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1.
Plast Reconstr Surg ; 102(3): 864-71, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9727457

RESUMO

As the open approach rhinoplasty has gained popularity, newer techniques for aggressive reshaping of the alar cartilage have become available. The most effective way to increase alar dome definition is the dome plication technique described by Daniel, which places a horizontal mattress suture, applied with incremental tension, between the medial and lateral crura. The disadvantage of this technique is that it can produce either overtightening or distortion of the cartilage, with excessive pinching of the nasal tip. Also, as it relies on a single nylon suture to fight against the cartilage's shape memory, it has the potential for relapse. The present article describes a new technique to overcome these problems. It consists of placing two parallel strips prepared from the resected alar cartilage excess under the domes. These grafted cartilages block the plication suture, thus avoiding the risk of excessive pinching of the domes and ensuring symmetry and stability. Using this technique, I have consistently obtained a nasal tip that is well defined over the nasal dorsum line in my patients.


Assuntos
Cartilagem/transplante , Rinoplastia/métodos , Adolescente , Adulto , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura , Resultado do Tratamento , Cicatrização/fisiologia
2.
Q J Nucl Med Mol Imaging ; 56(4): 375-84, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23013667

RESUMO

AIM: The purpose of the study was to assess the comparison of 18F-FDG PET/CT and CT in patients with breast cancer (BC) already treated with primary therapy, in evaluating the diagnostic and prognostic values. METHODS: We retrospectively studied 190 patients (187 women and 3 men, mean age 61±11 years) with previous BC (all stages) after surgery and other primary treatments. They underwent within three months CT and 18F-FDG PET/CT examinations for the evaluation of disease status. Disease relapse was confirmed by clinical evaluation and/or radiological findings. Survival curves of disease-free survival (DFS) and overall survival (OS) were computed using Kaplan-Meier method. Cox analysis regression was used to determine predictive factors of DFS and OS. RESULTS: Of the overall 190 patients, 82 (43%) had evidence of clinical and/or imaging disease relapse, while 108 (57%) did not. Sensitivity, specificity, negative predictive and positive predictive values for disease relapse or progression were of 89% vs. 77%, 73% vs. 53%, 90% vs. 75% and 72% vs. 55%, respectively for PET/CT and CT. DFS curves were significantly different in patients with both negative and positive PET/CT and CT (log-rank test 33.6; P<0.0001 and 12.7; P=0.003, respectively). OS curves were similar in patients with positive/negative PET/CT and CT (P=NS). By both univariate and multivariate Cox regression analysis positive PET/CT was found to be related to the disease recurrence (HR 0.18 and 0.20, both P<0.0001, respectively). CONCLUSION: PET/CT is more accurate than CT in identification of disease relapse in a large population of BC patients. In women at high-risk of recurrence, PET/CT imaging can provide the early detection of BC metastases, tailoring a proper treatment.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Fluordesoxiglucose F18 , Imagem Multimodal/estatística & dados numéricos , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Neoplasias da Mama/terapia , Neoplasias da Mama Masculina/diagnóstico , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/terapia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Prevalência , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
5.
Ann Plast Surg ; 30(2): 122-30, 1993 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8489175

RESUMO

A new systematization for onlay tip grafting is described, using a minigraft constructed from either irradiated, glutaraldehyde-processed bovine cartilage or soft-grade silicone blocks. The graft design consists of two pyramidal volumes amputated in the apex and carved with mild concave surfaces. The lateral profile of the graft is asymmetrical with an acute inclination in the front and a slight inclination in the back. The graft height ranges from 1.5 to 3.8 mm. With this type of implant, high tip projection with a natural appearance can be achieved easily. Since 1986, we have performed 39 tip implants (12 cartilage grafts and 27 silicone grafts). Silicone graft fate has been excellent with no complications, whereas cartilage grafts underwent a 25% resorption rate. Thus, the current technique is now solely undertaken with silicone minigrafts. Main indications are primary tip plasty in normal-size noses with poor tip projection, and secondary noses. This technique is not recommended for simultaneous use with primary rhinoplasty. For more than 4 years, this technique has provided consistent results, being highly effective in achieving the objective of increasing tip projection.


Assuntos
Bioprótese , Próteses e Implantes , Rinoplastia/métodos , Silicones , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Reoperação
6.
Microsurgery ; 6(3): 151-4, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-4058299

RESUMO

A new model for microvascular anastomosis between vessels of different diameter is described in the aorto-iliac region of the rat. The model consists of reversing the distal end of one iliac artery toward the aorta to perform an end-to-end or end-to-side microanastomosis, with 2:1 diameter ratio. The technique and the advantages of this model are presented and discussed.


Assuntos
Microcirurgia , Modelos Biológicos , Procedimentos Cirúrgicos Vasculares , Animais , Aorta/cirurgia , Artéria Ilíaca/cirurgia , Ratos
7.
Exp Neurol ; 80(3): 708-25, 1983 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-6852163

RESUMO

A moderately compressive tubulation procedure has been devised to improve regeneration that follows fascicular neurorrhaphy. The early phases of the regenerative process were analyzed to identify the underlying cellular mechanisms. Adult Sprague-Dawley rats were subjected to bilateral fascicular neurorrhaphy involving tubulation on one side with a dura mater sheet closely apposed to the suture site. One to 16 days postoperatively the nerves were processed for histological analysis. Compared with nontubulated nerves, the cuffed side displayed a longer extent of retrograde myelin and axonal degeneration, a faster rate of orthograde remyelination, axonal invasion of the suture plane at about the same period (fifth postoperative day), larger contingent of regenerating fibers invading the distal stump, more longitudinally oriented fibers at the repair level, no escape of regenerating fibers into the extraneural tissue through the repair borders, and less intraneural edema. These findings have implications for the potentially beneficial effects of mechanically restricting post-traumatic intraneural edema buildup during nerve regeneration.


Assuntos
Regeneração Nervosa , Nervos Periféricos/fisiologia , Animais , Axônios/fisiologia , Dura-Máter/fisiologia , Dura-Máter/cirurgia , Nervos Periféricos/patologia , Nervos Periféricos/cirurgia , Ratos , Ratos Endogâmicos , Nervo Isquiático/fisiologia , Nervo Isquiático/cirurgia
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