borromean surgeries, is also provided.......It is known that every oriented integral homology 3-sphere can be obtained from S3 by a finite sequence of Borromean surgeries. We give an explicit formula for the variation of the Casson invariant under such a surgery move. The formula involves simple classical invariants, namely the framing...

  7. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    -depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... and many patients said that they joined the RCT in order to bypass waiting lists. Patients who chose to cross-over described training as time consuming, boring and as unable to provide sufficient results within a reasonable timeframe. Some said their injured knees had given-way; others experienced new knee...... a variety of views and beliefs about those treatments, and trial participation happens in the absence of equipoise. Furthermore, opting for surgical reconstruction does not necessarily provide patients with satisfactory outcomes. Definition of successful outcome may require an individualised approach...

  8. Heart failure - surgeries and devices

    Science.gov (United States)

    CHF - surgery; Congestive heart failure - surgery; Cardiomyopathy - surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure

  9. [Impact of digital technology on clinical practices: perspectives from surgery].

    Science.gov (United States)

    Zhang, Y; Liu, X J

    2016-04-09

    Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Being integrated into clinical practice, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes.

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Other Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons ...

  13. Hip Replacement Surgery

    Science.gov (United States)

    ... Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB Download ... What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or diseased ...

  14. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  15. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  16. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...

  18. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... Ginther RM, Forbess JM. Pediatric cardiopulmonary bypass. In: ... Care . 5th ed. Philadelphia, PA: Elsevier; 2017:chap 37. LeRoy S, ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral and ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  20. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  1. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ... without straining Chronic mouth breathing Sleep apnea (breathing problems when sleeping, including snoring) Your dentist, orthodontist and ...

  3. [Analysis of three dimensional stability of the hypoplastic maxilla after orthognathic surgery in cleft lip and palate patients].

    Science.gov (United States)

    Yingwang, Jun-Zi; Shen, Shun-Yao; Li, Biao; Sun, Hao; Wang, Xu-Dong

    2016-06-01

    To establish a three dimensional spacial measurement method to analyze the short-term stability of maxilla after orthognathic surgery in cleft lip and palate patients. Twenty-five patients with maxillary hypoplasia secondary to cleft lip and palate seeking for orthognathic surgery were included in this study between January 2008 and September 2012. The spiral CT scan for the skull were taken 6 weeks preoperatively (T0), 4 days postoperatively (T1),3 months postoperatively (T2), and 6 months postoperatively (T3) and collected. A three dimensional analytic method for measuring maxilla was set up in ProPlan CMF software, and good repeatability of identification of landmarks was confirmed. Twenty-two indicators to describe the maxillary position and three new angles to describe the maxillary orientation were measured and analyzed. Student's t test was used to analyze the difference between T2 and T3 using SPSS 16.0 software package. In 25 patients with cleft palate there was a translational relapse upwards along vertical axis and a pitch-up relapse of maxilla with an average of 7.46% at the anterior part of the cleft maxilla. The relapse rate was 30.95% in LUCLP, 8.01% in RUCLP, and 34.76% in BCLP, but with no significant difference. Along the horizontal axis, there was a maxillary translational relapse toward noncleft side in both LUCLP and RUCLP group, while a yaw relapse was confirmed with the anterior part of maxilla toward noncleft side and the posterior part toward cleft side. There is a three-dimensional relapse tendency for the maxilla in the cleft patient postoperatively. The established three-dimensional analytic method well describes the special position of cleft maxilla especially in the translational and rotational movement of maxilla in three different axes comparing with that from lateral cephalometry, thus providing references for accurate measurements in study of the three dimensional maxillary stability after orthognathic surgery.

  4. Computer assisted radiology and surgery. CARS 2010

    International Nuclear Information System (INIS)

    Anon.

    2010-01-01

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  5. Computer assisted radiology and surgery. CARS 2010

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-06-15

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  6. Estudio cefalométrico del hueso hioides en niños respiradores bucales de 11 años.: Segunda parte Cephalometry study of hyoid bone in children aged 11 mouth-breathing (second part

    Directory of Open Access Journals (Sweden)

    Dariel Carulla Martínez

    2010-06-01

    Full Text Available Se realizó una correlación entre el comportamiento de la posición del hioides con el crecimiento del maxilar y de la mandíbula, los ángulos cérvico-basio-hioideo y el espacio aéreo póstero-inferior, desde el punto de vista cefalométrico, a un grupo de pacientes respiradores bucales. Se analizaron las historias clínicas de 60 pacientes, de 11 años de edad, que acudieron a la consulta de Ortodoncia en el área de salud de la Facultad de Estomatología. Se utilizaron matrices de coeficiente de correlación lineal de Pearson, para evaluar la posición del hioides con respecto a dichas variables. Se encontró descenso del hueso, y relaciones significativas con las variables que reflejan el crecimiento maxilar y mandibular, así como la posición de la columna vertebral (segmento cervical y de la cabeza, además del espacio aéreo posterior de la faringe, con un nivel de significación del 5 %.A correlation between the behavior of hyoid bone location and the maxilla and the mandible growth, the cérvico-basio-hyoid angles and the lower posterior aerial space from the cephalometry point of view in a group of patients mouth-breathing. The medical records from 60 patients aged 11 seen in the Orthodontics consultation from the health area of Stomatology Faculty were reviewed. We used matrix of Pearson's linear correlation to assess the hyoid bone location regarding such variables; noting a bone drop and significant relations with above variables reflecting the maxillary and mandibular growth, the spinal column position (cervical segment and the head; as well ass the posterior aerial space of the pharynx with a 5 % significance level.

  7. Gastric Bypass Surgery

    Science.gov (United States)

    ... gastrointestinal system Death (rare) Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They ... room, where medical staff monitors you for any complications. Your hospital stay may ... of bariatric surgery Each type of bariatric surgery has pros and ...

  8. Facial Cosmetic Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  10. Corrective Jaw Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We Are Find a Surgeon News Videos Contact Anesthesia Cleft Lip/Palate and Craniofacial Surgery Corrective Jaw Surgery Dental Implant Surgery Extractions and Other Oral Surgeries Facial Cosmetic ...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft tissues of the ... and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft tissues of the ...

  13. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Procedures Who is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery Life ... Bariatric Surgery FAQs Bariatric Surgery Procedures BMI Calculator Childhood and Adolescent Obesity 100 SW 75th Street, Suite 201, Gainesville, FL, ...

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  15. Limited-Access Heart Surgery

    Science.gov (United States)

    ... Surgery Menu Topics Topics FAQs Limited-Access Heart Surgery Article Info En español Thousands of heart surgeries ... with cardiovascular disease. What is minimally invasive heart surgery? In minimally invasive heart surgery, surgeons take steps ...

  16. Three-Dimensional Planning in Maxillofacial Fracture Surgery: Computer-Aided Design/Computer-Aided Manufacture Surgical Splints by Integrating Cone Beam Computerized Tomography Images Into Multislice Computerized Tomography Images.

    Science.gov (United States)

    Ren, Jiayin; Zhou, Zhongwei; Li, Peng; Tang, Wei; Guo, Jixiang; Wang, Hu; Tian, Weidong

    2016-09-01

    This study aimed to evaluate an innovative workflow for maxillofacial fracture surgery planning and surgical splint designing. The maxillofacial multislice computerized tomography (MSCT) data and dental cone beam computerized tomography (CBCT) data both were obtained from 40 normal adults and 58 adults who suffered fractures. The each part of the CBCT dentition image was registered into MSCT image by the use of the iterative closest point algorithm. Volume evaluation of the virtual splints that were designed by the registered MSCT images and MSCT images of the same object was performed. Eighteen patients (group 1) were operated without any splint. Twenty-one (group 2) and 19 patients (group 3) used the splints designed according to the MSCT images and registered MSCT images, respectively. The authors' results showed that the mean errors between the 2 models ranged from 0.53 to 0.92 mm and the RMS errors ranged from 0.38 to 0.69 mm in fracture patients. The mean errors between the 2 models ranged from 0.47 to 0.85 mm and the RMS errors ranged from 0.33 to 0.71 mm in normal adults. 72.22% patients in group 1 recovered occlusion. 85.71% patients in group 2, and 94.73% patients in group 3 reconstructed occlusion. There was a statistically significant difference between the MSCT images based splints' volume and the registered MSCT splints' volume in patients (P designing was feasible. The volume of the splints designed by MSCT images tended to be smaller than the splints designed by the integrated MSCT images. The patients operated with splints tended to regain occlusion. The patients who were operated with the splints which were designed according to registered MSCT images tended to get occlusal recovered.

  17. Integrating lingual orthodontics with orthognathic surgery

    Directory of Open Access Journals (Sweden)

    M S Kannan

    2016-01-01

    Full Text Available Appearance is the most important motivating factor for patients seeking orthodontic treatment and is self-evident that these patients would prefer an appliance that is less visible. Lingual "invisible" Appliances offer the best option to the patient seeking aesthetic correction for their malocclusion. A group of such patients who do not want their appliances to be visible also require surgical correction. Lingual appliance being comparable to the labial counterpart provides the opportunity of hiding appliances for patients requiring Orthognathic surgical correction for their condition. This case report depicts the successful treatment of a patient using lingual appliance in conjunction with anterior maxillary osteotomy.

  18. Integrating lingual orthodontics with orthognathic surgery

    OpenAIRE

    M S Kannan; Mansi Giri

    2016-01-01

    Appearance is the most important motivating factor for patients seeking orthodontic treatment and is self-evident that these patients would prefer an appliance that is less visible. Lingual "invisible" Appliances offer the best option to the patient seeking aesthetic correction for their malocclusion. A group of such patients who do not want their appliances to be visible also require surgical correction. Lingual appliance being comparable to the labial counterpart provides the opportunity of...

  19. Oncoplastic breast conservation surgery: the new paradigm.

    Science.gov (United States)

    Silverstein, Melvin J; Mai, Tam; Savalia, Nirav; Vaince, Faaiza; Guerra, Lisa

    2014-07-01

    Oncoplastic surgery combines plastic surgical techniques with sound surgical oncologic principles. The goal is to completely excise the cancer, with wide surgical margins while maintaining or improving cosmesis. For large, poorly defined, or unfavorably situated tumors, standard lumpectomies may lead to unacceptable cosmetic results in addition to close or involved resection margins. Similar problems may occur for smaller tumors in small breasts. Integration of the two surgical disciplines avoids or minimizes poor cosmetic results after wide excision. It increases the number of women who can be treated with breast-conserving surgery by allowing larger breast excisions with more acceptable cosmetic results. Oncoplastic surgery requires a multidisciplinary approach and thorough preoperative planning. It is absolutely necessary to enlist the cooperation and coordination of surgical oncology, plastic surgery, radiology, pathology, medical oncology, and radiation oncology. Oncoplastic surgery requires a philosophy that the appearance of the breast after tumor excision is important. © 2014 Wiley Periodicals, Inc.

  20. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid Christine; Neumann, Gudrun

    2014-01-01

    in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (pcarcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION......: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated...

  1. A New Three-Dimensional Cephalometric Analysis for Orthognathic Surgery

    Science.gov (United States)

    Gateno, Jaime; Xia, James J.; Teichgraeber, John F.

    2010-01-01

    Two basic problems are associated with traditional 2-dimensional ((2D) cephalometry First, many important parameters cannot be measured on plain cephalograms; and second, most 2D cephalometric measurements are distorted in the presence of facial asymmetry. Three-dimensional (3D) cephalometry, which has been facilitated by the introduction of cone beam computed tomography scans, can be solved these problems. However, before this can be realized, fundamental problems must be solved. They are the unreliability of internal reference systems and some 3D measurements, and the lack of tools to assess and measure symmetry. In this manuscript, the authors present a new 3D cephalometric analysis that uses different geometric approaches to solve the fundamental problems previously mentioned. This analysis allows the accurate measurement of the size, shape, position and orientation of the different facial units and incorporates a novel method to measure asymmetry. PMID:21257250

  2. Computational Modeling in Liver Surgery

    Directory of Open Access Journals (Sweden)

    Bruno Christ

    2017-11-01

    Full Text Available The need for extended liver resection is increasing due to the growing incidence of liver tumors in aging societies. Individualized surgical planning is the key for identifying the optimal resection strategy and to minimize the risk of postoperative liver failure and tumor recurrence. Current computational tools provide virtual planning of liver resection by taking into account the spatial relationship between the tumor and the hepatic vascular trees, as well as the size of the future liver remnant. However, size and function of the liver are not necessarily equivalent. Hence, determining the future liver volume might misestimate the future liver function, especially in cases of hepatic comorbidities such as hepatic steatosis. A systems medicine approach could be applied, including biological, medical, and surgical aspects, by integrating all available anatomical and functional information of the individual patient. Such an approach holds promise for better prediction of postoperative liver function and hence improved risk assessment. This review provides an overview of mathematical models related to the liver and its function and explores their potential relevance for computational liver surgery. We first summarize key facts of hepatic anatomy, physiology, and pathology relevant for hepatic surgery, followed by a description of the computational tools currently used in liver surgical planning. Then we present selected state-of-the-art computational liver models potentially useful to support liver surgery. Finally, we discuss the main challenges that will need to be addressed when developing advanced computational planning tools in the context of liver surgery.

  3. Surgery for Stress Urinary Incontinence

    Science.gov (United States)

    ... Surgery for Stress Urinary Incontinence Page Navigation ▼ ACOG Pregnancy Book Surgery for Stress Urinary Incontinence Patient Education FAQs Surgery for Stress Urinary Incontinence Patient Education ...

  4. [Thymus surgery in a general surgery department].

    Science.gov (United States)

    Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

    2005-01-01

    Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

  5. Bariatric metabolic surgery.

    Science.gov (United States)

    Scopinaro, N

    2014-08-01

    lifespan of severely obese individuals is decreased by an estimated 5-20 years depending on gender, age, and race. Weight loss and maintenance are the obvious aims of bariatric surgery. The ideal bariatric operation should be easy and quick to perform, with minimal perioperative and long-term complications. It should result in excellent weight loss and indefinite weight maintenance in the vast majority of operated patients, necessitating minimal follow-up care, and be equally suitable for all patients, independent of individual characteristics such as compliance, age, and different degrees of overweight. It is immediately apparent that such a surgical procedure does not exist, and therefore we must carefully evaluate all the different features and characteristics of each operation and of each patient to try to select the procedure that provides the greatest probability of long-term success for a particular patient, with the best cost/benefit ratio. Bariatric surgery has proven to be the most effective mode of treatment for morbidly obese patients, with recent long-term studies providing evidence of a substantial reduction of mortality in bariatric surgery patients, as well as a decreased risk of developing new health-related comorbidities. Furthermore, a reduction in the use of healthcare services and therefore a reduction in direct healthcare costs was also observed. Bariatric surgery is an established and integral part of the comprehensive management of morbidly obese patients.

  6. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... administer local anesthesia, all forms of sedation and general anesthesia. Click here to find out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft ...

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Extractions and ... more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  9. Preparing for Surgery

    Science.gov (United States)

    ... FAQs Preparing for Surgery Page Navigation ▼ ACOG Pregnancy Book Preparing for Surgery Patient Education FAQs Preparing for ... the person who is in charge of giving anesthesia and checking its effects. What can I do ...

  10. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Global Affairs and Humanitarian Efforts Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you ...

  11. Heart valve surgery

    Science.gov (United States)

    ... techniques are used: Percutaneous surgery (through the skin) Robot-assisted surgery If your surgeon can repair your ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... by a trained surgeon with specialized education and training. Click here to find out more. Extractions and ... Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, bone and ...

  13. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... more surgeries depending on the extent of the repair needed. Click here to find out more. Corrective ... more surgeries depending on the extent of the repair needed. Click here to find out more. Corrective ...

  14. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Jaw Surgery Download Download the ebook for further information Corrective jaw, or orthognathic surgery is performed by ... your treatment. Correction of Common Dentofacial Deformities ​ ​ The information provided here is not intended as a substitute ...

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the ... are not uncommon. Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Facial Injury / Trauma Surgery Facial trauma injuries include fractures of the upper and lower jaws and the ... Facial Injury / Trauma Surgery Facial trauma injuries include fractures of the upper and lower jaws and the ...

  19. Abdominal wall surgery

    Science.gov (United States)

    Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty ... Most of the time, this surgery is an elective or cosmetic procedure because it is an operation you choose to have. It is not usually needed for health reasons. Cosmetic abdomen repair ...

  20. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. ... more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  2. Refractive corneal surgery - discharge

    Science.gov (United States)

    ... after surgery, it should be OK to use artificial tears. Check with your provider. DO NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. DO NOT use any makeup, creams, or lotions ...

  3. Smoking and surgery

    Science.gov (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in ...

  4. Robotic liver surgery

    Science.gov (United States)

    Leung, Universe

    2014-01-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  5. RADIATION AND SURGERY

    African Journals Online (AJOL)

    Dr. S.A. Adewuyi

    of radical surgical procedures, surgery remains the only potential curative treatment for many cancer patients ... catheter, 'Toilet' procedure, e.g. simple mastectomy or amputation of a limb, for fungating tumours. Debulking .... that tumour is irradiated prior to surgery and post- operative implies after surgery. 10. Pre-operative.

  6. Cavus Foot Surgery

    Science.gov (United States)

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... their surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on many aspects of life. Following are some of the conditions that may ... front, or side Facial injury Birth defects Receding lower jaw and ...

  8. Breast Cancer Surgery

    Science.gov (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  9. Three-dimensional cephalometry: a method for the identification and for the orientation of the skull after cone-bean computed tomographic scan.

    Science.gov (United States)

    Frongia, Gianluigi; Bracco, Pietro; Piancino, Maria Grazia

    2013-05-01

    The aims of this work were (1) to describe a method to identify new skeletal landmarks useful to define the reference system to orient the skull in a new position after cone-bean computed tomographic scan and (2) to demonstrate the reliability of this new method.Ten orthognathic patients (5 male, 5 female; mean [SD] age, 18.9 [1.2] years) underwent the cone-bean computed tomographic scan before surgery. Seven 3-dimensional skeletal measurements derived from 4 skeletal point of construction (C) (right, left, and median orbital C, and sella C) have been used for this study. Reliability has been calculated using Pearson correlation coefficient tests.Intraobserver reliability was 0.9999 for operator A (T1-T2) and 0.9999 for operator B (T1-T2); interobserver reliability was 0.9999 between the first (T1-T1) measurement and 0.9999 between the second (T2-T2).The original method is able to reduce the variability of landmark identification due to the variability of the human anatomy and the influence of the human error in cephalometric analysis. The innovation of this new method is the real possibility to use the anatomical structures in a 3-dimensional way, enhancing the reliability of the reference points.

  10. Laser assisted robotic surgery in cornea transplantation

    Science.gov (United States)

    Rossi, Francesca; Micheletti, Filippo; Magni, Giada; Pini, Roberto; Menabuoni, Luca; Leoni, Fabio; Magnani, Bernardo

    2017-03-01

    Robotic surgery is a reality in several surgical fields, such as in gastrointestinal surgery. In ophthalmic surgery the required high spatial precision is limiting the application of robotic system, and even if several attempts have been designed in the last 10 years, only some application in retinal surgery were tested in animal models. The combination of photonics and robotics can really open new frontiers in minimally invasive surgery, improving the precision, reducing tremor, amplifying scale of motion, and automating the procedure. In this manuscript we present the preliminary results in developing a vision guided robotic platform for laser-assisted anterior eye surgery. The robotic console is composed by a robotic arm equipped with an "end effector" designed to deliver laser light to the anterior corneal surface. The main intended application is for laser welding of corneal tissue in laser assisted penetrating keratoplasty and endothelial keratoplasty. The console is equipped with an integrated vision system. The experiment originates from a clear medical demand in order to improve the efficacy of different surgical procedures: when the prototype will be optimized, other surgical areas will be included in its application, such as neurosurgery, urology and spinal surgery.

  11. Disparities in Aesthetic Procedures Performed by Plastic Surgery Residents.

    Science.gov (United States)

    Silvestre, Jason; Serletti, Joseph M; Chang, Benjamin

    2017-05-01

    Operative experience in aesthetic surgery is an important issue affecting plastic surgery residents. This study addresses the variability of aesthetic surgery experience during plastic surgery residency. National operative case logs of chief residents in independent/combined and integrated plastic surgery residency programs were analyzed (2011-2015). Fold differences between the bottom and top 10th percentiles of residents were calculated for each aesthetic procedure category and training model. The number of residents not achieving case minimums was also calculated. Case logs of 818 plastic surgery residents were analyzed. There was marked variability in craniofacial (range, 6.0-15.0), breast (range, 2.4-5.9), trunk/extremity (range, 3.0-16.0), and miscellaneous (range, 2.7-22.0) procedure categories. In 2015, the bottom 10th percentile of integrated and independent/combined residents did not achieve case minimums for botulinum toxin and dermal fillers. Case minimums were achieved for the other aesthetic procedure categories for all graduating years. Significant variability persists for many aesthetic procedure categories during plastic surgery residency training. Greater efforts may be needed to improve the aesthetic surgery experience of plastic surgery residents. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  12. DEVELOPMENT OF PLASTIC SURGERY.

    Science.gov (United States)

    Pećanac, Marija Đ

    2015-01-01

    Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  13. [Breast cancer surgery].

    Science.gov (United States)

    Vlastos, Georges; Berclaz, Gilles; Langer, Igor; Pittet-Cuenod, Brigitte; Delaloye, Jean-François

    2007-10-24

    Breast conserving surgery followed by radiation therapy is the treatment of choice for early breast cancer. For patients who choice or need a mastectomy, breast reconstruction provides an acceptable alternative. Breast cancer surgery has been evolving through minimally invasive approaches. Sentinel node biopsy has already remplaced axillary lymph node dissection in the evaluation of the axilla. Local ablation of the tumor may be a valuable alternative to surgery in the future.

  14. Gastric and intestinal surgery.

    Science.gov (United States)

    Fossum, Theresa W; Hedlund, Cheryl S

    2003-09-01

    Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

  15. Annals of surgery

    National Research Council Canada - National Science Library

    1885-01-01

    Includes the transactions of the American Surgical Association, New York Surgical Society, Philadelphia Academy of Surgery, Southern Surgical Association, Central Surgical Association, and at various...

  16. [Surgery of adrenal tumors].

    Science.gov (United States)

    Bondarenko, V O; Ermolov, A S; Kovalenko, T I; Kondratiev, A V

    2004-01-01

    From 1983 to 2003 examination and surgical treatment were performed in 463 patients with different adrenal tumors. Hormone-active tumors were revealed in 249 of them, non-active - in 214. Combination of CT or MRT with study of adrenal hormones is the basis of the diagnosis. In different cases multispiral computed tomography, angiography, selected taking of blood from inferior caval vein, US- or CT-guided biopsy were used. Open surgery through thoracofrenolumbotomy was performed in 392 patients, videolaparoscopic surgery - in 71. Expediency of laparoscopic surgery in line with open surgery is demonstrated.

  17. Hyperoxaluria and Bariatric Surgery

    Science.gov (United States)

    Asplin, John R.

    2007-04-01

    Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.

  18. Oncoplastic breast surgery.

    Science.gov (United States)

    Pillarisetti, Raghu Ram; Querci Della Rovere, Guidubaldo

    2012-06-01

    Breast Surgery is now a recognized subspecialty of General Surgery abroad with structured training for designated 'Oncoplastic Breast Surgeons'. Oncoplastic Breast surgery is probably one of the most interesting and challenging new developments over the past 20 years. The aims of Oncoplastic surgery are wide local excision of the cancer coupled with partial reconstruction of the defect to achieve a cosmetically acceptable result. Avoidance of mastectomy and consequent reduction of psychological morbidity are the principal goals in the development of various oncoplastic techniques. The use of plastic surgical techniques not only ensures good cosmetic outcome, but also allows the cancer surgeon to remove the tumour with greater volume of surrounding tissue, thus extending the boundaries of breast conserving surgery. Proper patient selection and careful planning after proper radiological and clinical assessment are the two essential prerequisites before undertaking oncoplastic breast surgery. Oncoplastic surgery involves both volume displacement and volume replacement techniques. Some commonly used volume displacement procedures are described in the article. The need for adjustment of contralateral breast should also be anticipated at the time of planning breast conserving surgery, which can be done either at the same time as breast cancer surgery or as a delayed setting.

  19. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  20. Annals of surgery

    National Research Council Canada - National Science Library

    Includes the transactions of the American Surgical Association, New York Surgical Society, Philadelphia Academy of Surgery, Southern Surgical Association, Central Surgical Association, and at various...

  1. [Crohn's disease surgery].

    Science.gov (United States)

    Kala, Zdeněk; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel

    2014-01-01

    Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries.

  2. Contemporary endodontic surgery.

    Science.gov (United States)

    Rubinstein, Richard; Torabinejad, Mahmoud

    2004-06-01

    During the past decade, endodontics has seen a dramatic shift in the application of periradicular surgery and the role it plays in endodontic treatment. With the introduction of enhanced magnification, periradicular ultrasonics and other associative technologies, teeth that might otherwise be extracted now have a chance for retention. This article describes the role of these advances in contemporary endodontic surgery.

  3. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  4. Robust surgery loading

    NARCIS (Netherlands)

    Hans, Elias W.; Wullink, Gerhard; van Houdenhoven, Mark; Kazemier, Geert

    2008-01-01

    We consider the robust surgery loading problem for a hospital’s operating theatre department, which concerns assigning surgeries and sufficient planned slack to operating room days. The objective is to maximize capacity utilization and minimize the risk of overtime, and thus cancelled patients. This

  5. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  6. Prehabilitation Before Major Surgery

    OpenAIRE

    Johnson Francis

    2018-01-01

    Prehabilitation is a new term for preoperative rehabilitation before major surgery. Some authors use the short form 'Prehab', though it is not so widely used. Prehabilitation involves measures to improve the physical, physiological, metabolic and psychosocial reserves in preparation for an elective surgery. This involves exercise, nutrition, education and psychosocial interventions.

  7. Annals of African Surgery

    African Journals Online (AJOL)

    The goal of the Annals of African Surgery is to provide a medium for the exchange of current information between surgeons in the African region. The journal embraces surgery in all its aspects; basic science, clinical research, experimental research, surgical education. It will assist surgeons in the region to keep abreast of ...

  8. Economics of epilepsy surgery

    Directory of Open Access Journals (Sweden)

    Venkatraman Sadanand

    2014-01-01

    Full Text Available Objective: Surgical decision-making is a complex process. First, a medical decision is made to determine if surgery is necessary. Second, another medical decision is made to determine the type of surgery. Third, a corporate decision is made if such a surgery is financially feasible. Finally, a legal decision is made to proceed or refuse the chosen surgery. This paper examines these issues in the case of surgery for medically intractable epilepsy and proposes a method of decision analysis to guide epilepsy surgery. Materials and Methods: A stochastic game of imperfect information using techniques of game theory and decision analysis is introduced as an analytical tool for surgical decision-making. Results: Surgery for appropriately chosen patients suffering from medically intractable epilepsy may not only be feasible, but may be the best medical option and the best financial option for the patient, families, society and the healthcare system. Such a situation would then make it legally or ethically difficult to reject or postpone surgery for these patients. Conclusions: A process to collect data to quantify the parameters used in the decision analysis is hereby proposed.

  9. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this ... Editorial team. Related MedlinePlus Health Topics Plastic and Cosmetic Surgery Browse the Encyclopedia A.D.A.M., Inc. ...

  10. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  11. Bariatric surgery and fertility.

    Science.gov (United States)

    Shah, Divya K; Ginsburg, Elizabeth S

    2010-06-01

    Bariatric surgery is the most reliable way to sustain weight loss in the morbidly obese. Reproductive age women comprise the majority of bariatric patients, and many may be interested in conceiving after surgery. The purpose of this review is to synthesize the recent literature on bariatric surgery and fertility to assist providers in patient counseling. Obesity adversely impacts fecundability and IVF outcomes through a variety of mechanisms. The body of literature on reproductive outcome after bariatric surgery is sparse and of mixed quality. Bariatric surgery has been shown to improve menstrual cyclicity in anovulatory women, but little is published on the impact of surgical weight loss on spontaneous or IVF-treatment-related pregnancy rates. The increased risk of miscarriage in obese women may decline after bariatric surgery. There are currently insufficient data to support recommendations regarding the ideal timing for pregnancy after bariatric surgery. Obesity has been shown to adversely impact fertility, and weight loss is associated with significant improvement in many parameters of reproductive function. Further research is required as to the specific impact of surgical weight loss on pregnancy and miscarriage rates, as well as the optimal timing of pregnancy after bariatric surgery.

  12. Sinus surgery: optimal surgery, optimal outcome?

    NARCIS (Netherlands)

    Fokkens, Wytske J.

    2016-01-01

    Sinus surgery remains an issue of discussion. We lack data on a number of important issues. In this issue of the journal Jiang et al. show that 67 % of their patients who underwent FESS for CRS had OSAS (of which more than half moderate to severe) but only 38% complained of daytime sleepiness

  13. Revision endoscopic sinonasal surgery.

    Science.gov (United States)

    Cantillano, Pablo; Rubio, Fabián; Naser, Alfredo; Nazar, Rodolfo

    Endoscopic sinonasal surgery is the procedure of choice in the treatment of chronic rhinosinusitis and sinonasal polyposis refractory to medical treatment, with high rates of success (76% to 97.5%). However, 2.5%-24% of those patients will require revision surgery (RESS). In this study, we present the clinical, anatomical, radiological and histological features of patients receiving RESS in our centre during a 3-year period. A retrospective review of clinical, anatomical, radiological and histopathological data of patients receiving revision endoscopic sinonasal surgery between 2012 and 2014 was carried out. From 299 surgery procedures performed, 27 (9%) were revision surgeries. The mean patient age was 46 years, with a male/female ratio of 1.4/1. The most frequent preoperative and postoperative diagnosis was chronic polypoid rhinosinusitis. The mean time since the previous surgery was 6.1 years, with 11.9 months of mean follow-up since that surgery. Stenotic antrostomy was found during revision in 81.5% of the patients and incomplete anterior ethmoidectomy and persistent uncinate process, in 59.3%. In radiology, 70.4% of patients had persistent anterior ethmoidal cells. Antrostomy or widening of antrostomy was performed in 96.3% of cases and anterior ethmoidectomy or completion of it was performed in 66.7%. Polyps, stenotic antrostomy and incomplete ethmoidectomy were the most frequent causes of revision surgery, in concordance with the procedures performed. The patients had long periods of time without follow-up between surgeries. Further investigation is necessary to generate measures to reduce the number of revision surgeries. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  14. Aortic valve surgery - minimally invasive

    Science.gov (United States)

    ... valve surgery. Techniques include min-thoracotomy, min-sternotomy, robot-assisted surgery, and percutaneous surgery. To perform the ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  15. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  16. Tests and visits before surgery

    Science.gov (United States)

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  17. Gamma knife surgery for craniopharyngioma

    International Nuclear Information System (INIS)

    Prasad, D.; Steiner, M.; Steiner, L.

    1995-01-01

    We present our results of Gamma Knife surgery for craniopharyngioma in nine patients. The current status of surgery, radiation therapy, intracavitary instillation of radionuclides and Gamma Knife surgery in the management of craniopharyngiomas is discussed. (author)

  18. Getting yourself healthy before surgery

    Science.gov (United States)

    ... 3 months after certain surgeries (joint replacement or heart valve surgery). So be sure to schedule your dental ... Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice . 20th ed. Philadelphia, ...

  19. Anesthesia for bariatric surgery.

    Science.gov (United States)

    Nishiyama, Tomoki; Kohno, Yumiko; Koishi, Keiko

    2012-02-01

    Bariatric surgery has a lot of problems in anesthesia. We retrospectively compared anesthesia for bariatric surgery in yellow race with that in normal weight patients. Twenty patients who received bariatric surgery and 20 normal body weight patients who received abdominal surgery in Japan were enrolled. Induction condition, depth of epidural space, dose of anesthetics, duration of the effects of muscle relaxants, ventilation, and fluid management in bariatric surgery were analyzed and compared with those in normal body weight patients. An epidural catheterization was successful under ultrasound guide in the bariatric group. The depth epidural space was significantly larger in the bariatric group. Cormack and Lehane classification and the number of intubation attempt were not different between the two groups, while one bariatric case was once awakened to intubate blindly. Pressure-controlled ventilation was used in the bariatric group. Four bariatric patients were continuously ventilated after surgery. The doses of anesthetics and fluid infusion rate were not different between the two groups when calculated by ideal body weight in the bariatric group. The duration of the effects of rocuronium and pancuronium were shorter in the bariatric group. For anesthesia of yellow race patients undergoing bariatric surgery, intravenous anesthetics and acetate Ringer's solution with 1% glucose could be administered per ideal body weight, the effects of muscle relaxants lasted shorter, pressure-controlled ventilation could keep oxygenation with adequate carbon dioxide, and ultrasound assist was useful in epidural catheterization in the bariatric patients.

  20. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. There have been some extraordinary accomplishments in that time, which have led to enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source that surveys surgery theory and its applications. Indeed, no one person could write such a survey. The sixtieth birthday of C. T. C. Wall, one of the leaders of the founding generation of surgery theory, provided an opportunity to rectify the situation and produce a

  1. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. The sixtieth birthday (on December 14, 1996) of C.T.C. Wall, a leading member of the subject''s founding generation, led the editors of this volume to reflect on the extraordinary accomplishments of surgery theory as well as its current enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source surveying surgery theory and its applications. Because no one person could write such a survey, the editors ask

  2. Keratomycosis after cataract surgery.

    Science.gov (United States)

    Mendicute, J; Orbegozo, J; Ruiz, M; Sáiz, A; Eder, F; Aramberri, J

    2000-11-01

    To evaluate cases and results of keratomycosis that developed after cataract surgery. Hospital de Guipúzcoa, San Sebastián, Spain. This retrospective study comprised 8 patients who developed keratomycosis soon after cataract surgery. Culture analysis revealed 7 cases of Aspergillus fumigatus and 1 of Aspergillus flavus. After medical treatment with antifungal agents, 6 cases resolved and 2 required evisceration. The presence of fungi in corneal ulcers that develop after cataract surgery should be considered. Initiation of early treatment determines the prognosis. Among the therapeutic options, collagen shields soaked in amphotericin B may be effective.

  3. Single port laparoscopic surgery

    DEFF Research Database (Denmark)

    Springborg, Henrik; Istre, Olav

    2012-01-01

    potential benefits. Theoretically, cosmetic outcomes, postoperative pain and complication rates could be improved with use of single site surgery. This study describes introduction of the method in a private hospital in Denmark, in which 40 patients have been treated for benign gynecologic conditions......LESS, or laparo-endoscopic single site surgery, is a promising new method in minimally invasive surgery. An increasing number of surgical procedures are being performed using this technique, however, its large-scale adoption awaits results of prospective randomized controlled studies confirming...

  4. Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients.

    Science.gov (United States)

    Choi, Jong Woo; Lee, Jang Yeol; Oh, Tae-Suk; Kwon, Soon Man; Yang, Sung Joon; Koh, Kyung Suk

    2014-04-01

    Although two dimensional cephalometry is the standard method for analyzing the results of orthognathic surgery, it has potential limits in frontal soft tissue analysis. We have utilized a 3 dimensional camera to examine changes in soft tissue landmarks in patients with skeletal class III dentofacial deformity who underwent two-jaw rotational setback surgery. We assessed 25 consecutive Asian patients (mean age, 22 years; range, 17-32 years) with skeletal class III dentofacial deformities who underwent two-jaw rotational surgery without maxillary advancement. Using a 3D camera, we analyzed changes in facial proportions, including vertical and horizontal dimensions, facial surface areas, nose profile, lip contour, and soft tissue cheek convexity, as well as landmarks related to facial symmetry. The average mandibular setback was 10.7 mm (range: 5-17 mm). The average SNA changed from 77.4° to 77.8°, the average SNB from 89.2° to 81.1°, and the average occlusal plane from 8.7° to 11.4°. The mid third vertical dimension changed from 58.8 mm to 57.8 mm (p = 0.059), and the lower third vertical dimension changed from 70.4 mm to 68.2 mm (p = 0.0006). The average bigonial width decreased from 113.5 mm to 109.2 mm (p = 0.0028), the alar width increased from 34.7 mm to 36.1 mm (p-value = 0.0002), and lip length was unchanged. Mean mid and lower facial surface areas decreased significantly, from 171.8 cm(2) to 166.2 cm(2) (p = 0.026) and from 71.23 cm(2) to 61.9 cm(2) (p analysis for orthognathic surgery, and enabled quantitative analysis of changes in frontal soft tissue landmarks and facial proportions that were not possible with conventional 2D cephalometric analysis. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Integral or integrated marketing

    Directory of Open Access Journals (Sweden)

    Davčik Nebojša

    2006-01-01

    Full Text Available Marketing theorists and experts try to develop business efficient organization and to get marketing performance at higher, business integrated level since its earliest beginnings. The core issue in this paperwork is the dialectic and practical approach dilemma should we develop integrated or integral marketing approach in the organization. The presented company cases as well as dialectic and functional explanations of this dilemma clearly shows that integrated marketing is narrower approach than integral marketing if we take as focal point new, unique and completed entity. In the integration the essence is in getting different parts together, which do not have to make necessary the new entity. The key elements in the definition of the integral marketing are necessity and holistic, e.g. necessity to develop new, holistic entity.

  6. [Cosmetic surgery among Norwegian women].

    Science.gov (United States)

    von Soest, Tilmann; Kvalem, Ingela Lundin; Roald, Helge Einar; Skolleborg, Knut Chr

    2004-07-01

    There are few data on the frequency of cosmetic surgery among Norwegian women. A random sample of 2000 Norwegian women aged 22 to 55 received a questionnaire on cosmetic surgery, demographic data, self-esteem, and to what extent people around them accepted cosmetic surgery. The response rate was 46% (907 women). Of these, 7.7% indicated that they had undergone cosmetic surgery, while 22.6% wished to do so. Other people's degree of acceptance predicted both the wish to undergo cosmetic surgery and already conducted surgery. Low self-esteem was correlated with a wish to undergo surgery, though women who had done surgery had no lower self-esteem than non-patients. Although the response rate was relatively low, this study gives the first reliable data on the frequency of cosmetic surgery in Norway. The results indicate that other people's degree of acceptance of cosmetic surgery is a predictor of such surgery being chosen.

  7. The integration of minimally invasive surgery in surgical practice in a Canadian setting: results from 2 consecutive province-wide practice surveys of general surgeons over a 5-year period

    Science.gov (United States)

    Hallet, Julie; Mailloux, Olivier; Chhiv, Mony; Grégoire, Roger C.; Gagné, Jean-Pierre

    2015-01-01

    Background Although minimally invasive surgery (MIS) has been quickly embraced, the introduction of advanced procedures appears more complex. We assessed the evolution of MIS in the province of Quebec over a 5-year period to identify areas for improvement in the modern surgical era. Methods We developed, test-piloted and conducted a self-administered questionnaire among Quebec general surgeons in 2007 and 2012 to examine stated MIS practice, MIS training and barriers and facilitators to the use of MIS. Results Response rates were 51.3% (251 of 489) in 2007 and 31.3% (153 of 491) in 2012. A significant increase was observed for performance of most advanced MIS procedures, especially for colectomy for benign (66.0% v. 84.3%, p surgery for malignancy (21.0% v. 54.6%, p general surgeons in Québec. This technique appears well established in current surgical practice. The growing place of MIS in residency training seems to be a paramount part of this development. Results from this study could be used as a baseline for studies focusing on ways to further improve the MIS practice. PMID:25598180

  8. Repetitive endoscopic sinus surgery failure: a role for radical surgery?

    NARCIS (Netherlands)

    Videler, Ward J. M.; Wreesmann, Volkert B.; van der Meulen, Freerk W.; Knegt, Paul P.; Fokkens, Wytske J.

    2006-01-01

    OBJECTIVES: Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the

  9. Cosmetic surgery: medicolegal considerations.

    Science.gov (United States)

    Piras, Mauro; Delbon, Paola; Conti, Adelaide; Graziano, Vincenzo; Capasso, Emanuele; Niola, Massimo; Bin, Paola

    2016-01-01

    Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery.

  10. [Pregnancy after bariatric surgery].

    Science.gov (United States)

    Tzur, Tamar; Sheiner, Eyal

    2011-06-01

    Recent research has put the spotlight on two different aspects of pregnancy after bariatric surgery: safety of the mother and fetus, and the procedure's effectiveness in preventing the complications surrounding reproduction and pregnancy often seen in the obese woman. To evaluate the pregnancy outcome foLlowing bariatric surgery. Although there are severaL reports documenting poor perinatal outcomes and late surgical complications during pregnancies subsequent to bariatric surgery, systematic studies have generaLLy not proven such an association. Pregnancy after bariatric surgery appears to be safe, and in general perinatal outcome is better when compared to pregnancies of obese women. Providers should be familiar with potential complications related to postoperative pregnancies and be prepared to provide appropriate interventions such as nutritional supplementation and band adjustment when necessary.

  11. Gastric Sleeve Surgery

    Science.gov (United States)

    ... regular exercise has family members who will provide emotional and practical support (like driving to every doctor's visit or buying healthy food ) Preparing for Gastric Sleeve Surgery Preparing for this ...

  12. Breast augmentation surgery

    Science.gov (United States)

    ... care - open Images Breast lift (mastopexy) - series Breast reduction (mammoplasty) - series Breast augmentation - series References Maxwell GP, Gabriel A. Breast augmentation. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013: ...

  13. Oophorectomy (Ovary Removal Surgery)

    Science.gov (United States)

    ... symptoms, such as hot flashes and vaginal dryness Depression or anxiety Heart disease Memory problems Decreased sex drive Osteoporosis Premature death Taking low doses of hormone replacement drugs after surgery and until about age ...

  14. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 10, No 1 (2014) >. Log in or Register to get access to full text downloads.

  15. [Pregnancy after bariatric surgery].

    Science.gov (United States)

    Pepe, Franco; DE Luca, Francesco; Stracquadanio, Mariagrazia; Garraffo, Claudia; Santonocito, Veronica C; Privitera, Agata

    2017-04-01

    Pregnancy after bariatric surgery has some peculiarities related to obesity, type of surgery, amount of weight loss, time elapsed from the surgery and adherence to medical prescriptions. Pregnant woman is at risk of nutritional deficiencies and it is unclear whether there is an increased incidence of intestinal complications during pregnancy after bariatric surgery and whether this kind of complications are more frequent during cesarean section. The fetus is at high risk of prematurity and fetal growth restriction, but they seem not at increased risk of birth defects (DTN) except in individual cases of folic acid deficiency (DTN) or vitamin K defect (similar abnormalities in patients receiving oral anticoagulants). In addition, the incidence of gestational diabetes and hypertension results to be decreased. Other postnatal outcomes from possible epigenetic modifications need to be evaluated in the long-term postnatal follow-up.

  16. Bariatric Surgery Misconceptions

    Science.gov (United States)

    ... quality of life than someone who is normal weight. Bariatric surgery results in highly significant improvement in psychosocial well- ... affecting an individual’s weight, such as psychological issues. Weight gain generally occurs when there is an energy imbalance ...

  17. Deep breathing after surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000440.htm Deep breathing after surgery To use the sharing features on ... way to do so is by doing deep breathing exercises. Deep breathing keeps your lungs well-inflated ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced ... make the lips meet without straining Chronic mouth breathing Sleep apnea (breathing problems when sleeping, including snoring) ...

  19. Art and Plastic Surgery.

    Science.gov (United States)

    Fernandes, Julio Wilson; Metka, Susanne

    2016-04-01

    The roots of science and art of plastic surgery are very antique. Anatomy, drawing, painting, and sculpting have been very important to the surgery and medicine development over the centuries. Artistic skills besides shape, volume, and lines perception can be a practical aid to the plastic surgeons' daily work. An overview about the interactions between art and plastic surgery is presented, with a few applications to rhinoplasty, cleft lip, and other reconstructive plastic surgeries. 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.

  20. Blood donation before surgery

    Science.gov (United States)

    ... very safe, some people choose to use a method called autologous blood donation. Autologous blood is blood donated by you, which you later receive if you need a transfusion during or after surgery. You can have blood ...

  1. Nigerian Journal of Surgery

    African Journals Online (AJOL)

    Comparative efficacy of amoxicillin/clavulanic acid and levofloxacin in the reduction of postsurgical sequelae after third molar surgery: A randomized, double blind, clinical trial in a Nigerian University Teaching Hospital.

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and orthodontist understand that this is a long-term commitment for you and your family, and will ... face, mouth and jaw surgery Contact Us Sitemap Terms of Use Privacy Policy © Copyright AAOMS 2008-2018 ...

  3. Retrosternal thyroid surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007558.htm Retrosternal thyroid surgery To use the sharing features on this page, please enable JavaScript. The thyroid gland is normally located at the front of ...

  4. Surgery - Multiple Languages

    Science.gov (United States)

    ... 简体中文) Expand Section Biopsy - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Getting Your Skin Ready for Surgery - 简体中文 (Chinese, ...

  5. Heart Surgery - Multiple Languages

    Science.gov (United States)

    ... Coronary Artery Bypass Surgery - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Pacemaker - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF ...

  6. After Surgery - Multiple Languages

    Science.gov (United States)

    ... After Total Joint Replacement - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Home Care Instructions After Surgery - 简体中文 (Chinese, Simplified ( ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ ...

  8. Robotics in Colorectal Surgery.

    Science.gov (United States)

    Weaver, Allison; Steele, Scott

    2016-01-01

    Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients.

  9. Blepharoplasty (Eyelid Surgery)

    Science.gov (United States)

    ... lid blepharoplasty is almost always done just for cosmetic reasons. Risks Possible risks of eyelid surgery include: Infection and bleeding Dry, irritated eyes Difficulty closing your eyes or other eyelid problems Noticeable scarring Injury to eye muscles Skin discoloration ...

  10. Alternative Refractive Surgery Procedures

    Science.gov (United States)

    ... the epithelial cells. Once the epithelial flap is created and moved aside, the procedure is the same ... Sites EyeWiki International Society of Refractive Surgery * Required * First Name: * Last Name: Member ID: * Phone Number: * Email: * ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... jaw surgery.™ What We Do Who We Are News Videos Contact Find a Surgeon What We Do ... out more. Who We Are Find a Surgeon News Videos Contact Administration of Anesthesia Cleft Lip/Palate ...

  12. LASIK Eye Surgery

    Science.gov (United States)

    ... your eye. Overcorrections may be more difficult to fix than undercorrections. Astigmatism. Astigmatism can be caused by ... back into place. The flap usually heals without stitches. During the surgery, you'll be asked to ...

  13. Orthopaedics in day surgery

    African Journals Online (AJOL)

    emergency patients for a surgical procedure, returning home the same day (1). Ambulatory orthopaedics happens to have double meaning, so in this communication day surgery will be the preferred term. In Kenya the three models of day.

  14. Cosmetic surgery: medicolegal considerations

    Directory of Open Access Journals (Sweden)

    Piras Mauro

    2016-01-01

    Full Text Available Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery.

  15. Breast Reduction Surgery

    Science.gov (United States)

    ... Breast reduction surgery might also help improve your self-image and your ability to participate in physical activities. ... under the breasts Nerve pain Restricted activity Poor self-image related to large breasts Difficulty fitting into bras ...

  16. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 1 (2011) >. Log in or Register to get access to full text downloads.

  17. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 14, No 1 (2018) >. Log in or Register to get access to full text downloads.

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... in face, mouth and jaw surgery.™ What We Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral and maxillofacial surgeons are extensively ...

  19. Expectations of Sinus Surgery

    Science.gov (United States)

    ... ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... reduce the pressure in your nose. Avoid strenuous exercise for the first 2 weeks after surgery. Also ...

  20. Corrective Jaw Surgery

    Medline Plus

    Full Text Available AAOMS - Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who ... surgeons surgically treat the soft tissues of the face, mouth and gums to improve function, appearance and ...

  1. Shoulder surgery - discharge

    Science.gov (United States)

    ... repair Shoulder arthroscopy Shoulder CT scan Shoulder MRI scan Shoulder ... by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. ...

  2. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... vitamins, herbal remedies, and spices including vitamin E, garlic, ginger, gingko, and ginseng may increase the risk of bleeding. Some patients may be asked to take antibiotics and/or steroids prior to sinus surgery. This ...

  3. Bariatric Surgery for Obesity.

    Science.gov (United States)

    le Roux, Carel W; Heneghan, Helen M

    2018-01-01

    In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Is day surgery safe?

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Engbæk, J; Bartholdy, Jens

    2012-01-01

    Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort.......Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort....

  5. Robotics in General Surgery

    OpenAIRE

    Wall, James; Chandra, Venita; Krummel, Thomas

    2008-01-01

    In summary, robotics has made a significant contribution to General Surgery in the past 20 years. In its infancy, surgical robotics has seen a shift from early systems that assisted the surgeon to current teleoperator systems that can enhance surgical skills. Telepresence and augmented reality surgery are being realized, while research and development into miniaturization and automation is rapidly moving forward. The future of surgical robotics is bright. Researchers are working to address th...

  6. Plastic surgery pitfalls.

    Science.gov (United States)

    Gorney, M

    1999-01-01

    As a founding member of the physician-owned insurance carrier The Doctors' Company, the author has reviewed many plastic surgery policy claims. In this article, he presents an overview of the plastic surgery procedures that produce the most severe losses. He then offers suggestions on how to proceed with these "medical malpractice favorites." The author discusses potential antitrust traps and legal recourse for plastic surgeons.

  7. Minimally Invasive Abdominal Surgery

    OpenAIRE

    Richardson, William S.; Carter, Kristine M.; Fuhrman, George M.; Bolton, John S.; Bowen, John C.

    2000-01-01

    In the last decade, laparoscopy has been the most innovative surgical movement in general surgery. Minimally invasive surgery performed through a few small incisions, laparoscopy is the standard of care for the treatment of gallbladder disease and the gold standard for the treatment of reflux disease. The indications for a laparoscopic approach to abdominal disease continue to increase, and many diseases may be treated with laparoscopic techniques. At Ochsner, laparoscopic techniques have dem...

  8. Surgery for Acute Pancreatitis

    OpenAIRE

    Navadgi, Suresh; Pandanaboyana, Sanjay; Windsor, John A.

    2015-01-01

    Surgery for acute pancreatitis has undergone significant changes over the last 3 decades. A better understanding of the pathophysiology has contributed to this, but the greatest driver for change has been the rise of less invasive interventions in the fields of laparoscopy, endoscopy and radiology. Surgery has a very limited role in the diagnosis of acute pancreatitis. The most common indication for intervention in acute pancreatitis is for the treatment of complications and most notably the ...

  9. Bariatric Surgery and Infertility: A Prospective Study.

    Science.gov (United States)

    Consalvo, Vincenzo; Canero, Antonio; Salsano, Vincenzo

    2017-12-22

    Obesity is a worldwide disease affecting 13% of the world's adult female population. The reasons and the fetal risk are still unclear. The effect of weight loss as a result of bariatric surgery seems to induce an improvement in fertility in obese women. The main purpose of this prospective study is to demonstrate if there is an association between bariatric surgery-induced weight loss and an improvement in the fertility of women at reproductive age. From June 2013 to April 2016, all bariatric female patients from our institutes were prospectively evaluated for suitability in this study. A pool of 52 eligible patients was extracted from our database in the recruitment period. Of these, 28 underwent bariatric surgery and 24 did not. Both groups were observed for two-year follow-up. During follow-up, anthropometrics parameters, blood analysis, and comorbidities were checked and a gynaecological consultation was prescribed. Fifty participants were studied. Twenty-seven successfully underwent bariatric surgery with a percentage of excess weight loss (EWL) >70% at 24 months, while 23 accepted the observation and control for 24 months as an integral part of the pre-surgical bariatric program. The contingency table analysis showed an extremely significant association (Pbariatric surgery) and event (pregnancy), with a relative risk (RR) = 15.33 and confidence interval (CI) 95%=2.213 to 106.26. Bariatric surgery improves fertility in obese women at two years' postoperative. Every obese woman with difficulties becoming pregnant should undergo a bariatric surgery consultation. Further studies are necessary to confirm our results.

  10. Medical litigation in cosmetic plastic surgery.

    Science.gov (United States)

    Mavroforou, Anna; Giannoukas, Athanasios; Michalodimitrakis, Emmanuel

    2004-01-01

    This article aims to highlight issues related to malpractice in plastic surgery and to point out the importance of good understanding of the law and the value of a patient's written informed consent as measures of professional protection. Search of relevant literature from PubMed. The demand for cosmetic plastic surgery increases despite the increasing cost, in contrast to other traditional goods for which demand typically declines as price increases. Cosmetic plastic surgery has moved beyond the stage of being an exclusive privilege of the rich and famous. Nevertheless, cosmetic plastic surgery is one of the medical specialties exposed to a substantially high risk of malpractice claims. Most malpractice claims in cosmetic plastic surgery are not consequences of technical faults but because of inadequate patient selection criteria and lack of adequate communication between patient and surgeon. Proven efficient training, careful utilization of computer imaging techniques in association with the adoption of simple precautions and guidelines and adequate communication along with a completed patient's consent form are important essentials in case of medical litigation. In today's litigious society, maintenance of high standards in daily practice with continuous training and appropriate documentation of every procedure are all a sufficient defense of the plastic surgeon in case of medical litigation. Written patient's informed consent remains an integral part of the communication between physicians and patients, and importantly is facilitating professional protection.

  11. Day surgery in Bristol.

    Science.gov (United States)

    Carrington, S

    1993-02-01

    As in the rest of the United Kingdom, day surgery in Bristol is on the increase. In the Bristol Royal Infirmary day surgery unit (DSU) we treat approximately 3,500 patients a year. We have recently opened a second operating theatre. This has shifted the proportion of cases from our general theatres. This has also improved our case mix, less minor surgery under local anaesthetics, to more of the recommended 'basket type' surgery ie hernia repair, varicose vein surgery, excision of breast lumps etc. We have recently introduced an appointment booking system that is progressing. Such changes have to be introduced with good preparation, communication and a lot of diplomacy. I would like to outline the management aspects that help to expand and improve on the service we give, including patient selection and the appointment booking system we have introduced. I will describe how we drew up a policy involving the organisation of operation lists and staff involvement in day surgery management and accountability for patient care from admission through to discharge including our latest care plan. Finally I will outline the methods we have developed for evaluating the care we give.

  12. Innovations in robotic surgery.

    Science.gov (United States)

    Gettman, Matthew; Rivera, Marcelino

    2016-05-01

    Developments in robotic surgery have continued to advance care throughout the field of urology. The purpose of this review is to evaluate innovations in robotic surgery over the past 18 months. The release of the da Vinci Xi system heralded an improvement on the Si system with improved docking, the ability to further manipulate robotic arms without clashing, and an autofocus universal endoscope. Robotic simulation continues to evolve with improvements in simulation training design to include augmented reality in robotic surgical education. Robotic-assisted laparoendoscopic single-site surgery continues to evolve with improvements on technique that allow for tackling previously complex pathologic surgical anatomy including urologic oncology and reconstruction. Last, innovations of new surgical platforms with robotic systems to improve surgeon ergonomics and efficiency in ureteral and renal surgery are being applied in the clinical setting. Urologic surgery continues to be at the forefront of the revolution of robotic surgery with advancements in not only existing technology but also creation of entirely novel surgical systems.

  13. Metabolic surgery: quo vadis?

    Science.gov (United States)

    Ramos-Leví, Ana M; Rubio Herrera, Miguel A

    2014-01-01

    The impact of bariatric surgery beyond its effect on weight loss has entailed a change in the way of regarding it. The term metabolic surgery has become more popular to designate those interventions that aim at resolving diseases that have been traditionally considered as of exclusive medical management, such as type 2 diabetes mellitus (T2D). Recommendations for metabolic surgery have been largely addressed and discussed in worldwide meetings, but no definitive consensus has been reached yet. Rates of diabetes remission after metabolic surgery have been one of the most debated hot topics, with heterogeneity being a current concern. This review aims to identify and clarify controversies regarding metabolic surgery, by focusing on a critical analysis of T2D remission rates achieved with different bariatric procedures, and using different criteria for its definition. Indications for metabolic surgery for patients with T2D who are not morbidly obese are also discussed. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  14. Understanding Antegrade Colonic Enema (ACE) Surgery

    Science.gov (United States)

    ... Colonic Enema (ACE) Surgery Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) is a procedure ... Risks / Benefits What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  15. A new dimension to cephalometry: DW plane

    Directory of Open Access Journals (Sweden)

    Shruti K Hatewar

    2015-01-01

    Full Text Available Context: An accurate jaw relationship is critically important in orthodontic diagnosis and treatment planning. Various angular and linear measurements that have been proposed can be erroneous because they depend on various factors. Aim: The purpose of this study is to establish a new cephalometric measurement to assess the skeletal jaw discrepancy using Walker's point. Settings and Design: Lateral cephalogram of 100 Indian subjects with age range (8–11, 12–18, 19-27 were obtained. Inclusion criteria were – clinically Class I occlusion; normal overjet and overbite; orthoganthic profile; competent lips and cephalometrically normal ANB; Wits appraisal; Rakosi Jarabak's angle of inclination and mandibular plane angle. Materials and Methods: Four skeletal landmarks: Point A, Point B, Walker's point (W and Wing point (w were used to indicate the severity and type of skeletal dysplasia. Double W (DW was constructed joining the Walker's and Wing point. Statistical Analysis Used: Analysis of variance test and Student's t-test was applied which showed significant results. Results: The difference between Walker's perpendicular to A Point and Walker's perpendicular to B Point gave the sagittal jaw discrepancy and was found to be 8.2 ± 0.9 mm. This measurement remained relatively constant throughout life. Conclusions: DW plane is an effective way to accurately establish the skeletal jaw relationship. It analyses the variance between linear measurements to determine the sagittal jaw relationship, linear measurements for vertical maxillary height and angular measurements to determine rotational jaw changes.

  16. Robotic Surgery for Thyroid Disease

    OpenAIRE

    Lee, Jandee; Chung, Woong Youn

    2013-01-01

    Robotic surgery is an innovation in thyroid surgery that may compensate for the drawbacks of conventional endoscopic surgery. A surgical robot provides strong advantages, including three-dimensional imaging, motion scaling, tremor elimination, and additional degrees of freedom. We review here recent adaptations, experience and applications of robotics in thyroid surgery. Robotic thyroid surgeries include thyroid lobectomy, total thyroidectomy, central compartment neck dissection, and radical ...

  17. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

    Science.gov (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

    2015-02-01

    and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.

  18. Innovations in Bariatric Surgery.

    Science.gov (United States)

    Zhu, Catherine; Pryor, Aurora D

    2015-11-01

    Surgery has consistently been demonstrated to be the most effective long-term therapy for the treatment of obesity. However, despite excellent outcomes with current procedures, most patients with obesity- and weight-related comorbidities who meet criteria for surgical treatment choose not to pursue surgery out of fear of operative risks and complications or concerns about high costs. Novel minimally invasive procedures and devices may offer alternative solutions for patients who are hesitant to pursue standard surgical approaches. These procedures may be used for primary treatment of obesity, early intervention for patients approaching morbid obesity, temporary management prior to bariatric surgery, or revision of bypass surgery associated with weight regain. Novel bariatric procedures can in general be divided into four categories: endoluminal space-occupying devices, gastric suturing and restrictive devices, absorption-limiting devices, and neural-hormonal modulating devices. Many of these are only approved as short-term interventions, but these devices may be effective for patients desiring low-risk procedures or a transient effect. We will see the expansion of indications and alternatives for metabolic surgery as these techniques gain approval.

  19. Robotic surgery in gynecology.

    Science.gov (United States)

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes

    2016-01-01

    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  20. Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery--a cephalometric study to evaluate various therapeutic effects.

    Science.gov (United States)

    Kinzinger, Gero; Frye, Linda; Diedrich, Peter

    2009-01-01

    It was the aim of this clinical study to compare the skeletal and dentoalveolar effects as well as those on the profile of three different treatment approaches in Class II patients (camouflage orthodontics, dentofacial orthopedics, and combined orthodontic and surgical treatment). Our study cohort consisted of 60 young adults presenting a skeletal Class II, Division 1 malocclusion: 20 patients whose overjet was reduced by camouflage following premolar extraction, 20 patients whose occlusions were corrected by placement of a fixed functional orthopedic appliance, and 20 who underwent orthognathic surgery (bilateral sagittal split osteotomy of the mandible without genioplasty). We documented the therapeutic progress using cephalometry. Each patient group achieved a reduction in overjet via their respective treatment. While no treatment-related changes in the maxillary area were assessable, the effects on the mandible differed. We observed advancement of the bony chin and an increase in mandibular length in the sagittal-diagonal dimension in the surgical and functional orthopedic groups. However, the extent of the treatment-related changes was significant only in the group of patients that had undergone orthognathic surgery. Only the surgical group presented changes in vertical relationships. Incisor repositioning as an outcome of the respective treatments differed fundamentally, with those in the surgical group revealing significant protrusion of the upper incisors. The maxillary incisors were retruded and mandibular incisors proclined in the functional orthopedic group, whereas the upper and lower incisors both retruded significantly in the extraction group. Soft-tissue remodeling bore no linear relationship to treatment-induced skeletal and dental effects. Still, orthognathic surgery led to the most marked profile changes. Treatment using fixed functional orthopedic appliances reduced the convexity of the soft-tissue profile at least moderately. Camouflage

  1. SURGERY AND CARDIOVASCULAR SURGERY JOURNALS ANALYSIS.

    Science.gov (United States)

    Schanaider, Alberto

    2015-01-01

    To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR), Elsevier/Scopus (SJR), and also Scielo databases were used. Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5%) and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor. Analisar criticamente a eficácia e valor de indicadores bibliométricos dos periódicos da Cirurgia e Cirurgia Cardiovascular no contexto dos Programas de Pós-Graduação da área Medicina III da CAPES. Foi avaliada uma amostragem com 16 programas acadêmicos e um mestrado profissional da área de Medicina III, compreendendo a Cirurgia Geral e do Aparelho Digestivo, a Cirurgia Cardiovascular e Cursos Multidisciplinares

  2. Toward the art of robotic-assisted vitreoretinal surgery

    Directory of Open Access Journals (Sweden)

    Amir Molaei

    2017-01-01

    Full Text Available New technological progress in robotics has brought many beneficial clinical applications. Currently, computer integrated robotic surgery has gained clinical acceptance for several surgical procedures. Robotically assisted eye surgery is envisaged as a promising solution to overcome the shortcomings inherent to conventional surgical procedures as in vitreoretinal surgeries. Robotics by its high precision and fine mechanical control can improve dexterity, cancel tremor, and allow highly precise remote surgical capability, delicate vitreoretinal manipulation capabilities. Combined with magnified three-dimensional imaging of the surgical site, it can enhance surgical precision. Tele-manipulation can provide the ability for tele-surgery or haptic feedback of forces generated by the manipulation of intraocular tissues. It presents new solutions for some sight-threatening conditions such as retinal vein cannulation where, due to physiological limitations of the surgeon's hand, the procedure cannot be adequately performed. In this paper, we provide an overview of the research and advances in robotically assisted vitreoretinal eye surgery. Additionally the barriers to the integration of this method in the field of ocular surgery are summarized. Finally, we discuss the possible applications of the method in the area of vitreoretinal surgery.

  3. Retracted articles in surgery journals. What are surgeons doing wrong?

    Science.gov (United States)

    Cassão, Bruna Dell'Acqua; Herbella, Fernando A M; Schlottmann, Francisco; Patti, Marco G

    2018-03-08

    Retraction of previously published scientific articles is an important mechanism to preserve the integrity of scientific work. This study analyzed retractions of previously published articles from surgery journals. We searched for retracted articles in the 100 surgery journals with the highest SJR2 indicator grades. We found 130 retracted articles in 49 journals (49%). Five or more retracted articles were published in 8 journals (8%). The mean time between publication and retraction was 26 months (range 1 to 158 months). The United States, China, Germany, Japan, and the United Kingdom accounted for more than 3 out of 4 of the retracted articles. The greatest number of retractions came from manuscripts about orthopedics and traumatology, general surgery, anesthesiology, cardiothoracic surgery, and plastic surgery. Nonsurgeons were responsible for 16% of retractions in these surgery journals. The main reasons for retraction were duplicate publication (42%), plagiarism (16%), absence of proven integrity of the study (14%), incorrect data (13%), data published without authorization (12%), violation of research ethics (11%), documented fraud (11%), request of an author(s) (5%), and unknown (3%). In 25% of the retracted articles, other publications by the same authors also had been retracted. Retraction of published articles does not occur frequently in surgery journals. Some form of scientific misconduct was present in the majority of retractions, especially duplication of publication and plagiarism. Retractions of previously published articles were most frequent from countries with the greatest number of publications; some authors showed recidivism. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  5. Recent advances in laparoscopic surgery.

    Science.gov (United States)

    Lee, Wei-Jei; Chan, Chien-Pin; Wang, Bing-Yen

    2013-02-01

    Laparoscopic surgery has been widely adopted and new technical innovation, procedures and evidence based knowledge are persistently emerging. This review documents recent major advancements in laparoscopic surgery. A PubMed search was made in order to identify recent advances in this field. We reviewed the recent data on randomized trials in this field as well as papers of systematic review. Laparoscopic cholecystectomy is the most frequently performed procedure, followed by laparoscopic bariatric surgery. Although bile duct injuries are relatively uncommon (0.15%-0.6%), intraoperative cholangiography still plays a role in reducing the cost of litigation. Laparoscopic bariatric surgery is the most commonly performed laparoscopic gastrointestinal surgery in the USA, and laparoscopic Nissen fundoplication is the treatment of choice for intractable gastroesophageal reflux disease. Recent randomized trials have demonstrated that laparoscopic gastric and colorectal cancer resection are safe and oncologically correct procedures. Laparoscopic surgery has also been widely developed in hepatic, pancreatic, gynecological and urological surgery. Recently, SILS and robotic surgery have penetrated all specialties of abdominal surgery. However, evidence-based medicine has failed to show major advantages in SILS, and the disadvantage of robotic surgery is the high costs related to purchase and maintenance of technology. Laparoscopic surgery has become well developed in recent decades and is the choice of treatment in abdominal surgery. Recently developed SILS techniques and robotic surgery are promising but their benefits remain to be determined. © 2012 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  6. Aesthetic/Cosmetic surgery and ethical challenges.

    Science.gov (United States)

    Atiyeh, Bishara S; Rubeiz, Michel T; Hayek, Shady N

    2008-11-01

    Is aesthetic surgery a business guided by market structures aimed primarily at material gain and profit or a surgical intervention intended to benefit patients and an integral part of the health-care system? Is it a frivolous subspecialty or does it provide a real and much needed service to a wide range of patients? At present, cosmetic surgery is passing through an identity crisis as well as an acute ethical dilemma. A closer look from an ethical viewpoint makes clear that the doctor who offers aesthetic interventions faces many serious ethical problems which have to do with the identity of the surgeon as a healer. Aesthetic surgery that works only according to market categories runs the risk of losing the view for the real need of patients and will be nothing else than a part of a beauty industry which has the only aim to sell something, not to help people. Such an aesthetic surgery is losing sight of real values and makes profit from the ideology of a society that serves only vanity, youthfulness, and personal success. Unfortunately, some colleagues brag that they chose the plastic surgery specialty just to become rich aesthetic surgeons, using marketing tactics to promote their practice. This is, at present, the image we project. As rightly proposed, going back a little to Hippocrates, to the basics of being a physician, is urgently warranted! Being a physician is all that a "cosmetic" surgeon should be. In the long run, how one skillfully and ethically practices the art of plastic surgery will always speak louder than any words.

  7. Surgery in Amphibians.

    Science.gov (United States)

    Chai, Norin

    2016-01-01

    Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. [Simulation in pediatric surgery].

    Science.gov (United States)

    Becmeur, François; Lacreuse, Isabelle; Soler, Luc

    2011-11-01

    Simulation in paediatric surgery is essential for educational, ethical, medicolegal and economic reasons, and is particularly important for rare procedures. There are three different levels of simulation:--simulation of basic techniques in order to learn or improve surgical skills (dissection, intracorporeal knots, etc.);--preparation for surgery using virtual reality, to perfect and test various procedures on a virtual patient, and to determine the best approaches for individual cases;--behavioral simulation underlines the importance of the preoperative check-list and facilitates crisis management (complications, conversion, etc.).

  9. Surgery in Spain.

    Science.gov (United States)

    Trias, M; Targarona, E M; Moral, A; Pera, C

    1998-02-01

    The Iberian Peninsula-the southwestern point of Europe, between the Mediterranean Sea and the Atlantic Ocean-was visited and settled in ancient times by a variety of peoples. Phoenicians, Carthaginians, Celts, Greeks, Romans, Visigoths, and Arabs all left their mark on the peninsula, and their cultures blended together to found, among other things, a rich tradition in medicine and surgery. During the Renaissance, the fluid exchange of technical skills and knowledge with the rest of Europe and the emergence of universities ensured the development of a high level of medical expertise. Today, surgery in Spain is at the forefront of innovations in the field.

  10. Standing equine dental surgery.

    Science.gov (United States)

    Menzies, Robert A; Easley, Jack

    2014-04-01

    Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, and revisits the AO pinless external fixator for fractures of the body of the mandible. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. [Bariatric surgery in Denmark.

    DEFF Research Database (Denmark)

    Funch-Jensen, P.; Iversen, M.G.; Kehlet, H.

    2008-01-01

    INTRODUCTION: In 2005 the National Board of Health (NBH) published guidelines on bariatric surgery in Denmark. The aim of the present study was to shed light on the national bariatric effort in relation to these guidelines. MATERIAL AND METHODS: The analysis is based on extraction of the following......, a tendency which was attributable to the activities of one of the private clinics. CONCLUSION: The frequency with which bariatric surgery is performed follows a strongly increasing trend and the procedures are only performed at the public departments selected by the National Board of Health...

  12. Female genital cosmetic surgery.

    Science.gov (United States)

    Shaw, Dorothy; Lefebvre, Guylaine; Bouchard, Celine; Shapiro, Jodi; Blake, Jennifer; Allen, Lisa; Cassell, Krista

    2013-12-01

    To provide Canadian gynaecologists with evidence-based direction for female genital cosmetic surgery in response to increasing requests for, and availability of, vaginal and vulvar surgeries that fall well outside the traditional realm of medically-indicated reconstructions. Published literature was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in 2011 and 2012 using appropriate controlled vocabulary and key words (female genital cosmetic surgery). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2012. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Recommendations 1. The obstetrician and gynaecologist should play an important role in helping women to understand their anatomy and to respect individual variations. (III-A) 2. For women who present with requests for vaginal cosmetic procedures, a complete medical, sexual, and gynaecologic history should be obtained and the absence of any major sexual or psychological dysfunction should be ascertained. Any possibility of coercion or exploitation should be ruled out. (III-B) 3. Counselling should be a priority for women requesting female genital cosmetic surgery. Topics should include normal variation and physiological changes over the lifespan, as well as the possibility of unintended consequences of cosmetic surgery to the genital area. The lack of evidence regarding outcomes and the lack of data on the

  13. Epiretinal membrane surgery

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; Correll Christensen, Ulrik; La Cour, Morten

    2017-01-01

    and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco-vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow-up. Primary outcome was the RE (the difference between predicted...... and achieved spherical equivalent); secondary outcomes were best-corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT). Results: Sixty-two eyes were enrolled. The mean RE showed a small myopic shift of -0.36D in all...

  14. Cosmetic Surgery Training in Plastic Surgery Residency Programs

    Directory of Open Access Journals (Sweden)

    Colton H. L. McNichols, MD

    2017-09-01

    Conclusions:. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

  15. Laser tumor treatment in oral and maxillofacial surgery

    Science.gov (United States)

    Neukam, F. W.; Stelzle, F.

    Cancer treatment is an integral part of oral and maxillofacial surgery. Oral cancer in particular is a highly prevalent neoplasm. Standard treatment for most of the tumors is radical surgery combined with stage-based neo-/adjuvant therapy. Laser surgery has become a reliable treatment option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. However, laser surgery has some major drawbacks: In contrast to conventional incisions with scalpels, the surgeon gets no feedback during laser ablation. There is no depth sensation and no tissue specificity with a laser incision, increasing the risk of iatrogenic damage to nerves and major blood vessels. Future prospects may solve these problems by means of an optical feedback mechanism that provides a tissue-specific laser ablation. First attempts have been made to perform remote optical tissue differentiation. Additionally, real time optical tumor detection during laser surgery would allow for a very precise and straight forward cancer resection, enhancing organ preservation and hence the quality of life for patients with cancer in the head and neck region.

  16. Multimodal Intraoperative Neurophysiological Monitoring in Spinal Cord Surgery.

    Science.gov (United States)

    Taskiran, Emine; Brandmeier, Sema; Ozek, Erdinc; Sari, Ramazan; Bolukbasi, Fatihhan; Elmaci, Ilhan

    2017-01-01

    Intraoperative neurophysiological monitoring (IONM) monitors the functional integrity of critical neural structures by electrophysiological methods during surgery. Multimodality combines different neurophysiological methods to maximize diagnostic efficacy and provide a safety margin to improve the outcomes of spinal surgery. Our aim was to share our intraoperative monitoring experiences with patients who underwent surgery because of spinal cord pathologies between September 2013 and January 2015. We had twenty-six cases. Location of the lesions, surgery, neurological findings, and electrophysiological findings intraoperatively and postoperatively were documented. The combination of motor evoked potential (MEP), somatosensorial evoked potential (SSEP), free-run and trigger electromyography (EMG) were performed according to lesion localization. MEPs plus SSEPs were run in 23 patients and MEPs with triggered EMG were performed in 4 patients. In only one patient, optimal recording could not be elicited because of technical problems. MEP and SSEP changes were recorded in 12 and 3 patients respectively. Postoperative neurological deficits were observed in 2 patients. Deficits were transient in one case and permanent in the other. While baseline MEP responses were either absent or low amplitude ( < 50 microvolt) in 7 patients, following resection they were either visible or increased in amplitude. Surgery was ended in one patient with C7-T2 intramedullary tumour after the right distal MEP response disappeared. Multimodal IONM is an important method to monitor the neural structures under risk in spine surgery and to keep the surgery within safety limits, especially for intramedullary spinal cord lesion surgery.

  17. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    International Nuclear Information System (INIS)

    2008-01-01

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available AAOMS - Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who We Are News Videos Contact Find ... Surgeon What We Do Anesthesia Anesthesia Oral and maxillofacial surgeons are extensively trained to appropriately administer local ...

  19. Aortic valve surgery - open

    Science.gov (United States)

    ... while you are connected to this machine. This machine does the work of your heart while your heart is stopped. If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve ...

  20. Plastic Surgery: Tackling Misconceptions

    African Journals Online (AJOL)

    will succeed. First impressions tend to last, and if young people's first impression of plastic surgeons is that they spend much of their time doing cosmetic surgery then this is a first impression that might be long ... Res 2014;4 Suppl S3:169‑70. Access this article online. Quick Response Code: Website: www.amhsr.org. DOI:.

  1. Plastic Surgery: Tackling Misconceptions

    African Journals Online (AJOL)

    Misconceptions. Dear Sir,. Denadai and Raposo-Amaral have presented an interesting account of undergraduate plastic surgery education and the challenges associated with it.[1] They have outlined a comprehensive program to ensure that medical students get a much deeper understanding of the activities of plastic ...

  2. Gastric bypass surgery

    Science.gov (United States)

    ... Buchwald H, ed. Buchwald's Atlas of Metabolic and Bariatric Surgical Techniques and Procedures . Philadelphia, PA: Elsevier Saunders; 2012:chap 5. Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients ...

  3. Heart bypass surgery

    Science.gov (United States)

    ... from the hospital. The day before your surgery: Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. Make sure that you dry ...

  4. Mitral valve surgery - open

    Science.gov (United States)

    ... return. The day before your surgery, take a shower and wash your hair. You may need to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. You also may need to ...

  5. Ghrelin and Metabolic Surgery

    Directory of Open Access Journals (Sweden)

    Dimitrios J. Pournaras

    2010-01-01

    Full Text Available Metabolic surgery is the most effective treatment for morbid obesity. Ghrelin has been implicated to play a role in the success of these procedures. Furthermore, these operations have been used to study the gut-brain axis. This article explores this interaction, reviewing the available data on changes in ghrelin levels after different surgical procedures.

  6. Bariatric Surgery and Hypertension.

    Science.gov (United States)

    Owen, Jonathan G; Yazdi, Farshid; Reisin, Efrain

    2017-12-08

    Obesity continues to increase in prevalence worldwide. Hypertension has long been associated with obesity, and weight loss continues to be a first-line therapy in the treatment of hypertension. Lifestyle modification and pharmacologic therapy, however, often meet with treatment failure. Bariatric surgery continues to be the most successful approach to sustained weight loss. This review focuses on the underlying physiologic mechanisms of obesity-hypertension, and the impact of bariatric surgery on the treatment of hypertension. Current available literature on the physiologic mechanisms of obesity-hypertension, and the major trials, meta-analyses and systematic reviews of the impact of bariatric surgery procedures on hypertension are reviewed. Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures. Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric Banding. Though long-term control of hypertension following surgery remains a concern, available follow-up post-operative data of up to 10 years suggests a sustained, if lessened, effect on hypertension control over time. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Robotics in gynecologic surgery.

    Science.gov (United States)

    Frick, A C; Falcone, T

    2009-06-01

    Robotic surgery has evolved from an investigational surgical approach to a clinically useful adjunct in multiple surgical specialties over the past decade. Advocates of robotic-assisted gynecologic surgery revere the system's wristed instrumentation, ergonomic positioning, and three-dimensional high-definition vision system as significant improvements over laparoscopic equipment's four degrees of freedom and two-dimensional laparoscope that demand the surgeon stand throughout a procedure. The cost, lack of haptic feedback, and the bulky size of the equipment make robotics less attractive to others. Studies evaluating outcomes in robotic-assisted gynecologic surgery are limited. Multiple small retrospective studies demonstrate the safety and feasibility of robotic hysterectomy. With increased surgeon experience, operative times are similar to, or shorter than, laparoscopic cases. Robotic assistance can facilitate suturing in laparoscopic myomectomies, and is associated with decreased blood loss and a shorter hospital stay, although may require longer operative times. Robotic assistance has also been applied to multiple procedures in the subspecialties of infertility, urogynecology and gynecologic oncology with good success and relatively low morbidity. However, further research is warranted to better evaluate the relative benefits and costs of robotic assisted gynecologic surgery.

  8. Scoliosis surgery - child

    Science.gov (United States)

    ... from getting worse. But, when they no longer work, the child's health care provider will recommend surgery. There are ... urinate. Your child's stomach and bowels may not work for a few days ... Your child may need to receive fluids and nutrition through ...

  9. Nigerian Journal of Surgery

    African Journals Online (AJOL)

    The Nigerian Journal of Surgery publishes original articles, special articles (by invitation), reviews, case reports, correspondences and notes. Materials cited for publication will include scientific research papers read at the meetings of the Nigerian Surgical Research Society, and of the Association of Surgeons of Nigeria and ...

  10. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. ... Nonconventionalmesocaval prosthetic shunt interposition in refractory case with portal hypertension in a 10-kg female infant · EMAIL FREE FULL TEXT EMAIL FREE FULL ...

  11. Surgery for adrenal tumors

    International Nuclear Information System (INIS)

    Salamah, S.M.

    2002-01-01

    Objective: To analyze the presentation, localization, pathology, surgical management and outcome of surgery for adrenal gland tumors. Design: Prospective clinico epidemiological study. Place and Duration of Study: The study was conducted at the Department of General Surgery, University Unit, Riyadh medical Complex Kingdom of Saudi Rabia from June, 1991 to may, 2001. Subjects and Methods: A total of 21 cases with adrenal tumors were studied for demographic data, clinical presentation, diagnostic workup, localization, surgical management, pathology and outcome. The outcome of these patients was followed prospectively. Results: The study included 12 female and 9 male patients. The mean age at surgery was 36.7 years. Hypertension (69.%) was the commonest presentation in hypersecretory functional tumors. The localization accuracy for ultrasonography, computerized tomography, MRI and MIBG scan was 95.2%, 98.3% 87.8% and 83.6% respectively. Pheochromocytoma was the most common adrenal pathology observed in 14 (66.6%) cases. The overall morbidity was 19% with no hospital mortality. Complete follow-up of available 19 patients (90.5 %) revealed no tumor recurrence and persistent hypertension in 14.3% cases. Conclusion: surgery on adrenal glands is safe in experienced hands and is recommended in institutes with all backup facilities. (author)

  12. COMPUTERS IN SURGERY

    African Journals Online (AJOL)

    BODE

    to keep abreast of the rapidly changing trends in surgical fields. What are the legal implications of on- line referrals, treatment via telemedicine, surgical decisions following video-conferencing? In robot- assisted remote surgery and telemedicine, is the consulted or remote doctor bound by the licensing regulations of the ...

  13. Robotic endovascular surgery.

    Science.gov (United States)

    Au, Stephanie; Ko, Koel; Tsang, Josephine; Chan, Yiu Che

    2014-01-01

    The purpose of this review is to compare conventional endovascular procedures and the robotic endovascular approach in aortic aneurysm repair. Despite advantages over open surgery, conventional endovascular surgery has limitations. To develop an alternative, efforts have been focused on robotic endovascular systems. Two of the 3 studies comparing procedure times demonstrated reduced procedure time in the robotic group, by 6 times (p robotic procedures reduced fluoroscopic exposure time by 12 minute (p robotic surgery was reduced up to 10 times (p robotic performance score showed a better performance score in the robotic endovascular group (p = 0.007). These results demonstrate that the robotic technique has multiple advantages over the conventional procedure, including improved catheter stability, a shorter learning curve, reduced procedure time, and better performance in cannulating tortuous vessels. However, robotic endovascular technology may be limited by the cost of the system, the size of the catheter, and the setup time required preoperatively. Further comparative studies between conventional and robotic approaches regarding cost-effectiveness, safety, and performance in cases involving complex anatomy and fenestrated stent grafts are essential. Nevertheless, this revolutionary technology is increasingly popular and may be the next milestone in endovascular surgery.

  14. Advances in trauma surgery

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... to be fully conscious within 48 hours, then a CT of the whole cervical spine is required to exclude any cervical spine injury. Surgical management of penetrating neck injuries. The patient presenting to the emergency room with massive bleeding from a penetrating neck injury requires haemostatic surgery.

  15. [DRG and gastrointestinal surgery].

    Science.gov (United States)

    Leardi, S; Altilia, F; Pietroletti, R; Risetti, A; Schietroma, M; Simi, M

    1999-01-01

    The diagnosis-related-groups (DRG) is the cost-based system for hospital reimbursement. However, the proceeds does not coincide with the costs. Aim of the study was to identify the profit, which we could gained with 147, 155, 158, 162, 165, 198 gastrointestinal surgery DRG. 30 consecutive patients, undergone to surgery in Clinica Chirurgica of L'Aquila University, had been studied. We had calculated the daily costs of medical and nursing practice, diagnostic tests, drugs, hospitalization, surgical instruments for every patient's therapy. The DRG-proceeds had been correlated with the DRG-costs. The "major gastrointestinal surgery" had not profit (147 DRG: anterior resection of rectum = -354428 Pounds, Miles = -94020 Pounds; 155 DRG: total gastrectomy = -1920641 Pounds). On the contrary, "minimal surgery" had good profits (158 DRG: hemorroidectomy with local anestesia = 1469605 Pounds;162 DRG: sutureless groin hernioplasty = 1561200 Pounds; 198 DRG: videolaparochole-cystectomy: 1208807 Pounds). The study seems to demonstrate the disparity of the reimbursement system related to DRG. However, the surgeons, as managers, must employ warily the resources for producing DRG.

  16. [Health education. Heart surgery].

    Science.gov (United States)

    Iriarte Roteta, Andrea; Wilson-Barnett, Jenifer; Narvaiza, M Jesús

    2003-06-01

    By means of a literature review of nursing articles, the authors aim to evaluate the importance of educational programmes before and after cardiac surgery, to assess the advantages and drawbacks of these programmes and to evaluate the need for following-up patients and their carers after being discharged from hospital. Health Education and cardiac surgery: Delivering information following cardiac surgery is an essential task, not only to achieve a behavioural change and the development of patients' self-care attitudes but also to reduce their anxiety. It is also essential to educate family members as they are the most importance source of physical and emotional support following surgery. Issues about in-hospital teaching programmes: Despite the numerous benefits of in-hospital teaching programmes, the actual tendency to shorten hospitalisation length in association with the high levels of anxiety, impede patients and carers' learning. Some studies suggest that these educational programmes have not completely achieved the task of preparing patients and their families to face the early recovery. Education during the early recovery: The authors highlight those studies that have focused on patients and their carers' needs for information following discharge from hospital. Results from these studies show the need for following-up patients and their carers at this period. Educational programmes can extent and reinforce the information provided at hospital.

  17. Psychiatric issues in cosmetic plastic surgery.

    Science.gov (United States)

    Ericksen, William Leif; Billick, Stephen Bates

    2012-09-01

    The objective of cosmetic surgery is increased patient self-esteem and confidence. Most patients undergoing a procedure report these results post-operatively. The success of any procedure is measured in patient satisfaction. In order to optimize patient satisfaction, literature suggests careful pre-operative patient preparation including a discussion of the risks, benefits, limitations and expected results for each procedure undertaken. As a general rule, the patients that are motivated to surgery by a desire to align their outward appearance to their body-image tend to be the most satisfied. There are some psychiatric conditions that can prevent a patient from being satisfied without regard aesthetic success. The most common examples are minimal defect/Body Dysmorphic Disorder, the patient in crisis, the multiple revision patient, and loss of identity. This paper will familiarize the audience with these conditions, symptoms and related illnesses. Case examples are described and then explored in terms of the conditions presented. A discussion of the patient's motivation for surgery, goals pertaining to specific attributes, as well as an evaluation of the patient's understanding of the risks, benefits, and limitations of the procedure can help the physician determine if a patient is capable of being satisfied with a cosmetic plastic surgery procedure. Plastic surgeons can screen patients suffering from these conditions relatively easily, as psychiatry is an integral part of medical school education. If a psychiatric referral is required, then the psychiatrist needs to be aware of the nuances of each of these conditions.

  18. Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics

    Directory of Open Access Journals (Sweden)

    Narayan H Gandedkar

    2016-01-01

    Full Text Available Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity.

  19. ROBOTIC SURGERY: BIOETHICAL ASPECTS.

    Science.gov (United States)

    Siqueira-Batista, Rodrigo; Souza, Camila Ribeiro; Maia, Polyana Mendes; Siqueira, Sávio Lana

    2016-01-01

    The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. To present review of the ethical aspects of robot use in surgery. Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. A utilização de robôs em procedimentos cirúrgicos tem sido cada vez mais frequente na atualidade, o que permite a emergência de inúmeras questões bioéticas nesse âmbito. Apresentar revisão sobre os aspectos éticos dos usos de robôs em cirurgia. Realizou-se revisão nas bases de dados Pubmed, SciELO e Lilacs cruzando-se os descritores "bioética", "cirurgia", "ética", "laparoscopia" e "robótica". Do total de citações obtidas, selecionou-se 17 artigos, os quais foram utilizados para a elaboração do artigo. Ele contém breve apresentação sobre a robótica, sua inserção na saúde e os aspectos bioéticos da utilização dos robôs em procedimentos cirúrgicos. A cirurgia robótica é uma realidade, hoje, em muitas unidades hospitalares, o que torna essencial a reflexão bioética sobre as relações entre profissionais da saúde, autômatos e pacientes.

  20. Nanotechnology in plastic surgery.

    Science.gov (United States)

    Ibrahim, Ahmed M S; Gerstle, Theodore L; Rabie, Amr N; Song, Yong-Ak; Melik, Rohat; Han, Jongyoon; Lin, Samuel J

    2012-12-01

    Nanotechnology has made inroads over time within surgery and medicine. Translational medical devices and therapies based on nanotechnology are being developed and put into practice. In plastic surgery, it is anticipated that this new technology may be instrumental in the future. Microelectromechanical systems are one form of nanotechnology that offers the ability to develop miniaturized implants for use in the treatment of numerous clinical conditions. The authors summarize their published preliminary findings regarding a microelectromechanical systems-based electrochemical stimulation method through modulation of ions around the nerve that is potentially implantable and clinically efficacious, and expand upon current and potential usages of nanotechnology in plastic surgery. Sciatic nerves (n = 100) of 50 American bullfrogs were placed on a microfabricated planar gold electrode array and stimulated electrically. Using Ca(2+)-selective membranes, ion concentrations were modulated around the nerve environment in situ. In addition, a comprehensive review of the literature was performed to identify all available data pertaining to the use of nanotechnology in medicine. A 40 percent reduction of the electrical threshold value was observed using the Ca(2+) ion-selective membrane. The uses of nanotechnology specifically applicable to plastic surgery are detailed. Nanotechnology may likely lead to advancements in the art and science of plastic surgery. Using microelectromechanical systems nanotechnology, the authors have demonstrated a novel means of modulating the activation of nerve impulses. These findings have potentially significant implications for the design of special nano-enhanced materials that can be used to promote healing, control infection, restore function, and aid nerve regeneration and rehabilitation.

  1. [Cosmetic surgery of the female genitalia].

    Science.gov (United States)

    Foldès, P; Droupy, S; Cuzin, B

    2013-07-01

    This review studies rationale and outcome of vulvovaginal aesthetic surgery. Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty, vaginoplasty, perineoplasty, female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; references from bibliographies of papers found through the literature search and in the author's reading of available literature until January 2012. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention. A physical psychological and sexological evaluation is mandatory before a procedure of female cosmetic genital surgery. Perineoplasties in wide vagina sensations should be proposed after careful evaluation of patients, by trained surgeons, in part of a multidisciplinary approach especially sexologic, after attempt of conservative treatments (pelvic floor rehabilitation). Patients should be informed of results and complications. Female genital mutilation repair with surgery is possible and improve majority of patients. Improvement mechanism is complex and clinical trials are ongoing. Asking for this surgery, is more often result of a deep reflexion for patient who integrate his own story and those of her family. She should be listened to, respected and managed in a reference center. Sexotherapy should be systematically proposed. Concerning hymenoplasty, the procedure is considered as "legally" by medical doctors. Several techniques are available, few described, and there is no evidence-based publication. Labioplasty is a procedure whose patient expectations should be properly evaluated by surgeon and benefits risks should be informed. A preliminary discussion around "normality" and a psychotherapy should be tried, in order to not treat a dysmorphobia by surgery. Vaginal "rejuvenation

  2. [Di Paolo's cephalometrical analysis of lower face by means of Cone-Beam CT].

    Science.gov (United States)

    Dobai, Adrienn; Vizkelety, Tamás; Markella, Zsolt; Rosta, Adrienne; Kucserá, Ágnes; Barabás, József

    2016-06-01

    3D cephalometry is often the only way to set up accurate diagnosis and treatment plan in the field of reconstructive surgery. In these cases complement exposures are needed beyond common cephalograms with higher accuracy than conventional Cone-Beam CT. Consequently the aim of our study was to perform a complex 3D cephalometry. As the first step of this approach, was the 3D adaptation of DiPaolo's Quadrilateral technique, and to determine norms of references in lower face by means of CBCT. Thirty non-orthodontic CBCT scans were selected for the digitalization. The most important inclusion criteria was Class I occlusion. Locations of 55 landmarks were signed three times by three observers by means of Cranio Viewer software. However Quadrilateral analysis contains only millimetric values we also integrate angles in the 3D version to determine the width of maxilla and mandible. In the 2D examination--where landmarks were projected to the middle plane. The SDs of the lengths were between 2,66 mm and 5,20 mm. The ratios of normodivergent lower face were significant different from the one by DiPaolo. In 3D adaptation there were no significant differences between the measurements of the two sides (p ≥ 0.05). We found mostly strong and significant correlations between each anatomical structure except of angles. Creation of 3D Quadrilateral cephalometry by means of strong correlation and norms of Class I occlusion provide a practical, reliable method to measure also the transversal asymmetry of lower face which is necessary part of 3D cephalometry.

  3. Congenital heart defect - corrective surgery

    Science.gov (United States)

    ... up and over time, cause medical problems and arrhythmias. Sometimes, an ASD can be closed without open- ... surgery. The surgery may be done in the newborn period if the infant has severe symptoms. If ...

  4. Cancer Surgery: Physically Removing Cancer

    Science.gov (United States)

    ... 30, 2017. Townsend CM Jr, et al. Emerging technology in surgery: Informatics, robotics, electronics. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, Pa.: Elsevier; 2017. ...

  5. Infant open heart surgery (image)

    Science.gov (United States)

    During open-heart surgery an incision is made through the breastbone (sternum) while the child is under general anesthesia. ... During open-heart surgery an incision is made through the breastbone (sternum) while the child is under general anesthesia.

  6. Preventing Wrong-Site Surgery in Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Assael, Leon A

    2017-05-01

    This article discusses the risk for wrong-site surgery in oral and maxillofacial surgery and the development and utility of checklists. The intent of checklists and the specific applicability of each of them to ambulatory oral and maxillofacial surgery are presented. Checklists and other considerations to mitigate the risk of wrong-site surgery are evaluated. The role of interprofessional teams in improving patient care outcomes with the checklist as a vehicle is evaluated. Recommendations for the use of checklists and related methods in the ambulatory oral and maxillofacial surgery setting are made. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Nigerian Journal of Plastic Surgery

    African Journals Online (AJOL)

    The Nigerian Journal of Plastic Surgery has its objectives in publishing original articles about developments in all areas related to plastic and reconstructive surgery as well as to trauma surgery. It also serves as a means of providing a forum for correspondence, information and discussion. It also accepts review articles that ...

  8. Visual Outcome of Cataract Surgery

    African Journals Online (AJOL)

    non-governmental organization (Amen Foundation) to commence a free cataract surgery programme in January. 2008. Since its inception, the patient turnout for cataract surgery has increased. The World Health Organization (WHO) categorizes the outcome of cataract surgeries into 3 groups: good (visual acuity of 6/ 6-6/ ...

  9. Robot-assisted endoscopic surgery

    NARCIS (Netherlands)

    Ruurda, J.P.

    2003-01-01

    During the last three years, robot-assisted surgery systems are increasingly being applied in endoscopic surgery. They were introduced with the objective to overcome the challenges of standard endoscopic surgery. With the improvements in manipulation and visualisation that robotic-assistance offers,

  10. Training in urological robotic surgery. Future perspectives.

    Science.gov (United States)

    El Sherbiny, Ahmed; Eissa, Ahmed; Ghaith, Ahmed; Morini, Elena; Marzotta, Lucilla; Sighinolfi, Maria Chiara; Micali, Salvatore; Bianchi, Giampaolo; Rocco, Bernardo

    2018-01-01

    As robotics are becoming more integrated into the medical field, robotic training is becoming more crucial in order to overcome the lack of experienced robotic surgeons. However, there are several obstacles facing the development of robotic training programs like the high cost of training and the increased operative time during the initial period of the learning curve, which, in turn increase the operative cost. Robotic-assisted laparoscopic prostatectomy is the most commonly performed robotic surgery. Moreover, robotic surgery is becoming more popular among urologic oncologists and pediatric urologists. The need for a standardized and validated robotic training curriculum was growing along with the increased number of urologic centers and institutes adopting the robotic technology. Robotic training includes proctorship, mentorship or fellowship, telementoring, simulators and video training. In this chapter, we are going to discuss the different training methods, how to evaluate robotic skills, the available robotic training curriculum, and the future perspectives.

  11. The role of probiotics in gastrointestinal surgery.

    Science.gov (United States)

    Correia, Maria Isabel T D; Liboredo, Juliana C; Consoli, Marcella L D

    2012-03-01

    The intestinal microbiota, which is a complex and dynamic population of different bacterial species, represents an important contribution to the health of the host. This microbiota plays a key role by promoting the integrity of the epithelial barrier and the development of mucosal immunity. However, under some stressful situations, such as after gastrointestinal surgery, infectious complications may originate from the intestinal microbiota of the patient. This phenomenon is known as the gut origin of sepsis hypothesis. However, the supply of probiotics has beneficial effects under similar conditions despite some controversial results. Therefore, it is important to carefully assess the efficacy of probiotics in the prevention and treatment of complications in surgical patients and to evaluate the safety of its use. This review provides an overview of the proposed mechanisms of probiotic action and the significant progress in this field, mainly concerning gastrointestinal surgery. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. HYPOTHYROIDISM FOLLOWING THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    M. Lankarani

    2008-06-01

    Full Text Available Postsurgical hypothyroidism and its incidence has not been fully investigated. In this study, the incidence of hypothyroidism and its possible risk factors at Shariati Hospital was assessed. One hundred and two patients with benign thyroid diseases, who had undergone thyroidectomy, were investigated with regards to thyroid function profile during period of one year after the operation every three months with post-operative sample as the baseline. Hypothyroidism was developed in 36 patients (35.2% on average 5 ± 3.2 months after surgery. Factors such as increased age, operation type, histopathologic type, underlying disease, lymphocytic infiltration and use of levothyroxine before surgery were associated with the increased incidence of hypothyroidism. It seems that use of indicators such as Graves' disease and lymphocytic infiltration in pathologic specimens should be helpful in projecting the potential occurrence of hypothyroidism in patients undergoing thyroidectomy.

  13. Robotic mitral valve surgery.

    Science.gov (United States)

    Kypson, Alan P; Nifong, L Wiley; Chitwood, W Randolph

    2003-12-01

    A renaissance in cardiac surgery has begun. The early clinical experience with computer-enhanced telemanipulation systems outlines the limitations of this approach despite some procedural success. Technologic advancements, such as the use of nitinol U-clips (Coalescent Surgical Inc., Sunnyvale, CA) instead of sutures requiring manual knot tying, have been shown to decrease operative times significantly. It is expected that with further refinements and development of adjunct technologies, the technique of computer-enhanced endoscopic cardiac surgery will evolve and may prove to be beneficial for many patients. Robotic technology has provided benefits to cardiac surgery. With improved optics and instrumentation, incisions are smaller. The ergometric movements and simulated three-dimensional optics project hand-eye coordination for the surgeon. The placement of the wristlike articulations at the end of the instruments moves the pivoting action to the plane of the mitral annulus. This improves dexterity in tight spaces and allows for ambidextrous suture placement. Sutures can be placed more accurately because of tremor filtration and high-resolution video magnification. Furthermore, the robotic system may have potential as an educational tool. In the near future, surgical vision and training systems might be able to model most surgical procedures through immersive technology. Thus, a "flight simulator" concept emerges where surgeons may be able to practice and perform the operation without a patient. Already, effective curricula for training teams in robotic surgery exist. Nevertheless, certain constraints continue to limit the advancement to a totally endoscopic computer-enhanced mitral valve operation. The current size of the instruments, intrathoracic instrument collisions, and extrathoracic "elbow" conflicts still can limit dexterity. When smaller instruments are developed, these restraints may be resolved. Furthermore, a working port incision is still required for

  14. [Bariatric surgery in Denmark.

    DEFF Research Database (Denmark)

    Funch-Jensen, P.; Iversen, M.G.; Kehlet, H.

    2008-01-01

    INTRODUCTION: In 2005 the National Board of Health (NBH) published guidelines on bariatric surgery in Denmark. The aim of the present study was to shed light on the national bariatric effort in relation to these guidelines. MATERIAL AND METHODS: The analysis is based on extraction of the following......, a tendency which was attributable to the activities of one of the private clinics. CONCLUSION: The frequency with which bariatric surgery is performed follows a strongly increasing trend and the procedures are only performed at the public departments selected by the National Board of Health...... data from the National Patient Registry in the period from 2005 through 2007: annual number of operations, type of operation, laparoscopic versus open procedure. Furthermore, the centres were compared. RESULTS: A total of 2,098 bariatric procedures were performed in the years 2005 to 2007. Apart from...

  15. [Cataract surgery in children].

    Science.gov (United States)

    Pavlović, S

    2000-01-01

    Cataract extraction in children has improved and became more popular over the past few decades but, due to particular features of children's eyes, still remains controversial--especially regarding the intraocular lens implantation. In contrast to adults, indications for cataract surgery in children are much more difficult to determine. Since subjective visual acuity cannot be obtained, greater reliance must be placed on the morphology and location of the lens opacity, and the behavior of the child. Forced preferential looking and visual evoked potentials can be helpful, but they should not be the only criteria. In management of pediatric cataract, correction of postoperative aphakia is still an incompletely resolved problem. Conventionally, optical correction is achieved by spectacles or contact lenses. The power of both spectacles and contact lenses can be readily adjusted to compensate for ocular growth. The success of both depends significantly on parental compliance and the child's acceptance. Hutchinson reported that 44% children with aphakia stopped wearing glasses or contact lenses 2 months after surgery. Contact lens wearing can also result in a number of corneal complications, including infectious keratitis, corneal vascularization and hypoxic corneal ulceration. IOL implantation is theoretically superior to glasses and contact lenses since it provides almost immediate optical correction which is much more reliable because it does not depend on parental or child's compliance. Still, there are many controversies about IOL implantation in infants and young children like IOL-size, material, IOL power calculation, prevention and management of secondary cataract, as well as long term safety of IOLs in children's eyes. Although short-term anatomic results after cataract extraction and primary IOL implantation in children are excellent and stable, long-term follow-up is necessary to answer questions about the long-term safety of implants in children's eyes. A

  16. Surgery of the Trachea

    Directory of Open Access Journals (Sweden)

    Mark S. Allen

    2015-08-01

    Full Text Available Surgical procedures on the trachea have only been undertaken within the past 50 years. Knowing the unique blood supply of the trachea and how to reduce tension on any anastomosis are key to a successful outcome. Tracheal conditions requiring surgery usually present with shortness of breath on exertion, and preoperative evaluation involves computed tomography and rigid bronchoscopy. Tracheal resection and reconstruction can be safely performed with excellent outcomes by following a well-described technique.

  17. Pregnancy and bariatric surgery.

    Science.gov (United States)

    Mahawar, Kamal K

    2017-12-01

    A large number of women experience pregnancy after bariatric surgery. The purpose of this review was to understand the evidence base in this area to come up with practical, evidence-based recommendations. We examined PubMed for all published articles on pregnancy in patients who have previously undergone a bariatric surgery. There is an increasing body of evidence pointing towards a beneficial effect of weight loss induced by bariatric surgery on female and male fertility prompting calls for recognition of infertility as a qualifying co-morbidity for patients between the Body Mass Index of 35.0 kg/m2 and 40.0 kg/m2. Women in childbearing age group should be routinely offered contraceptive advice after bariatric surgery and advised to avoid pregnancy until their weight has stabilized. Until more focused studies are available, the advice to wait for 12 months or 2 months after the weight loss has stabilized, whichever is latter, seems reasonable. Patients should be advised to seek clearance from their bariatric teams prior to conception and looked after by a multi-disciplinary team of women health professionals, bariatric surgeons, and dietitians during pregnancy. The main objective of care is to ensure adequate nutritional state to allow for a satisfactory weight gain and fetal growth. There is a relative lack of studies and complete lack of Level 1 evidence to inform practice in this area. This review summarizes current literature and makes a number of practical suggestions for routine care of these women while we develop evidence to better inform future practice.

  18. Nanotechnology in Thoracic Surgery*

    Science.gov (United States)

    Schulz, Morgan D.; Khullar, Onkar; Frangioni, John V.; Grinstaff, Mark W.; Colson, Yolonda L.

    2011-01-01

    Nanotechnology is an exciting and rapidly progressive field offering potential solutions to multiple challenges in the diagnosis and treatment of lung cancer, with the potential for improving imaging and mapping techniques, drug delivery and ablative therapy. With promising preclinical results in many applications directly applicable to thoracic oncology, it is possible that the frontiers of minimally invasive thoracic surgery will eventually be explored on a nanoscale. PMID:20494008

  19. Cell response to surgery.

    LENUS (Irish Health Repository)

    Ni Choileain, Niamh

    2012-02-03

    OBJECTIVES: To describe the profound alterations in host immunity that are produced by major surgery as demonstrated by experimental and clinical studies, and to evaluate the benefits of therapeutic strategies aimed at attenuating perioperative immune dysfunction. DATA SOURCES: A review of the English-language literature was conducted, incorporating searches of the MEDLINE, EMBASE, and Cochrane collaboration databases to identify laboratory and clinical studies investigating the cellular response to surgery. STUDY SELECTION: Original articles and case reports describing immune dysfunction secondary to surgical trauma were included. DATA EXTRACTION: The results were compiled to show outcomes of different studies and were compared. DATA SYNTHESIS: Current evidence indicates that the early systemic inflammatory response syndrome observed after major surgery that is characterized by proinflammatory cytokine release, microcirculatory disturbance, and cell-mediated immune dysfunction is followed by a compensatory anti-inflammatory response syndrome, which predisposes the patient to opportunistic infection, multiple organ dysfunction syndrome, and death. Because there are currently no effective treatment options for multiple organ dysfunction syndrome, measures to prevent its onset should be initiated at an early stage. Accumulating experimental evidence suggests that targeted therapeutic strategies involving immunomodulatory agents such as interferon gamma, granulocyte colony-stimulating factor, the prostaglandin E(2) antagonist, indomethacin, and pentoxifylline may be used for the treatment of systemic inflammatory response syndrome to prevent the onset of multiple organ dysfunction syndrome. CONCLUSIONS: Surgical trauma produces profound immunological dysfunction. Therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological proinflammatory-anti-inflammatory cell imbalance associated with major surgery.

  20. Epilepsy surgery in children

    OpenAIRE

    Sita Jayalakshmi; Sudhindra Vooturi; Swapan Gupta; Manas Panigrahi

    2017-01-01

    Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In approximately 15% of these patients, the seizures are not adequately controlled with anticonvulsive drugs, and such patients are potential candidates for surgical treatment and majority are children. Epilepsy surgery in children, who have been carefully chosen, can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two-third of children with intractable seizures. In...

  1. Ambulatory paediatric surgery

    African Journals Online (AJOL)

    Urology: Dental surgery: 1. Please be in ... Ward/Clinic at *7.00 a.m.r9.30 a.m.. 2. If you cannot bring your child, please telephone to make a new appointment. 3. If your child has a cold, ... Please do not give your child medicines containing aspirin for 2 weeks before ... Extraction/filling of teeth under general .. anaesthetic in ...

  2. Pregnancy following bariatric surgery.

    Science.gov (United States)

    Woodard, Carla B

    2004-01-01

    Gastric bypass surgery for morbid obesity is considered an appropriate intervention when other weight-loss measures have proven unsuccessful. Weight loss often brings about improvement in overall health by lessening the effects of obesity-related comorbidities such as chronic hypertension and diabetes. In fact, the ability to become pregnant is enhanced, as weight loss often allows for a normalization of sex hormones. However, the nutrition challenges brought about by the surgery may have a profound impact on maternal health and pregnancy outcome. Surgical procedures for morbid obesity may be classified according to the digestive aftereffects brought about by the particular procedure. These categories include the "restrictive" procedures, "restrictive-malabsorptive" procedures, and the less common "malabsorptive" procedures. Deficiencies in iron, vitamin B12, folate, and calcium can result in maternal complications, such as severe anemia, and in fetal complications, such as neural tube defect, intrauterine growth restriction, and failure to thrive. Nutrient supplementation following bariatric surgery and close supervision before, during, and after pregnancy can help prevent nutrition-related complications and improve maternal and fetal health.

  3. Robotic assisted andrological surgery

    Science.gov (United States)

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  4. Art and epilepsy surgery.

    Science.gov (United States)

    Ladino, Lady Diana; Hunter, Gary; Téllez-Zenteno, José Francisco

    2013-10-01

    The impact of health and disease has led many artists to depict these themes for thousands of years. Specifically, epilepsy has been the subject of many famous works, likely because of the dramatic and misunderstood nature of the clinical presentation. It often evokes religious and even mythical processes. Epilepsy surgical treatment has revolutionized the care of selected patients and is a relatively recent advance. Epilepsy surgery has been depicted in very few artistic works. The first portrait showing a potential surgical treatment for patients with epilepsy was painted in the 12th century. During the Renaissance, Bosch famously provided artistic commentary on traditional beliefs in "The stone of madness". Several of these works demonstrate a surgeon extracting a stone from a patient's head, at one time believed to be the source of all "folly", including epileptic seizures, psychosis, intellectual disability, depression, and a variety of other illnesses. There are some contemporary art pieces including themes around epilepsy surgery, all of them depicting ancient Inca Empire procedures such as trepanning. This article reviews the most relevant artistic works related with epilepsy surgery and also its historical context at the time the work was produced. We also present a painting from the Mexican artist Eduardo Urbano Merino that represents the patient's journey through refractory epilepsy, investigations, and ultimately recovery. Through this work, the artist intends to communicate hope and reassurance to patients going through this difficult process. © 2013.

  5. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Jean eBouquet De Jolinière

    2016-05-01

    Full Text Available Abstract Minimally invasive surgery (MIS can be considered as the greatest surgical innovation over the past thirty years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D monitor reduction in-depth perception, camera instability, limited range of motion and steep learning curves. The surgeon has a low force feedback which allows simple gestures, respect for tissues and more effective treatment of complications.Since 1980s several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon's skills, achieve accuracy and high precision during complex surgery and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three- dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision.

  6. Gamma surgery for hemangiopericytomas

    International Nuclear Information System (INIS)

    Payne, B.R.; Prasad, D.; Steiner, M.; Steiner, L.

    2000-01-01

    A retrospective analysis of a consecutive series of 12 patients with 15 intracranial hemangiopericytomas treated at the University of Virginia using gamma surgery is presented. Clinical and radiographic follow up of 3 to 56 months is available for 10 patients with 12 tumors. There was one tumor present at the time of initial gamma surgery in each patient. Two new tumors occurred in patients previously treated. Nine of the tumors decreased in volume and three remained stable. Four of the nine tumors that shrank later progressed at an average of 22 months after treatment. Of the tumors that decreased in volume and have not progressed, the response has been for an average of 11 months. The follow-up for two tumors that remained unchanged was 10 and 34 months (average 22 months). A third tumor was unchanged at 42 months but the patient died of new disease adjacent to the treated area in the anterior skull base. There were no complications and the quality of life following the procedure was maintained or improved in every case. Gamma surgery is effective in palliating the patients by decreasing tumor volume and delaying recurrence. (author)

  7. Nutritional considerations after bariatric surgery.

    Science.gov (United States)

    Elliot, Kelly

    2003-01-01

    Malnutrition is a risk that is associated with all bariatric surgeries. Malnutrition is largely preventable after these surgeries if proper patient selection, thorough preoperative nutrition education, and postoperative nutritional follow-up take place along with patient compliance. Bariatric surgery is divided into 2 major categories: restrictive or malabsorptive (with or without the restrictive aspect). The more dramatic weight loss is generally associated with procedures that are malabsorptive in nature. There is an increased risk of specific nutritional deficiencies associated with these surgeries. With proper supplementation these deficiencies are largely avoidable. This article reviews the more common bariatric surgeries and the nutritional considerations associated specifically with each surgery. The article then summarizes the typical diet advancement schedule and reviews critical care nutrition in regards to total parenteral nutrition administration for the morbidly obese individual, following bariatric surgery.

  8. Cavalieri integration

    CSIR Research Space (South Africa)

    Ackermann, ER

    2012-09-01

    Full Text Available We use Cavalieri’s principle to develop a novel integration technique which we call Cavalieri integration. Cavalieri integrals differ from Riemann integrals in that non-rectangular integration strips are used. In this way we can use single Cavalieri...

  9. Acceptance of cosmetic surgery: personality and individual difference predictors.

    Science.gov (United States)

    Swami, Viren; Chamorro-Premuzic, Tomas; Bridges, Stacey; Furnham, Adrian

    2009-01-01

    This study examined the association between several attitudinal constructs related to acceptance of cosmetic surgery, and participant demographics, personality, and individual difference variables. A sample of 332 university students completed a battery of scales comprising the Acceptance of Cosmetic Surgery Scale (ACSS) and measures of the Big Five personality factors, self-esteem, conformity, self-assessed attractiveness, and demographics. Multiple regressions showed that the predictor variables explained a large proportion of the variance in ACSS factors (Adj. R(2) ranging between .31 and .60). In addition, structural equation modelling revealed that distal factors (sex and age) were generally associated with acceptance of cosmetic surgery through the mediate influence of more proximate variables (in the first instance, the Big Five personality factors, followed by self-esteem and conformity, and finally self-assessed attractiveness). These results allow for the presentation of a preliminary model integrating personality and individual differences in predicting acceptance of cosmetic surgery.

  10. Current status of cerebral glioma surgery in China.

    Science.gov (United States)

    Wu, Jin-song; Zhang, Jie; Zhuang, Dong-xiao; Yao, Cheng-jun; Qiu, Tian-ming; Lu, Jun-feng; Zhu, Feng-ping; Mao, Ying; Zhou, Liang-fu

    2011-09-01

    The treatment of gliomas is highly individualized. Surgery for gliomas is essentially for histological diagnosis, to alleviate mass effect, and most importantly, to favor longer survival expectancy. During the past two decades, many surgical techniques and adjuvants have been applied to glioma surgery in China, which lead to a rapid development in the field of cerebral glioma surgery. This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China. A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China. The following databases were searched: the Pubmed (January 1995 to date); China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date). A selection criterion was established to exclude duplicates and irrelevant studies. The outcome measures were extracted from included studies. A total of 3307 articles were initially searched. After excluded by abstracts and full texts, 69 studies conducted in the mainland of China were included and went through further analysis. The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change. Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients. The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention. The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.

  11. Bariatric surgery insurance requirements independently predict surgery dropout.

    Science.gov (United States)

    Love, Kaitlin M; Mehaffey, J Hunter; Safavian, Dana; Schirmer, Bruce; Malin, Steven K; Hallowell, Peter T; Kirby, Jennifer L

    2017-05-01

    Many insurance companies have considerable prebariatric surgery requirements despite a lack of evidence for improved clinical outcomes. The hypothesis of this study is that insurance-specific requirements will be associated with a decreased progression to surgery and increased delay in time to surgery. Retrospective data collection was performed for patients undergoing bariatric surgery evaluation from 2010-2015. Patients who underwent surgery (SGY; n = 827; mean body mass index [BMI] 49.1) were compared with those who did not (no-SGY; n = 648; mean BMI: 49.4). Univariate and multivariate analysis were performed to identify specific co-morbidity and insurance specific predictors of surgical dropout and time to surgery. A total of 1475 patients using 12 major insurance payors were included. Univariate analysis found insurance requirements associated with surgical drop out included longer median diet duration (no-SGY = 6 mo; SGY = 3 mo; Psurgery dropout. Additionally, surgical patients had an average interval between initial visit and surgery of 5.8±4.6 months with significant weight gain (2.1 kg, Psurgery insurance requirements were associated with lack of patient progression to surgery in this study. In addition, delays in surgery were associated with preoperative weight gain. Although prospective and multicenter studies are needed, these findings have major policy implications suggesting insurance requirements may need to be reconsidered to improve medical care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  12. 42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Billing for services of assistant at surgery during..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.1701 Billing for services of assistant at surgery during cataract...

  13. Confirmatory Factor Analysis of the Beck Depression Inventory-II in Bariatric Surgery Candidates

    Science.gov (United States)

    Hall, Brian J.; Hood, Megan M.; Nackers, Lisa M.; Azarbad, Leila; Ivan, Iulia; Corsica, Joyce

    2013-01-01

    Screening for depression is an integral part of psychological evaluations conducted prior to bariatric surgery. The Beck Depression Inventory-II (BDI-II) is the most commonly used measure of depression in these treatment evaluations. The reliability and validity of the BDI-II has not yet been evaluated within bariatric surgery-seeking samples,…

  14. The John D. Constable International Traveling Fellowship: A Reciprocal Education in Plastic Surgery.

    Science.gov (United States)

    Eberlin, Kyle R; Del Frari, Barbara; Dai, Xinyi; Austen, William G

    2015-06-01

    The John D. Constable International Traveling Fellowship has been an integral part of the American Association of Plastic Surgeons since 2006 and has provided an opportunity for international plastic surgeons to work with leaders in American plastic surgery.

  15. SEBACEOUS CYSTS MINOR SURGERY

    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Agung Laksemi

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Minor surgery is small surgery or localized example cut ulcers and boils, cyst excision, and suturing. Somethings that need to be considered in the preparation of the surgery is minor tools, operating rooms and operating tables, lighting, maintenance of tools and equipment, sterilization and desinfection equipment, preparation of patients and anesthesia. In general cysts is walled chamber that consist of fluid, cells and the remaining cells. Cysts are formed not due to inflammation although then be inflamed. Lining of the cysts wall is composed of fibrous tissue and usually coated epithelial cells or endothelial. Cysts formed by dilated glands and closed channels, glands, blood vessels, lymph channels or layers of the epidermis. Contents of the cysts wall consists of the results is serum, lymph, sweat sebum, epithelial cells, the stratum corneum, and hair. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  16. Military surgery in Rwanda.

    Science.gov (United States)

    Farrow, G B; Rosenfeld, J V; Crozier, J A; Wheatley, P; Warfe, P

    1997-10-01

    In April of 1994, a vicious civil was erupted in Rwanda, with more than 500,000 people massacred by extremist militias. The second United Nations Assistance Mission in Rwanda (UNAMIR II) deployed in August 1994 to monitor the ceasefire, with an Australian Defence Force Contingent of Health Service Support consisting of staff for the UNAMIR Head-quarters, and the Australian Medical Support Force (AS MSF). A retrospective audit was conducted of all operative surgery performed during the year-long deployment, in the AS MSF operating theatres. Twenty surgeons rotated through in 6-week intervals. A total of 750 operations were performed on 547 patients, of which 636 (84.8%) involved civilians. A total of 558 (74.4%) cases were the result of trauma both accidental (38.4%) and war related (36%). The mean age of patients was 21.7 years. The age distribution was skewed, with 289 (38.5%) cases being performed on children. General surgeons performed a wide range of surgery, covering the majority of surgical specialties. These included cardiothoracic, neurosurgical, vascular and paediatric cases. Orthopaedic surgeons dealt with amputations, debridements and skin grafting in addition to bony injuries and infections. Children formed a substantial number of those treated, and required surgery for war-related injuries significantly more often than adults. Surgeons involved in future peacekeeping missions should be aware of the broad variety of clinical problems encountered, and undertake refresher training in the sub-specialties. Children are at great risk of violence in war, and if a civilization can be judged by the protection it affords its helpless, the Rwandan genocide and ensuing civil war represents a horrific example of the opposite extreme.

  17. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  18. Workplace Bullying in Surgery.

    Science.gov (United States)

    Ling, Mary; Young, Christopher J; Shepherd, Heather L; Mak, Cindy; Saw, Robyn P M

    2016-11-01

    The aim of this study was to determine the extent and nature of workplace bullying among General Surgery trainees and consultants in Australia. An online questionnaire survey of General Surgery trainees and consultant surgeons in Australia was conducted between March and May 2012. Prevalence of bullying was measured using both a definition of workplace bullying and the revised Negative Acts Questionnaire (NAQ-R). Sources of bullying were also examined, as well as the barriers and outcomes of formal reporting of bullying. The response rate was 34 % (370/1084) with 41 % (n = 152) of respondents being trainees. Overall, 47 % (n = 173) of respondents reported having been bullied to some degree and 68 % (n = 250) reported having witnessed bullying of surgical colleagues in the last 12 months. The prevalence of bullying was significantly higher in trainees and females, with 64 % of trainees and 57 % of females experiencing some degree of bullying. The majority of respondents (83 %) had experienced at least one negative behavior in the last 12 months, but 38 % experienced at least one negative behavior on a weekly or daily basis. The persistent negative behaviors that represent work-related bullying most commonly experienced were 'having opinions ignored' and 'being exposed to an unmanageable workload.' Consultant surgeons were the most common source of bullying for both trainees and consultants, with administration the next common source. Of those who reported being bullied, only 18 % (n = 32) made a formal complaint. Despite increased awareness and interventions, workplace bullying remains a significant problem within General Surgery in Australia. The findings in this study serve as a baseline for future questionnaires to monitor the effectiveness of implemented anti-bullying interventions.

  19. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  20. [Temporomandibular joint disc surgery].

    Science.gov (United States)

    Potier, J; Maes, J-M; Nicot, R; Dumousseau, T; Cotelle, M; Ferri, J

    2016-09-01

    Temporomandibular joint (TMJ) disorders are a common disease and may be responsible for major functional and painful repercussions. Treatment is not consensual. The literature highlights the role of conservative treatments (physiotherapy, analgesics, splints) in a first attempt. Minimally invasive surgical techniques (arthroscopy, arthrocentesis) have developed rapidly in recent decades. They have proven effective and reliable, especially in patients suffering from irreducible or reducible anterior disc dislocation or presenting with arthopathies. The goal of our work was to make an update about disk surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Revisional Bariatric Surgery.

    Science.gov (United States)

    Switzer, Noah J; Karmali, Shahzeer; Gill, Richdeep S; Sherman, Vadim

    2016-08-01

    Revisional bariatric procedures are increasingly common. With more primary procedures being performed to manage severe obesity and its complications, 5% to 8% of these procedures will fail, requiring revisional operation. Reasons for revisional bariatric surgery are either primary inadequate weight loss, defined as less than 25% excess body weight loss, or weight recidivism, defined as a gain of more than 10 kg based on the nadir weight; however, each procedure also has inherit specific complications that can also be indications for revision. This article reviews the history of each primary bariatric procedure, indications for revision, surgical options, and subsequent outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

    Full Text Available Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.

  3. Surgery and transfusion

    Directory of Open Access Journals (Sweden)

    C.O. Ramos-Peñafiel

    2016-04-01

    Full Text Available Even though blood transfusion saves thousands of lives worldwide, it causes complications in some patients, and must therefore be correctly administered. As there is no universally accepted consensus on blood transfusion in surgical patients, we have reviewed the latest studies and gathered the best available evidence on blood management strategies. In this study, we discuss indicators for transfusion of erythrocytes and other blood products, haemostatic agents for cardiothoracic and orthopaedic interventions where it is imperative to regulate blood loss, and alternatives in specific situations such as Jehovah's Witnesses patients. Finally, we put forward an algorithm for the preoperative management of surgery patients with low haemoglobin levels.

  4. Integral trees and integral graphs

    NARCIS (Netherlands)

    Wang, Ligong

    2005-01-01

    This monograph deals with integral graphs, Laplacian integral regular graphs, cospectral graphs and cospectral integral graphs. The organization of this work, which consists of eight chapters, is as follows.

  5. Challenges During Baha Surgery: Our Experience.

    Science.gov (United States)

    Marfatia, Hetal; Priya, Ratna; Sathe, Nilam U; Mishra, Shampa

    2016-09-01

    Baha has proven performance and advantages for patients with aural atresia or chronic ear drainage. Being a per cutaneous osseo integrated implant the skin around the fixture is in contact with a foreign body that leads to chronic inflammatory reaction and complications such as skin irritation and overgrowth occur frequently. Challenges that are faced during Baha surgery include those during candidate selection, work up, anesthesia related as well as intra-operative and post operative complications. Ours was a retrospective and observational study where case records of 10 patients who underwent Baha surgery in the Department of E.N.T during the time period from January 2010 to June 2013 were reviewed. Here, the candidates were advised Baha either for congenital external ear deformity or single sided deafness. Out of 10 patients, who underwent Baha implantation, 8 underwent single staged Baha implant and two patients had two staged implant owing to bone thickness implant in two patients, skin overgrowth due to more thickness of scalp (Holgers grade 4) in one of the patient. The patient had to undergo revision surgery to replace the abutment. And one of the patients underwent failure of osseointegration and was re-implanted later. Proper surgical technique and post operative wound care play an important role in avoiding complications.

  6. Artificial Intelligence in Surgery: Promises and Perils.

    Science.gov (United States)

    Hashimoto, Daniel A; Rosman, Guy; Rus, Daniela; Meireles, Ozanan R

    2018-01-31

    The aim of this review was to summarize major topics in artificial intelligence (AI), including their applications and limitations in surgery. This paper reviews the key capabilities of AI to help surgeons understand and critically evaluate new AI applications and to contribute to new developments. AI is composed of various subfields that each provide potential solutions to clinical problems. Each of the core subfields of AI reviewed in this piece has also been used in other industries such as the autonomous car, social networks, and deep learning computers. A review of AI papers across computer science, statistics, and medical sources was conducted to identify key concepts and techniques within AI that are driving innovation across industries, including surgery. Limitations and challenges of working with AI were also reviewed. Four main subfields of AI were defined: (1) machine learning, (2) artificial neural networks, (3) natural language processing, and (4) computer vision. Their current and future applications to surgical practice were introduced, including big data analytics and clinical decision support systems. The implications of AI for surgeons and the role of surgeons in advancing the technology to optimize clinical effectiveness were discussed. Surgeons are well positioned to help integrate AI into modern practice. Surgeons should partner with data scientists to capture data across phases of care and to provide clinical context, for AI has the potential to revolutionize the way surgery is taught and practiced with the promise of a future optimized for the highest quality patient care.

  7. Oncoplastic breast surgery in Asia

    Directory of Open Access Journals (Sweden)

    Ava Kwong

    2017-02-01

    Full Text Available Oncoplastic breast conservation surgery has given a new light to the options of performing breast conserving surgery by combining oncological principles of breast cancer surgery with plastic surgery techniques. The ultimate oncoplastic achievement would be the conversion of what normally would be considered as an oncologic and/or cosmetic failure when using standard techniques of breast conserving surgery into both oncological and cosmetic success and to avoid mastectomy where possible. Most Techniques are fairly well established. However surgical techniques may also need to be adjusted based on the cohorts that the treatment is offered to. For example, for larger breasts, the technique is more forgiving. However for smaller breast, there is still a limitation of the cosmetic outcome when a high percentage of breast volume has been excised no matter how good the technique or the surgeon is. Various aspects of oncoplastic breast surgery technique will be discussed and its applicability to Asian Cohorts.

  8. Laparoscopic surgery in colorectal cancer

    International Nuclear Information System (INIS)

    Bressler Hernandez, Norlan; Martinez Perez, Elliot; Fernandez Rodriguez, Leopoldo; Torres Core, Ramiro

    2011-01-01

    In the current age of minimally invasive surgery, laparoscopic surgery for colon cancer has been established as oncologically equivalent to conventional open surgery. The advantages of laparoscopic surgery have translated into smaller incisions and shorter recovery. Since the advent of laparoscopy, surgeons have been fueled to develop less invasive operative methods as feasible alternatives to traditional procedures. As techniques evolved and technology advanced, laparoscopy became more widely accepted and is now more commonly used in many institutions. Recently, a trend toward less invasive surgery, driven by patient and surgeon alike, has been a major objective for many institutions because of the ability of laparoscopic surgery to reduce postoperative pain, achieve a quicker recovery time, and improve cosmetic outcomes. Although still evolving, traditional laparoscopy has served as a foundation for even further refinements in the minimally invasive approach and as a result, more advanced equipment and newer techniques have arisen

  9. Robotic Surgery in Gynecologic Oncology

    Science.gov (United States)

    DeBernardo, Robert; Starks, David; Barker, Nichole; Armstrong, Amy; Kunos, Charles A.

    2011-01-01

    Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management. PMID:22190946

  10. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery.

    Science.gov (United States)

    Liou, Eric J W; Chen, Po-Hsung; Wang, Yu-Chih; Yu, Chung-Chih; Huang, C S; Chen, Yu-Ray

    2011-03-01

    The surgery-first approach indicates that the orthognathic surgery precedes the orthodontic treatment, whereas the orthodontics-first approach indicates that the orthodontic treatment precedes the orthognathic surgery. The conventional approach is an orthodontics-first approach. The purposes of this article are to introduce the concept of the surgery-first approach and to report the guidelines for orthodontic management and model surgery without presurgical orthodontic decompensation. The surgery-first approach treats facial esthetics first and then occlusion, whereas the conventional approach treats occlusion first and then facial esthetics. The surgery-first approach uses osteotomy to solve both skeletal problems and dental compensation, and a "transitional" occlusion is set up postoperatively. Orthodontics in the surgery-first approach is a postoperatively adjunctive treatment to transfigure the transitional occlusion into the solid final occlusion. The advantages of the surgery-first approach are that 1) the patient's chief complaint, dental function, and facial esthetics are achieved and improved in the beginning of the treatment; 2) the entire treatment period is shortened to 1 to 1.5 years or fewer depending on the complexity of orthodontic treatment; and 3) the phenomenon of postoperatively accelerated orthodontic tooth movement reduces the difficulty and treatment time of orthodontic management in the surgery-first approach. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Oncoplastic breast surgery in Denmark

    DEFF Research Database (Denmark)

    Klit, Anders; Henriksen, Trine Foged; Siersen, Hans Erik

    2014-01-01

    With improved survival rates after breast cancer treatment, more attention is drawn to improve the cosmetic outcome after surgical treatment of breast cancer. In this process the oncoplastic breast surgery was conceived. It supplements the traditional surgical treatments (mastectomy and breast...... conserving surgery) with increased focus on individualized therapy. The ambition is to obtain the best possible cosmetic outcome without compromising recurrence rates and survival. This article provides an overview of the current oncoplastic breast surgery treatment offered in Denmark....

  12. Computed tomography, after abdominal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, H.; Toedt, H.C.

    1985-09-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which faciltated the differential diagnosis to tumor recurrency. The changes of the roentgenmorphology were not so obvious after gastrointestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolus injection. (orig.).

  13. Computed tomography, after abdominal surgery

    International Nuclear Information System (INIS)

    Vogel, H.; Toedt, H.C.; Hamburg Univ.

    1985-01-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which fascilated the differentialdiagnosis to tumorrecurrency. The changes of the roentgenmorphology were not so abvious after gastro-intestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolusinjection. (orig.) [de

  14. New Trends in General Surgery

    OpenAIRE

    Bautista Iturrizaga, Juan

    2014-01-01

    Currently, with the advance of science, more and more basic disciplines are associated with surgery exerting some influence and giving rise to the concept of Medical-Surgical Science. Besides that, surgery has evolved in paralel with immunology (in the field of transplants), interventional radiology and diagnostic-therapeutic endoscopy. Indeed, many of changes in surgery, such as the use of new diagnostic tools, approaches with shorter incisions, and the colaboration -still in an evaluative p...

  15. Parathyroid transplantation in thyroid surgery

    OpenAIRE

    Barczyński, Marcin; Gołkowski, Filip; Nawrot, Ireneusz

    2017-01-01

    Permanent hypoparathyroidism following thyroid surgery is rare. Its prevalence is reported to be below 1–2% if surgery is performed by experienced thyroid surgeons. Parathyroid identification and preservation in situ with good vascular supply is the mainstay of safe thyroid surgery. However, if the parathyroid glands are damaged, autotransplantation should be undertaken to preserve their function. Parathyroid transplantation can be considered in three distinct modes of application: (I) fresh ...

  16. Surgery for psychiatric disorders.

    Science.gov (United States)

    Cosgrove, G R

    2000-10-01

    The modern therapeutic approach to most psychiatric diseases involves a combination of well-supervised psychotherapy, pharmacotherapy, and electroconvulsive therapy. Patients who fail to adequately respond to these modern treatment methods and remain severely disabled may be considered for surgical intervention. Cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy are the most common psychosurgical procedures performed today, with response rates in the 35% to 65% range. Modern stereotactic techniques have reduced complication rates, but controversy remains regarding the optimal surgical procedure. The major psychiatric diagnostic categories that might respond to surgery include treatment-refractory major affective disorders, obsessive-compulsive disorder, and chronic anxiety states. Surgery should be considered as one part of an entire treatment plan and must be followed by an appropriate psychiatric rehabilitation program. It should only be carried out by an expert multidisciplinary team consisting of a neurologist a neurosurgeon, and a psychiatrist with experience in these disorders. Surgical intervention remains a reasonable therapeutic option for select patients with a disabling psychiatric disease and may be underutilized.

  17. Eye Surgery Light

    Science.gov (United States)

    1978-01-01

    During eye surgery, the surgeon uses an illuminating instrument called an opthalmoscope for close examination of the retina or the interior of the eye. Ordinarily, electric power for the head-mounted light is supplied through a cord from an overhead swivel arm or a floor pedestal. Within limits of cord length and swivel arm movement, the surgeon has considerable freedom of motion. But when more than one opthalmoscope is involved, tangling and interference of the power cords becomes a problem. St. Luke's Hospital, Cleveland, Ohio asked Lewis Research Center for assistance in finding a solution. Lewis responded with a battery-powered system that totally frees the surgeon of attached cords and swivels. Borrowing from space technology, Lewis used small, lightweight nickel-cadmium batteries that can deliver high intensity light for an hour and can be recharged overnight. The Opthalmoscope Powerpack consists of eight batteries in three containers affixed to a webbed belt, and a novel on-off switch equipped with a springloaded plexiglass "flapper." The belt pack is worn underneath the surgical gown and the flapper permits the doctor to activate the switch by elbow pressure. Lewis built five units and they have been in service at St. Luke's Hospital for a year. Used for routine examinations as well as for surgery, they have demonstrated excellent reliability.

  18. [Cosmetic eyelid surgery].

    Science.gov (United States)

    Ruban, J-M; Barbier, J; Malet, T; Baggio, E

    2014-01-01

    Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Female cosmetic genital surgery.

    Science.gov (United States)

    Goodman, Michael P

    2009-01-01

    Genital plastic surgery for women has come under scrutiny and has been the topic of discussion in the news media, online, and in medical editorials. In the absence of measurable standards of care, lack of evidence-based outcome norms, and little standardization either in nomenclature or training requirements, concern has been raised by both ethicists and specialty organizations.Some women request alteration of their vulvas and vaginas for reasons of cosmesis, increasing self-esteem, and improving sexual function. Patients must be assured their surgeon is properly trained and should understand that few validated long-term safety or outcome data are presently available in this relatively new field. Women also should be made aware that, although they may wish to cosmetically or physically alter their external genitalia, this does not mean that they are developmentally or structurally "abnormal." It is important that training guidelines for practitioners be established and that long-term outcome, psychosexual, and safety data be published. The genital plastic surgeon must have sufficient training in sexual medicine to withhold these procedures from women with sexual dysfunction, mental impairment, or body dysmorphic disorder. In an atmosphere in which trademarked marketing terms are becoming part of the lexicon, a more descriptive terminology is suggested, incorporating the terms "labiaplasty," "reduction of clitoral hood," "perineoplasty," "hymenoplasty," and "vaginoplasty." The term "female cosmetic genital surgery" is presented as a descriptive umbrella encompassing these genital plastic procedures.

  20. Symplectic topology of integrable Hamiltonian systems

    International Nuclear Information System (INIS)

    Nguyen Tien Zung.

    1993-08-01

    We study the topology of integrable Hamiltonian systems, giving the main attention to the affine structure of their orbit spaces. In particular, we develop some aspects of Fomenko's theory about topological classification of integrable non-degenerate systems, and consider some relations between such systems and ''pure'' contact and symplectic geometry. We give a notion of integrable surgery and use it to obtain some interesting symplectic structures. (author). Refs, 10 figs

  1. How Is Adrenal Surgery Performed?

    Science.gov (United States)

    ... Frequently Asked Questions Office visit worksheet ALSO SEE: NEUROENDOCRINE SYSTEM PARATHYROID GLANDS THYROID GLANDS How is adrenal surgery performed? This document is available in ... Parathyroid Glands | Thyroid Gland

  2. Surgery Risk Assessment (SRA) Database

    Data.gov (United States)

    Department of Veterans Affairs — The Surgery Risk Assessment (SRA) database is part of the VA Surgical Quality Improvement Program (VASQIP). This database contains assessments of selected surgical...

  3. Additional Surgery after Breast-Conserving Surgery Varies Widely

    Science.gov (United States)

    A study published in the Feb. 1, 2012, issue of JAMA found that the number of women who have one or more additional surgeries to remove suspected residual tumor tissue (re-excisions) following breast-conserving surgery (BCS) for breast cancer varies widely across surgeons and hospitals.

  4. Clinical trials in Surgery | Mwachaka | Annals of African Surgery

    African Journals Online (AJOL)

    Annals of African Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Clinical trials in Surgery. P Mwachaka, JWM Kigera. Abstract.

  5. Dynamics of hospital-based plastic surgery.

    Science.gov (United States)

    Chandawarkar, Rajiv Y; Dutta, Satyajit

    2007-02-01

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

  6. Oncoplastic surgery: pushing the limits of breast-conserving surgery.

    Science.gov (United States)

    Clough, Krishna B; Benyahi, Djazia; Nos, Claude; Charles, Caroline; Sarfati, Isabelle

    2015-01-01

    In recent decades, the surgical management of breast cancer has steadily and considerably improved. Mutilating procedures have given way to more individualized surgical approaches aiming to preserve the breast as much as possible. For large tumors, preoperative chemotherapy is a major tool, but emerging oncoplastic surgery techniques are also a new approach in the armamentarium of breast cancer surgery, as a third option between conventional breast-conserving surgery and mastectomy. As this new treatment modality allows wider margin excision, it reduces the need for re-excision procedures and possibly increases breast conservation rates by extending the indications of breast-conserving surgery. This review will provide an overview of current practices and clinical data available to date on oncoplastic surgery. © 2015 Wiley Periodicals, Inc.

  7. Surgery in India.

    Science.gov (United States)

    Mukerjee, S; Gupta, T

    1997-06-01

    Surgical practice in India is mostly managed by the central and state governments and is totally government financed, offering free medical aid. However, with the economic growth and affluence of the middle-class population in urban areas, more and more hospitals, nursing homes, and clinics managed by the private sector are arising in cities and towns. Privately owned hospitals are built and managed by large industrial houses and trusts. It is essential, according to government directives, for these hospitals to have certain numbers of general beds that will provide for the economically weaker sections of the population. Medical insurance is popular amongst the urban population; in addition to well-established insurance companies, many new medical service reimbursement organizations are forming. Surgical care standards are uniformly high in the larger teaching institutions and hospitals run by the private sector in major cities in India, in which superspecialty surgical care that meets worldwide standards is available in addition to general surgical care. These hospitals are manned by surgeons holding master's degrees in general surgery, superspecialties, and subspecialties. In the hospitals and dispensaries in rural areas, only basic surgical facilities are available; for major surgical procedures, the patients are referred to the closest urban hospitals. Therefore, the government of India is placing more and more emphasis on building hospitals that offer better surgical facilities away from the cities and towns. A diploma course in surgery is run by the National Board of Surgery, and these diplomates are encouraged to practice more in rural areas and small hospitals. Economic constraints and the population explosion are the biggest hurdles to progress in surgical care, teaching, and research activities. With the advancement in education and growth of the economy, more and more multinationals are walking into the field of medical care, which is proving to be a

  8. Ethical issues of obesity surgery--a health technology assessment.

    Science.gov (United States)

    Saarni, Samuli I; Anttila, Heidi; Saarni, Suoma E; Mustajoki, Pertti; Koivukangas, Vesa; Ikonen, Tuija S; Malmivaara, Antti

    2011-09-01

    New surgical technologies may challenge societal values, and their adoption may lead to ethical challenges. Despite proven cost-effectiveness, obesity (bariatric) surgery and its public funding have been questioned on ethical arguments relating to, for example, the self-inflicted or non-disease nature of obesity. Our aim was to analyze the ethical issues relevant to bariatric surgery. A comprehensive health technology assessment was conducted on bariatric surgery for morbid obesity using the EUnetHTA method, including a fully integrated ethical analysis. The ethical arguments suggesting that obesity should not be surgically treated because it is self-inflicted were rejected. Medicalization of obesity may have both positive and negative effects that impact the various stakeholders differently, thus being difficult to balance. Informing bariatric surgery patients and actively supporting their autonomy is exceptionally important, as the benefits and harms of both obesity and bariatric surgery are complex, and the outcome depends on how well the patient understands and adheres to the life-long changes in eating habits required. Justice considerations are important in organizing surgical treatment of obesity, as the obese are discriminated against in many ways and obesity is more common in socioeconomically disadvantaged populations who might have problems of access to treatments. Obesity should be treated like other diseases in health care, and obesity surgery rationed like other cost-effective treatments. Positive actions to ensure patient autonomy and just access to surgical treatments may be warranted.

  9. A systematic approach to developing a global surgery elective.

    Science.gov (United States)

    Hoehn, Richard S; Davis, Bradley R; Huber, Nathan L; Edwards, Michael J; Lungu, Douglas; Logan, Jocelyn M

    2015-01-01

    Interest in global health has been increasing for years among American residents and medical students. Many residency programs have developed global health tracks or electives in response to this need. Our goal was to create a global surgery elective based on a synergistic partnership between our institution and a hospital in the developing world. We created a business plan and 1-year schedule for researching potential sites and completing a pilot rotation at our selected hospital. We administered a survey to general surgery residents at the University of Cincinnati and visited medical facilities in Sierra Leone, Cameroon, and Malawi. The survey was given to all general surgery residents. A resident and a faculty member executed the fact-finding trip as well as the pilot rotation. Our general surgery residents view an international elective as integral to residency training and would participate in such an elective. After investigating 6 hospitals in sub-Saharan Africa, we conducted a pilot rotation at our selected hospital and gained the necessary information to organize a curriculum. We will begin sending senior residents for 8-week rotations in the coming academic year. By systematically approaching the process of creating a global surgery elective, we were able to gain considerable insight into choosing a location and organizing the elective. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Bariatric surgery patients: reasons to visit emergency department after surgery.

    Science.gov (United States)

    Gonzalez-Sánchez, Juan A; Corujo-Vázquez, Omar; Sahai-Hernández, Mrisa

    2007-01-01

    Morbid obesity prevalence is reaching epidemic proportions in Western society. Long-term weight loss can be achieved by bariatric surgery. This surgery also has a positive impact in the reduction of obesity related co-morbid conditions. The purpose of this study is to determine the reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery. A retrospective chart review study was performed at the UPR Hospital in Carolina. Patients with the diagnosis of morbid obesity who had bariatric surgery were identified. Of the 283 patients who met the criteria, the following information was obtained: gender, age, height, weight, pre-operative BMI, obesity-related comorbid conditions, post operative length of stay (LOS), and reasons and length of stay of Emergency Department (ED) visits within a 3 month period after surgery. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) Program. The same profile of gender and BMI was obtained between the population that had the surgery and the sample that visited the ED, the group of patients between 20-29 years old was more likely to visit the ED. No correlation was found between a longer post operative length of stay and an increased probability of visiting the ED. Of the population, 5% had to visit ED within a three month period. The most common post operative complications were: Abdominal Pain (46.2%), Emesis (38.5%), and Dehydration (30.8%). Other less frequent complications were nausea, DVT, pneumonia, dizziness, gastritis, infected wound and upper GI bleeding. The most common reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery were: abdominal pain, emesis, dehydration and nausea. These complications could most likely be attributed to patient poor compliance with diet, resulting in the classical symptoms of the dumping syndrome which is common in patients that have undergone

  11. Urogenital Reconstructive Surgery

    DEFF Research Database (Denmark)

    Jakobsen, Lotte Kaasgaard

    Urogenital reconstructive surgery Lotte Kaasgaard Jakobsen1 Professor Henning Olsen1 Overlæge Gitte Hvistendahl1 Professor Karl-Erik Andersson2 1 – Dept. of Urology, Aarhus University Hospital 2 – Dept. of Gynecology and Obstetrics, Aarhus University hospital Background: Congenital obstruction...... 3, and intermittent unloading by urethrostomy in group 4. Group 2 will not be unloaded and serve as continously obstructed controls, whilst group 1 serves as sham-operated, non-obstructed controls. Urodynamic assessment will be performed and samples of urine, blood and bladder tissue...... or intermittent means, we hope to make it easier to choose which treatment to offer the patients. By establishing a solid animal model of congenital infravesical obstruction, we expect to make way for development of better treatments of a rare, but serious condition....

  12. Smartphones in Surgery

    Directory of Open Access Journals (Sweden)

    Ara A. Salibian

    2011-01-01

    Full Text Available Smartphones have the capability of enhancing many aspects of the continuum of surgical care by providing an efficient means of multimedia communication among surgeons and healthcare personnel. The ability for mobile Internet and email access, along with features such as built-in cameras and video calling, allow surgeons to rapidly access, send and receive patient information without being restricted by issues of connectivity. Smartphones create an unrestricted network of data sharing, improving the flexibility of patient consultation, timeliness of preoperative preparation, efficiency of post-operative care and the effectiveness of a surgical team. Furthermore, smartphones provide mobile access to a multitude of surgical resources to bolster continued surgical education. This article presents a review of the current literature on the utilizations of smartphones in surgery, discusses their benefits and limitations, and addresses the possibility of incorporating smartphones into the protocol of surgical care.

  13. Hernia inguinal laparoscopic surgery

    International Nuclear Information System (INIS)

    Morelli Brum, R. . E mail: raulmorelli@hotmail.com

    2005-01-01

    The purpose of this paper is to enhance treatment of inguinal hernia through a bibliographic study of its main complications and the analysis of a retrospective series of laparoscopic restorations performed by the author in the same private medical care center. From December 1994 through July 2003, ninety-nine patients were operated in 108 procedures.The technique employed was trans-abdominal peritoneal (TAPP)Follow-up covered over 2 years in 80% of patients with a relapse of 2.8%. Main morbidity was neuralgia due to a nerve being trapped, which fact required re-intervention.There was no mortality.The conclusion arrived at is that it is and excellent technique which requires a long learning curve and its main indication would be relapse of conventional surgery, bilateralism, coexistence with another laparoscopic abdominal pathology and doubts concerning contra lateral hernia

  14. Apparatus for stereotactic surgery

    International Nuclear Information System (INIS)

    Koslow, M.A.M.

    1982-01-01

    Apparatus for stereotactic surgery consisting of a probe and a computerized tomographic scanning system is described. The scanning system comprises a display and means for reconstructing cross-sectional images on the display using data from partial circumferential scans of source and detectors. It operates on the data with an algorithm that provides the difference between the local values of the linear attenuation coefficient and average of these values within a circle centered at each reconstruction point. The scanning system includes a means of maintaining the frames of reference of the probe and scanning system rigid with respect to one another. The position of the probe, which may be a cryogenic probe, with respect to the actual anatomical structure of the body, particularly a human head, may thus be viewed by the surgeon. (author)

  15. [Functional endoscopic sinus surgery].

    Science.gov (United States)

    Han, D M

    1992-01-01

    Eighty-two cases of functional endoscopic sinus surgery were analyzed. It include 62 males and 20 females; the oldest was 72 years of age and the youngest eight years of age. A hard endoscope with a diameter of 4mm and the CCD micro-videorecorder produced by Circon and Olympus Company were used. Operations were done under general anesthesia in all cases. Twenty-three cases (28.1%) recovered in one stage and recovery was delayed in 28 cases (34.2%); late inflammation occurred in 23 cases (28.1%); 8 cases failed (9.8%). The cure rate was 62.2%. Two cases (2.4%) had operative complications namely injury to the lamina papyracea and anterior ethmoidal artery, all recovered uneventfully.

  16. [Andreas Vesalius and surgery].

    Science.gov (United States)

    Van Hee, R

    1993-01-01

    By publishing De Humani Corporis Fabrica Libri Septem in 1543, Andries van Wesel (1514-1564) gave surgical science an immense impulse. The revolutionary renovation in the knowledge of man's anatomical structure changed slowly and progressively into topographical and physiological understanding of surgical diseases. At the same time, this made better aimed and more secure operations possible. Apart from the importance of this anatomical publication, Andreas Vesalius also won his spurs as a surgeon. He taught surgery in Padua for many years. He was appointed court physician and surgeon at the Habsburg Court of Charles V and Philip II. He personally performed lots of operations known at the time as major ones. He not only quickly adopted the surgical innovations of his fellow-surgeon Ambroise Paré, but he even performed operations that had been forgotten during several centuries, among which thoracocentesis for pleural empyema. His clinical perspicacity in discovering the indication for some operations was staggering and was appreciated by all great monarchs of Europe in the 16th century. In his several consilia, numerous pieces of advice were given for the treatment of surgical patients. The surgical practice which Vesalius had in Brussels for many years, consequently became most successful. Many publications by Vesalius about surgery and blood-letting are well-known. His Chirurgia magna in septem Libros digesta still remains controversial; these books were published by Prospero Borgarruccio (1560) in 1568 by the Venetian editor Valgrisi. This book gives an excellent survey of surgical pathology as it was taught and treated in the 16th century. The scientific method that Vesalius used, not only in his anatomical studies but also in his surgical practice, deserves not only our full appraisal but should still be studied in our own time.

  17. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel M; Sørensen, Lars T

    2012-01-01

    : To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery.......: To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery....

  18. The Imperative of Academia in the Globalization of Plastic Surgery.

    Science.gov (United States)

    Nayar, Harry S; Bentz, Michael L; Baus, Gustavo Herdocia; Palacios, Jorge; Dibbell, David G; Noon, John; Poore, Samuel O; King, Timothy W; Mount, Delora L

    2015-06-01

    Although vertical health care delivery models certainly will remain a vital component in the provision of surgery in low-and-middle-income countries, it is clear now that the sustainability of global surgery will depend on more than just surgeons operating. Instead, what is needed is a comprehensive approach, that is, a horizontal integration that develops sustainable human resources, physical infrastructure, administrative oversight, and financing mechanisms in the developing world. We propose that such a strategy for development would necessarily involve an active role by academic institutions of high-income countries.

  19. Endoscopy and surgery for obesity

    International Nuclear Information System (INIS)

    Mejia, Andres Felipe; Unigarro, Ivan; Bolanos, Eduardo; Chaux, Carlos Felipe

    2006-01-01

    Actually bariatric surgery appears to be a secure, feasible and durable option for patients with morbid obesity. Most of the complications that arise from bariatric surgery can be solved with the use of endoscopy avoiding the morbidity and mortality of a surgical intervention. This group of patients has become a challenge for the endoscopist and favours the development of interventional endoscopy

  20. Robotic Surgery by G Watanabe

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    Robotic Surgery is the next big innovation after Minimally Invasive. Surgery. Emerging within a generation of each other, the two have synergized to show the way to the future, where soft advantages like patient comfort and convenience and surgeon ergonomics meld seamlessly with hard considerations like safety,.