A new minimally invasive, nonexcisional, surgical browlift technique with minimal scarring: a protocol for a prospective observational study.

Background: The aim of this study is to prospectively evaluate the new minimal invasive (MINE) browlift technique with possibly superior results and minimal visible scarring. Study design: A prospective observational study will be performed on all available data from patients who will undergo a browlift procedure in the HMC from 1 June 2021 till 31 May 2024. Our goal is to include at least 50 patients. Inclusion criteria are: patients with medical (i.e. brow ptosis and facial paralysis) or cosmetic indication, patients with sufficient understanding of the Dutch or English language and willingness to participate in extra study specific follow-up moments and filling in of questionnaires. Exclusion criteria are: less than 18 years of age and patients with previous brow or eyelid surgery. Patients will be photographed preoperatively and postoperatively using the VECTRA camera. Outcome measurements: Scarring after procedure; functionality of eyebrow movement; amount of correction in brow ptosis, measured in VECTRA; longevity of procedure in months; aesthetic result as assessed by questionnaires and adverse effects of procedure will be measured. Ethics and dissemination: The database management software 'Castor' will be used to store and collect the data from the questionnaire. The Medical Research Ethics Committee found this study not eligible to be submitted to the Dutch Medical Research Involving Human Subjects Acts (WMO). Written consent will be obtained from all patients.

Does Scarpa's Fascia Preservation in Abdominoplasty Reduce Seroma? A Systematic Review.

Abdominoplasty is a widely utilized cosmetic surgery procedure. Despite its popularity, seroma formation remains a prevalent complication. Seroma can lead to extended recovery time, increased medical appointments, and the potential for infection or the need for additional surgical revision. Preserving Scarpa's fascia may mitigate the risk of seroma in patients following abdominoplasty. The goal of this systematic review was to determine the impact of preserving Scarpa's fascia on the occurrence of seroma and total drain output following an abdominoplasty procedure. This review searched academic literature in MEDLINE (via PubMed), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials (CENTRAL) for clinical and observational studies published in peer-reviewed journals, from March 2022 to November 2022, that evaluated the impact of preserving Scarpa's fascia on postoperative seroma and total drain output during abdominoplasty. The primary outcomes of interest were seroma and total drain output, with secondary outcomes of interest including hematoma, time to drain removal, length of hospital stay, wound dehiscence, and infection rate. The systematic review of 8 studies, involving 846 patients, found that the preservation of Scarpa's fascia during an abdominoplasty procedure was associated with decreased seroma occurrence, reduced drain output, faster drain removal, and fewer infections. However, it did not affect the incidence of hematoma, hospital stay duration, or wound dehiscence. The preservation of Scarpa's fascia during an abdominoplasty procedure should be considered as a routine practice, because it has been shown to result in reduced seroma incidence rates and faster drain removal.

Inflammatory cytokines and mononuclear cells in sudden sensorineural hearing loss.

OBJECTIVE: This study evaluated tumour necrosis factor-α, interleukins 10 and 12, and interferon-γ levels, peripheral blood mononuclear cells, and clusters of differentiation 17c and 86 expression in unilateral sudden sensorineural hearing loss. METHODS: Twenty-four patients with unilateral sudden sensorineural hearing loss, and 24 individuals with normal hearing and no history of sudden sensorineural hearing loss (who were attending the clinic for other problems), were enrolled. Peripheral blood mononuclear cells, and clusters of differentiation 11c and 86 were isolated and analysed. Plasma and supernatant levels of tumour necrosis factor-α, interferon-γ, and interleukins 10 and 12 were measured. RESULTS: There were no significant differences with respect to age and gender. Monocyte population, mean tumour necrosis factor-α level and cluster of differentiation 86 expression were significantly increased in the study group compared to the control group. However, interferon-γ and interleukin 12 levels were significantly decreased. The difference in mean interleukin 10 level was not significant. CONCLUSION: Increases in tumour necrosis factor-α level and monocyte population might play critical roles in sudden sensorineural hearing loss. This warrants detailed investigation and further studies on the role of dendritic cells in sudden sensorineural hearing loss.

Oral arginine supplementation and the effect on skin graft donor sites: a randomized clinical pilot study.

Although arginine has been shown to improve healing in rodents and in small induced wounds in healthy volunteers, little is known about the effects of arginine supplementation on healing of clinically relevant surgical wounds. We studied 18 patients in a double-blind randomized pilot study (12 men, 6 women), who underwent skin transplantation as part of reconstructive surgery. Patients were randomly assigned to receive arginine (n = 8) or placebo (n = 10) supplementation as an enteral dose of 36.2 g of l-arginine-HCl or an isocaloric amount of placebo (51.2 g alanine), respectively. Wound healing was evaluated at the donor sites of skin grafts by measuring angiogenesis, reepithelialization, and neutrophil count. Arginine metabolism was studied by measuring plasma and wound fluid amino acid concentrations. Our results show that none of these parameters were significantly different between the oral arginine supplementation group and the placebo group. In conclusion, enteral arginine supplementation does not improve wound healing of skin donor sites.

Pseudotumour in the bladder as a complication of total hip replacement: ultrasonography, CT and MR findings.

We report a pseudotumour in the urinary bladder following total hip replacement with review of the literature. Pseudotumour in the urinary bladder as a late complication of total hip replacement is an extremely rare condition. In this case, cross-sectional imaging modalities including sonography, CT and MR showed a hypervascular polypoid mass in the urinary bladder and adjacent wall thickening with a band connecting between the mass and the acetabulum. Histopathological diagnosis confirmed acute and chronic inflammation with calcification.

Changes in intrapulpal temperature after Er:YAG laser irradiation.

OBJECTIVE: This study was performed to investigate the changes in temperature induced by an Er:YAG laser irradiation and to find the means to minimize potential thermal damage due to temperature rise after irradiation. BACKGROUND DATA: Intrapulpal temperature rise was found to last after irradiation at times, although the addition of appropriate water spray during tooth ablation by Er:YAG laser produced efficient ablation with little thermal damage. METHODS: To investigate intrapulpal temperature change, each extracted tooth specimen was embedded into a resin block and temperature-measuring probes were placed on the irradiated and the opposite pulpal walls. An Er:YAG laser irradiation was performed at 300 mJ/pulse and 20 Hz, with a water flow rate of 1.6 mL/min for 3 sec. Each lasing was followed by (1) no application of post-irradiation water spray, (2) post-irradiation water spray for 1 sec and (3) for 2 sec. RESULTS: No significant temperature change was found on the irradiated pulpal wall during Er:YAG laser, while there existed significant temperature rise on the irradiated pulpal wall after irradiation. However, the addition of water spray for 1 or 2 sec after irradiation significantly decreased intrapulpal temperature compared to no application of post-irradiation water spray. There were no significant differences between the 1- and 2-sec groups. CONCLUSION: It is suggested that the addition of water spray for 1 or more seconds after irradiation reduces post-irradiation temperature rise, possibly leading to thermal damage on the dental pulp tissue.

Irradiation time and ablation rate of enamel in contact and non-contact irradiation with Er:YAG laser.

OBJECTIVE: The relationship between changes in ablation rate of enamel with irradiation time was investigated to find the most effective irradiation time for tooth ablation by Er:YAG laser. BACKGROUND DATA: Previous studies have shown that the Er:YAG laser has the ability to ablate tooth material effectively, but that the efficiency and effectiveness of ablation are determined by various parameters such as energy, pulse frequency, the amount of water, and irradiation time. METHODS: Contact and non-contact irradiation of the Er:YAG laser were carried out respectively for 1, 3, 5, and 7 s on the enamel surface of each specimen using a combination of a 400 mJ/pulse at 20 Hz and water flow rate of 6.75 mL/min, and quantitative measurements using a mass balance were performed to compare the resulting ablation rates. RESULTS: The ablation weight, by taking the mean of both contact and non-contact irradiation, generally increased with irradiation exposure time, but no significant increases in ablation were seen in specimens that had been exposed for > 3 s in either the contact or non-contact irradiation group. Results in the non-contact irradiation group indicated superior ablation of enamel compared to that in the contact irradiation group. CONCLUSION: Irradiation exposure of < or = 3 s per application of laser beam is recommended to ablate enamel effectively in both non-contact and contact irradiation.

Urinary ascites and anuria caused by bilateral fungal balls in a premature infant.

A case is reported of anuria and urinary ascites secondary to bilateral ureteropelvic obstruction by fungal balls. Management consisted of bilateral nephrostomy drainage with local irrigation with amphotericin B, and systemic antifungal treatment without surgery. Aspiration by paracentesis was performed for the urinary ascites and continuous drainage through an 8 Fr pig tail catheter for the urinoma. The literature on renal fungus balls in neonates and infants is reviewed.

Two cases of perineal ectopic testis.

PURPOSE: Perineal ectopic testis is seen very rarely and here we report on two patients with perineal ectopic testis. METHODS/RESULTS: We experienced two cases of perineal ectopic testis on which orchiopexies to the corresponding hemiscrotums were performed. CONCLUSIONS: On surgical exploration, the gubernaculum testes were found to lie fixed to the perineum.