ABSTRACT
Many cosmetic surgical procedures, including cervico facial liposuction, are appropriately performed by oral surgeons in conjunction with orthognathic and other reconstructive techniques. The technique can be safely and predictably used to remove localized deposits of fat from the face and neck of carefully selected patients. Cervicofacial liposuction adds little to overall operating time, and has few complications. The history and biology of this procedure are discussed.
Subject(s)
Face/surgery , Lipectomy , Neck/surgery , Adult , Esthetics, Dental , Face/anatomy & histology , Female , Humans , Lipectomy/instrumentation , Lipectomy/methods , Male , Neck/anatomy & histology , Orthognathic Surgical Procedures , Patient Care Planning , Postoperative ComplicationsABSTRACT
A patient was seen by a general practitioner for surgical removal of his third molar. A standard high-speed handpiece was used to remove the tooth. During the procedure, subcutaneous emphysema developed. Later the same day, the patient's swelling increased and his airway was compromised. The patient's condition, the differential diagnosis, etiological factors, and treatment of this condition are all detailed within this clinical report.
Subject(s)
Dental High-Speed Equipment/adverse effects , Emphysema/etiology , Subcutaneous Emphysema/etiology , Tooth Extraction/adverse effects , Adult , Humans , Male , Mandible , Molar, Third/surgery , Subcutaneous Emphysema/therapyABSTRACT
Particulate, nonresorbable hydroxylapatite is currently a popular implant material for the augmentation of atrophic alveolar ridges. Most reports have demonstrated favorable biocompatibility with common usage, but how the host bone will respond to the implant in the presence of an infection has not yet been investigated. Hydroxylapatite was implanted subperiosteally on one side of the mandible in four New Zealand White rabbits. After 3 months were allowed to elapse for stabilization of the implant, an infection was induced in both sides of each mandible by inoculation with Bacteroides melaninogenicus. One month later the animals were put to death and both sides of each mandible were examined microscopically. On the nonaugmented side there was total resolution of the infection. The side of each mandible containing the hydroxylapatite implant showed very mild chronic inflammation throughout the medullary space and periosteum. Although the number of animals used was small, the results suggest that the presence of the hydroxylapatite implant may have interfered with the host's ability to resolve the infection in the underlying bone. The possible mechanism of this interference is discussed.
Subject(s)
Bacteroides Infections , Hydroxyapatites , Mandible/surgery , Prostheses and Implants , Alveolar Ridge Augmentation , Animals , Bacteroides Infections/physiopathology , Biocompatible Materials , Connective Tissue/pathology , Durapatite , Mandible/pathology , Mandible/physiology , Osteitis/pathology , Osteomyelitis/pathology , Pilot Projects , Prevotella melaninogenica , Rabbits , Wound HealingABSTRACT
Previous manometric studies of the pylorus in humans have yielded conflicting data. These interstudy variations may be the result of differences in technique. It is also possible that pyloric pressure shows cyclic variations with the interdigestive motility complex. Pyloric pressure was monitored continuously for 300 min in 6 healthy men by means of a Dent sleeve. Gastroduodenal activity was measured simultaneously by using a perfused catheter system with two antral and two duodenal ports. With this method the pylorus was shown to have no elevation in basal pressure above baseline duodenal pressure during phase III. Basal pyloric pressure varied between subjects in phases I and II, being elevated in some but not in others. Subjects restudied on a separate day often showed a different pattern of activity. Pyloric pressure increased gradually in response to duodenal acidification. This response was blocked by pretreatment with naloxone. The pylorus also showed phasic activity, which was maximal in phase III. This phasic activity could not be distinguished from that of the adjacent antrum and duodenum. In conclusion, pyloric pressure patterns showed marked variation within and between subjects. These variations may explain some of the differences between previous studies.
Subject(s)
Pylorus/physiology , Adult , Duodenum/drug effects , Duodenum/physiology , Fasting , Fluoroscopy , Gastrointestinal Motility/drug effects , Humans , Hydrochloric Acid/pharmacology , Intubation, Gastrointestinal , Male , Manometry/methods , Middle Aged , Naloxone/pharmacology , PressureABSTRACT
The gastric emptying of liquids is determined by the pressure gradient between the stomach and the duodenum. This study monitored intragastric and intraduodenal pressures of 7 healthy volunteers during the gastric emptying of an acid meal (pH 2) and an oleate meal (50 mM) in comparison with the gastric emptying of a 154 mM saline meal (pH 7) in order to elucidate the mechanisms of delayed gastric emptying seen with the acid and the fatty meals. Antroduodenal motility was measured by means of a continuously perfused catheter system, and fundic pressure was monitored by means of a water-filled balloon. Gastric emptying was measured with the double sampling dye dilution technique. As expected, the gastric emptying of the pH 7 meal (t 1/2 = 2.2 +/- 0.7 min) was significantly faster than that of the acid (t 1/2 = 11 +/- 2.1 min) and the oleate (t 1/2 = 18 +/- 2 min) meals. The rapid gastric emptying of the neutral meal was consistently associated with a significant increase in tonic fundic pressure (p less than 0.05), a feature never seen with the acid and the oleate meals. There was no change in duodenal motility with the gastric emptying of the neutral meal, whereas duodenal activity did tend to increase with the acid and oleate meals. Thus the proximal stomach appears to be the main determinant of variations in the gastric emptying of liquids, whereas the duodenum appears to have a less prominent role.
