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1.
Micromachines (Basel) ; 14(6)2023 May 24.
Article in English | MEDLINE | ID: mdl-37374691

ABSTRACT

Currently, an urgent need in the field of wearable electronics is the development of flexible sensors that can be attached to the human body to monitor various physiological indicators and movements. In this work, we propose a method for forming an electrically conductive network of multi-walled carbon nanotubes (MWCNT) in a matrix of silicone elastomer to make stretchable sensors sensitive to mechanical strain. The electrical conductivity and sensitivity characteristics of the sensor were improved by using laser exposure, through the effect of forming strong carbon nanotube (CNT) networks. The initial electrical resistance of the sensors obtained using laser technology was ~3 kOhm (in the absence of deformation) at a low concentration of nanotubes of 3 wt% in composition. For comparison, in a similar manufacturing process, but without laser exposure, the active material had significantly higher values of electrical resistance, which was ~19 kOhm in this case. The laser-fabricated sensors have a high tensile sensitivity (gauge factor ~10), linearity of >0.97, a low hysteresis of 2.4%, tensile strength of 963 kPa, and a fast strain response of 1 ms. The low Young's modulus values of ~47 kPa and the high electrical and sensitivity characteristics of the sensors made it possible to fabricate a smart gesture recognition sensor system based on them, with a recognition accuracy of ~94%. Data reading and visualization were performed using the developed electronic unit based on the ATXMEGA8E5-AU microcontroller and software. The obtained results open great prospects for the application of flexible CNT sensors in intelligent wearable devices (IWDs) for medical and industrial applications.

2.
Bioengineering (Basel) ; 9(1)2022 Jan 13.
Article in English | MEDLINE | ID: mdl-35049745

ABSTRACT

This article describes the manufacturing technology of biocompatible flexible strain-sensitive sensor based on Ecoflex silicone and multi-walled carbon nanotubes (MWCNT). The sensor demonstrates resistive behavior. Structural, electrical, and mechanical characteristics are compared. It is shown that laser radiation significantly reduces the resistance of the material. Through laser radiation, electrically conductive networks of MWCNT are formed in a silicone matrix. The developed sensor demonstrates highly sensitive characteristics: gauge factor at 100% elongation -4.9, gauge factor at 90° bending -0.9%/deg, stretchability up to 725%, tensile strength 0.7 MPa, modulus of elasticity at 100% 46 kPa, and the temperature coefficient of resistance in the range of 30-40 °C is -2 × 10-3. There is a linear sensor response (with 1 ms response time) with a low hysteresis of ≤3%. An electronic unit for reading and processing sensor signals based on the ATXMEGA8E5-AU microcontroller has been developed. The unit was set to operate the sensor in the range of electrical resistance 5-150 kOhm. The Bluetooth module made it possible to transfer the received data to a personal computer. Currently, in the field of wearable technologies and health monitoring, a vital need is the development of flexible sensors attached to the human body to track various indicators. By integrating the sensor with the joints of the human hand, effective movement sensing has been demonstrated.

3.
Spectrochim Acta A Mol Biomol Spectrosc ; 227: 117682, 2020 Feb 15.
Article in English | MEDLINE | ID: mdl-31672377

ABSTRACT

The results of the study of composites based on bovine serum albumin (BSA) and single-walled carbon nanotubes (SWCNT) are presented. Nanocomposites were created by evaporation of the water-albumin dispersion with nanotubes using diode laser with temperature control. Two types of nanotubes were used. SWCNT I were synthesized using the electric arc method, SWCNT II were synthesized using the gas phase method. SWCNT I had a diameter and length less than SWCNT II. The mechanism of interaction between BSA and SWCNT in solid nanocomposites is considered. An experimental and theoretical studies of the interaction between aspartic (Asp) and glutamic (Glu) amino acids located on the outer surface of BSA and nanotubes using of vibrational spectroscopy (Fourier-transform infrared (FTIR) and Raman spectroscopy) was carried out. The possibility of nanotubes functionalization by oxygen atoms of negative amino acid residues Asp and Glu, which are on the outer surface of BSA, is shown by molecular modeling. The formation of covalent bonds between BSA and SWCNT in nanocomposites with different concentrations of nanotubes (0.01, 0.1 and 1 g/l) was confirmed by vibrational spectra. The covalent interaction between BSA with SWCNT under the laser irradiation leads to the conformational changes in the secondary and tertiary structures of albumin. This is confirmed by a significant decrease in the intensity of the absorption bands in the high-frequency region. The calculation of the vibrational spectra of the three Glycine:Glycine, Glutamic acid:Threonine and Aspartic acid:Lysine complexes, which take into account hydrogen, ion-dipole and ion-ion bonds, showed that a disturbance in the intermolecular interaction between amino acid residues led to significant decrease in the intensity of absorption bands in the region of stretching vibrations bonds OH and NH. From the Raman spectra, it was found that a significant number of defects in SWCNT is caused by the covalent attachment of oxygen atoms to the graphene surface of nanotubes. An increase in the diameter of nanotubes (4 nm) has practically no effect on the absorption spectrum of nanocomposite, while measuring the concentration of SWCNT affects the FTIR spectra. This confirmed the hydrophobic interaction between BSA and SWCNT. Thus, it was shown that BSA solid nanocomposites with CNTs can interact either with the help of hydrophobic forces or with the formation of covalent bonds, which depends on the diameter of the used nanotubes. The viability of connective fibroblast tissue cells on nanocomposites with both types of SWCNT was demonstrated. It was found that nanocomposites based on SWCNT I provide slightly better compatibility of their structure with fibroblasts. It allows to achieve better cell adhesion to the nanocomposite surface. These criteria make extensive use of scaffold nanocomposites in biomedicine, depending on the requirements for their quality and application.


Subject(s)
Nanocomposites/chemistry , Nanotubes, Carbon/chemistry , Serum Albumin, Bovine/metabolism , Spectrum Analysis, Raman , Vibration , Animals , Cattle , Cell Line , Cell Survival , Fibroblasts/cytology , Fibroblasts/ultrastructure , Humans , Nanotubes, Carbon/ultrastructure , Particle Size , Protein Binding , Protein Domains , Quantum Theory , Serum Albumin, Bovine/chemistry , Spectroscopy, Fourier Transform Infrared
4.
Magn Reson Imaging ; 52: 24-32, 2018 10.
Article in English | MEDLINE | ID: mdl-29857037

ABSTRACT

MR in microscopy can non-invasively image the morphology of living tissue, which is of particular interest in studying the mammalian brain. Many studies use live animals for basic research on brain functions, disease pathogenesis, and drug development. However, in vitro systems are on the rise, due to advantages such as the absence of a blood-brain barrier, predictable pharmacokinetics, and reduced ethical restrictions. Hence, they present an inexpensive and adequate technique to answer scientific questions and to perform drug screenings. Some publications report the use of acute brain slices for MR microscopy studies, but these only permit single measurements over several hours. Repetitive MR measurements in longitudinal studies demand an MR-compatible setup which allows cultivation for several days or weeks, and hence properly functioning in vitro systems. Organotypic hippocampal slice cultures (OHSC) are a well-established and robust in vitro system which still exhibits most histological hallmarks of the hippocampal network in vivo. An MR compatible incubation platform is introduced in which OHSC are cultivated according to the interface method following Stoppini et al. In this cultivation method a tissue slice is placed onto a membrane with nutrition medium underneath and a gas atmosphere above, where the air-tissue interface perpendicular to the B0 field induces strong artefacts. We introduce a handling protocol that suppresses these artefacts and increases signal quality significantly to acquire high resolution images of tissue slices. An additional challenge is the lack of available of MR microscopy equipment suitable for small animal scanners. A Lenz lens with an attached capacitor can dramatically increase the SNR in these cases, and wirelessly bring the detection system in close proximity to the sample without compromising the OHSC system through the introduction of wired detectors. The resultant signal gain is demonstrated by imaging a PFA-fixed brain slice with a 72 mm diameter volume coil without a Lenz lens, and with a broadband and a self-resonant Lenz lens. In our setting, the self-resonant Lenz lens increases the SNR 10-fold over using the volume coil only.


Subject(s)
Brain/diagnostic imaging , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Animals , Artifacts , In Vitro Techniques , Mice , Microscopy , Models, Animal
5.
Ann Chir Plast Esthet ; 62(1): 109-112, 2017 Feb.
Article in French | MEDLINE | ID: mdl-27156132

ABSTRACT

Embedded ring injury is a rare condition often associated with mental illness or cognitive disorders. Clinical presentation varies from simple oedema to serious neurovascular deficits. We report the unusual case of a 69-year-old woman presenting with two embedded ring injuries. The rings had been in place for over 20 years, however she had no past medical history of psychiatric or neurological disorder. A non-invasive approach was decided to treat the patient by simply cutting the rings allowing to resolve the situation without further morbidity.


Subject(s)
Finger Injuries/etiology , Foreign Bodies/complications , Jewelry/adverse effects , Love , Metaphor , Aged , Edema/etiology , Female , Finger Injuries/pathology , Finger Injuries/therapy , Foreign Bodies/diagnosis , Foreign Bodies/therapy , Humans , Ischemia/etiology , Mental Competency , Treatment Outcome
6.
Ann Chir Plast Esthet ; 61(2): 136-40, 2016 Apr.
Article in French | MEDLINE | ID: mdl-26321309

ABSTRACT

OBJECTIVES: The treatment of malar mounds is challenging. We report a case series of direct excision of malar mounds and review the existing literature. MATERIAL AND METHODS: The procedure is carried out under local anesthesia with light sedation. A pinch test allows to estimate the width of the resection. The skin is resected, and if needed, some of the sub-orbicularis oculi fat. The orbicularis muscle is not closed, and the skin is closed in two layers. RESULTS: Eight patients were treated by the same surgeon between January and December 2013. The ages ranged from 41 to 74, with an average of 53. The patients were highly satisfied. The results were considered excellent for 5 patients and good for 3. There were no complications, in particular no scleral show, no ectropion, and no hematoma. CONCLUSION: Direct excision of malar mounds is simple, efficient, and reproducible. The scars are most often inconspicuous, in particular in the elderly.


Subject(s)
Blepharoplasty/methods , Aged , Humans , Middle Aged , Oculomotor Muscles/surgery , Patient Satisfaction , Photography , Retrospective Studies
7.
Neurology ; 73(23): 2018-22, 2009 Dec 08.
Article in English | MEDLINE | ID: mdl-19996076

ABSTRACT

OBJECTIVE: Idiopathic generalized epilepsies (IGE) are characterized by specific EEG changes including 3- to 5-Hz generalized spike-and-wave discharges. The thalamus and its cortical interactions are considered essential in the production and propagation of spike-and-wave discharges. In animal studies, corticoreticular and limbic system property changes have been observed in absence seizures and during spike-and-wave discharges and suggest the involvement of different types of thalamic nuclei. With the development of deep brain stimulation in epilepsy, the role of the thalamic nuclei needs to be clarified in human IGE. METHODS: Ten patients with IGE were recorded using 3T EEG-fMRI during spike-and-wave discharges. Hemodynamic response functions were calculated for 4 regions of interest corresponding to the anterior thalamic and centromedian and parafascicular (CM-Pf) nuclei of each thalamus. The time to peak of the hemodynamic response function was compared within thalamic structures (left compared to right) and between structures (anterior thalamic compared to CM-Pf nucleus). RESULTS: CM-Pf and anterior nucleus are both activated during GSWDs. However, the positive time to peak in the CM-Pf (4.4 +/- 2.5 s) occurred significantly earlier than in the anterior nucleus (7.6 +/- 3.2 s). CONCLUSIONS: We demonstrated in humans the involvement of the centromedian and parafascicular part of the corticoreticular system and of the anterior nucleus part of the limbic system during generalized spike-and-wave discharges. The different time courses suggest that the posterior intralaminar nuclei may be involved in epileptic discharge initiation or early propagation, while the anterior nucleus may only play a role in its maintenance. These results may help to understand the clinical effect of deep brain stimulation within thalamic nuclei in intractable idiopathic generalized epilepsy patients.


Subject(s)
Electroencephalography , Epilepsy, Generalized/diagnosis , Epilepsy, Generalized/physiopathology , Magnetic Resonance Imaging , Thalamic Nuclei/physiology , Adolescent , Adult , Electroencephalography/methods , Female , Humans , Magnetic Resonance Imaging/methods , Male , Young Adult
8.
Neurology ; 73(23): 2023-30, 2009 Dec 08.
Article in English | MEDLINE | ID: mdl-19996077

ABSTRACT

OBJECTIVE: In patients with nonlesional frontal lobe epilepsy (FLE), the delineation of the epileptogenic zone is difficult. Therefore these patients are often not considered for surgery due to an unclear seizure focus. The aim of this study was to investigate whether EEG-fMRI can add useful information in the preoperative evaluation of these patients. METHODS: Nine nonlesional FLE patients were studied with EEG-fMRI using a 3 T scanner. Spike-related blood oxygen level dependent (BOLD) signal changes were compared to the topography of the spikes and to PET and SPECT results if available. The structural MRIs were reviewed for subtle abnormalities in areas that showed BOLD responses. For operated patients, postoperative resection and histology were compared to BOLD responses. RESULTS: Concordance between spike localization and positive BOLD response was found in 8 patients. PET and SPECT investigations corresponded with BOLD signal changes in 6 of 7 investigations. In 2 cases, reviewing the structural MRI guided by EEG-fMRI data resulted in considering a suspicious deep sulcus. Two patients were operated. In 1, the resected cortex corresponded with the suspicious sulcus and fMRI results and histology showed cortical dysplasia. In another, histology revealed an extended microdysgenesis not visible on structural MRI. EEG-fMRI had shown activation just adjacent to the resected pathologic area. CONCLUSIONS: Our study provides different types of support (topography, concordance with PET and SPECT, structural peculiarities, postoperative histology) that EEG-fMRI may help to delineate the epileptic focus in patients with nonlesional frontal lobe epilepsy, a challenging group in the preoperative evaluation.


Subject(s)
Electroencephalography/methods , Epilepsy, Frontal Lobe/diagnosis , Epilepsy, Frontal Lobe/physiopathology , Magnetic Resonance Imaging/methods , Epilepsy, Frontal Lobe/surgery , Humans , Preoperative Care/methods
9.
HIV Med ; 10(5): 263-8, 2009 May.
Article in English | MEDLINE | ID: mdl-19178590

ABSTRACT

OBJECTIVES: Antiretroviral therapy has dramatically improved the survival of HIV-infected children. Nevertheless, side effects comparable to those found in adults have been encountered, such as facial lipoatrophy, which can have a negative impact on the self-esteem of otherwise healthy adolescents. Cosmetic surgical procedures in adolescents raise psychological issues which need to be specifically addressed and which have never been previously reported in this population. We evaluated the patient satisfaction, safety and cosmetic results of HIV-infected adolescents who experienced autologous fat transplants for the correction of facial lipoatrophy. METHODS: We report the results of plastic surgery using autologous fat transplants (Coleman's Lipostructure) in six HIV-infected adolescents with facial lipoatrophy: three boys and three girls, aged 14-19 years. RESULTS: The quantity of reinjected fat on each side of the face varied from 5 to 12 mL within a single procedure. All the patients reported being satisfied or very satisfied with the cosmetic results and reported a positive impact on their daily life. CONCLUSIONS: With well-trained surgeons and carefully selected indications, corrective surgery of facial lipoatrophy in HIV-infected adolescents can provide immediate and long-lasting benefits in terms of physical appearance and psychological wellbeing, and should be considered as a component of comprehensive care.


Subject(s)
Adipose Tissue/transplantation , Anti-HIV Agents/adverse effects , Cosmetic Techniques , HIV-Associated Lipodystrophy Syndrome/surgery , Stavudine/adverse effects , Adolescent , Adult , Antiretroviral Therapy, Highly Active/adverse effects , Body Image , Child , Face , Female , HIV Infections/drug therapy , HIV-Associated Lipodystrophy Syndrome/chemically induced , HIV-Associated Lipodystrophy Syndrome/psychology , Humans , Male , Patient Satisfaction , Quality of Life , Self Concept , Transplantation, Autologous , Treatment Outcome , Young Adult
10.
Brain ; 131(Pt 8): 2042-60, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18669486

ABSTRACT

Malformations of cortical development (MCDs) are commonly complicated by intractable focal epilepsy. Epileptogenesis in these disorders is not well understood and may depend on the type of MCD. The cellular mechanisms involved in interictal and ictal events are notably different, and could be influenced independently by the type of pathology. We evaluated the relationship between interictal and ictal zones in eight patients with different types of MCD in order to better understand the generation of these activities: four had nodular heterotopia, two focal cortical dysplasia and two subcortical band heterotopia (double-cortex). We used the non-invasive EEG-fMRI technique to record simultaneously all cerebral structures with a high spatio-temporal resolution. We recorded interictal and ictal events during the same session. Ictal events were either electrical only or clinical with minimal motion. BOLD changes were found in the focal cortical dysplasia during interictal and ictal epileptiform events in the two patients with this disorder. Heterotopic and normal cortices were involved in BOLD changes during interictal and ictal events in the two patients with double cortex, but the maximum BOLD response was in the heterotopic band in both patients. Only two of the four patients with nodular heterotopia showed involvement of a nodule during interictal activity. During seizures, although BOLD changes affected the lesion in two patients, the maximum was always in the overlying cortex and never in the heterotopia. For two patients intracranial recordings were available and confirm our findings. The dysplastic cortex and the heterotopic cortex of band heterotopia were involved in interictal and seizure processes. Even if the nodular gray matter heterotopia may have the cellular substrate to produce interictal events, the often abnormal overlying cortex is more likely to be involved during the seizures. The non-invasive BOLD study of interictal and ictal events in MCD patients may help to understand the role of the lesion in epileptogenesis and also determine the potential surgical target.


Subject(s)
Cerebral Cortex/abnormalities , Electroencephalography , Epilepsy/pathology , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Adult , Child , Epilepsy/physiopathology , Female , Humans , Male , Middle Aged
11.
Brain ; 129(Pt 6): 1593-608, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16632553

ABSTRACT

Discrete high-frequency oscillations (HFOs) in the range of 100-500 Hz have previously been recorded in human epileptic brains using depth microelectrodes. We describe for the first time similar oscillations in a cohort of unselected focal epileptic patients implanted with EEG macroelectrodes. Spectral analysis and visual inspection techniques were used to study seizures from 10 consecutive patients undergoing pre-surgical evaluation for medically refractory focal epilepsy. Four of these patients had focal seizure onset in the mesial temporal lobe, and in all 12 of their seizures, well-localized, segmental, very high frequency band (VHF: 250-500 Hz) oscillations were visually identified near the time of seizure onset from contacts in this zone. Increased high-frequency band (HF: 100-200 Hz) activity compared with the background was distinguished both visually and with spectral analysis later in the seizures of 3/4 mesial temporal patients, involving contacts in the generator region and, in one patient, areas of contralateral peri-hippocampal propagation. Three patients with well-defined neocortical seizure-onset areas also demonstrated focal HF or VHF oscillations confined to the seizure-onset channels during their eight seizures. No discrete HF or VHF activity was present in the poorly localized seizures from the remaining three patients. These results show that discrete HFOs can be recorded from human focal epileptic brain using depth macroelectrodes, and that they occur mostly in regions of primary epileptogenesis and rarely in regions of secondary spread. Absent high-frequency activity seems to indicate poor localization, whereas the presence of focal HFOs near the time of seizure onset may signify proximity to the epileptogenic focus in mesial temporal lobe and neocortical seizures. We postulate that focal HFOs recorded with depth macroelectrodes reflect the partial synchronization of very local oscillations such as those previously studied using microelectrodes, and result from interconnected small neuronal ensembles. Our finding that localized HFOs occur in varying anatomical structures and pathological conditions perhaps indicates commonality to diverse epileptogenic aetiologies.


Subject(s)
Brain/physiopathology , Epilepsies, Partial/physiopathology , Adult , Biological Clocks , Brain Mapping , Electrodes, Implanted , Electroencephalography , Female , Humans , Male , Middle Aged , Signal Processing, Computer-Assisted
12.
Clin Neurophysiol ; 117(4): 912-27, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16458594

ABSTRACT

OBJECTIVE: To devise an automated system to remove artifacts from ictal scalp EEG, using independent component analysis (ICA). METHODS: A Bayesian classifier was used to determine the probability that 2s epochs of seizure segments decomposed by ICA represented EEG activity, as opposed to artifact. The classifier was trained using numerous statistical, spectral, and spatial features. The system's performance was then assessed using separate validation data. RESULTS: The classifier identified epochs representing EEG activity in the validation dataset with a sensitivity of 82.4% and a specificity of 83.3%. An ICA component was considered to represent EEG activity if the sum of the probabilities that its epochs represented EEG exceeded a threshold predetermined using the training data. Otherwise, the component represented artifact. Using this threshold on the validation set, the identification of EEG components was performed with a sensitivity of 87.6% and a specificity of 70.2%. Most misclassified components were a mixture of EEG and artifactual activity. CONCLUSIONS: The automated system successfully rejected a good proportion of artifactual components extracted by ICA, while preserving almost all EEG components. The misclassification rate was comparable to the variability observed in human classification. SIGNIFICANCE: Current ICA methods of artifact removal require a tedious visual classification of the components. The proposed system automates this process and removes simultaneously multiple types of artifacts.


Subject(s)
Artifacts , Bayes Theorem , Electroencephalography/methods , Epilepsy/diagnosis , Scalp/physiology , Signal Processing, Computer-Assisted/instrumentation , Algorithms , Electrodes/standards , Epilepsy/physiopathology , Evoked Potentials/physiology , Humans , Reaction Time/physiology , Time Factors
13.
Clin Neurophysiol ; 117(3): 549-61, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16461002

ABSTRACT

OBJECTIVE: To apply independent component analysis (ICA) in intracranial recordings to analyze interactions during temporal lobe seizures. METHODS: Seizures from 20 patients with bitemporal implantation were classified as unilateral or bilateral and analyzed with ICA. During the period preceding bilateral activity, correlation coefficients were calculated between ICA components having ictal activity during the unilateral seizure phase (early ICA components) and every channel of the original EEG. ICA components were classified as unilateral if the correlation was >0.2 exclusively with channels in one hemisphere; and bilateral if both hemispheres were involved. RESULTS: One hundred twenty-three seizures were analyzed. Thirty-two percent of visually classified unilateral seizures and 64% of bilateral seizures (during the unilateral phase) had bilateral ICA components. The proportion of early ICA components that were bilateral and the proportion of channels contralateral to the visually identified seizure with correlation higher than 0.2 with at least one early ICA component were significantly lower in seizures that stayed unilateral than in seizures that later became bilateral by visual inspection (11 and 10%, respectively, in unilateral seizures; 33 and 28% in bilateral seizures; P=0.001). CONCLUSIONS: In patients with bitemporal epilepsy, approximately 20% of the components extracted using ICA have a bitemporal distribution even at the time when the seizures are apparently unilateral. The presence of early contralateral ictal activity is more frequent and extensive in seizures that later become evidently bilateral. SIGNIFICANCE: Minimal contralateral seizure activity is present even when the discharge appears unilateral and this is more frequent in seizures which later spread to the contralateral temporal lobe.


Subject(s)
Epilepsy, Temporal Lobe/physiopathology , Functional Laterality/physiology , Temporal Lobe/physiopathology , Adult , Brain Mapping , Electroencephalography/methods , Female , Humans , Male
16.
J Pharm Biomed Anal ; 27(5): 845-9, 2002 Feb 01.
Article in English | MEDLINE | ID: mdl-11814728

ABSTRACT

Ferrocene-A (ferrocenyl-1-phenyl-1-dioxy-1,4-butin-2) has significant antitumour and antibacterial properties. This study was designed to estimate main pharmacokinetic parameters of ferrocene-A (FC-A). These parameters are very important from the standpoint to elucidate the mechanism of pharmacological action of ferrocene-A. Examined substance was administrated intramuscularly and orally to rabbits. For determination of small quantities of ferrocene-A in a blood plasma liquid-liquid extraction and reversed-phase high performance liquid chromatography (HPLC) method was applied. Kinetic parameters were estimated using the one-compartment linear pharmacokinetic model.


Subject(s)
Ferrous Compounds/blood , Ferrous Compounds/pharmacokinetics , Administration, Oral , Animals , Chromatography, High Pressure Liquid/methods , Ferrous Compounds/administration & dosage , Injections, Intramuscular , Male , Metallocenes , Rabbits
18.
Plast Reconstr Surg ; 106(7): 1614-8; discussion 1619-23, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11129195

ABSTRACT

A retrospective study was done on a population of 258 women who had undergone surgery for abdominal dermolipectomy between January of 1991 and May of 1996. The postoperative complications and flaws seen at long-term follow-up are discussed. The surgical techniques used, with or without lipoaspiration, were the infraumbilical plasty and full plasties with horizontal or inverted T scars. Six types of postoperative complications were noted: hemorrhage in 1.2 percent, lymphorrhea in 10.9 percent, infection in 7 percent, skin necrosis in 6.6 percent, secondary dehiscence of the scar in 2.3 percent, and thromboembolic accidents in 1.2 percent. No significant difference was found in the rate of necrosis development between patients who did and did not undergo lipoaspiration. However, a statistically significant difference was seen in the rate of skin necrosis between the T-type plasty (35.5 percent) and the other two procedures (1.43 percent for infraumbilical plasties and 4.60 percent for full plasties with horizontal scar). With regard to the flaws found at long-term follow-up, the rate of above-scar fat folds and/or dog-ears was 27.9 percent, and the rate of defective scars was 26 percent. No significant difference was found with regard to the rate of flaws. The rate of all secondary surgical procedures was 29.1 percent, but performance of secondary procedures depended on the willingness of the patient and on the surgeon's judgment. Abdominoplasty procedures involve a high risk of early complications. The rate of skin necrosis is clearly augmented in cases of T-type plasty. The need for secondary surgical correction is frequent, and the patient should be reminded of this possibility during preoperative consultation.


Subject(s)
Abdomen/surgery , Dermatologic Surgical Procedures , Lipectomy/adverse effects , Postoperative Complications , Adipose Tissue/pathology , Adolescent , Adult , Aged , Cicatrix/etiology , Female , Follow-Up Studies , Humans , Longitudinal Studies , Lymph/metabolism , Middle Aged , Necrosis , Postoperative Hemorrhage/etiology , Reoperation , Retrospective Studies , Skin/pathology , Surgical Wound Dehiscence/etiology , Surgical Wound Infection/etiology , Thromboembolism/etiology , Treatment Outcome
19.
Congest Heart Fail ; 6(3): 146-151, 2000.
Article in English | MEDLINE | ID: mdl-12029182

ABSTRACT

The congestive heart failure continuum was developed in collaboration with the medical management committee of our hospital in response to a need to decrease readmissions for this chronic and progressive disease. This is accomplished via a multidisciplinary team that provides education and long-term telemanagement, as well as care management to assist these patients in maintaining an optimum level of functioning and the ability to remain in their homes for as long as possible. Since October 1996 there have been 375 patients referred with a decrease in the 31-day readmission rate from 21% to an average of 5%. Costs are presently $55.00 per month per patient. Evaluation of the congestive heart failure phone management tool revealed a strong 77% positive correlation between the patient's score and the number of interventions needed to stabilize the patient. Care management visits, when necessary, help reduce the need for hospitalization. (c)2000 by CHF, Inc.

20.
Ann Chir Plast Esthet ; 43(1): 82-6, 1998 Feb.
Article in French | MEDLINE | ID: mdl-9768097

ABSTRACT

The purpose of this study was to assess the cost of a minimal surgical operation: skin surgery under local anesthesia in the outpatients department. A two-month prospective study was carried out on 149 operations, with a mean duration of 33 minutes. The mean cost of the operation was 434 FF. Although this study is very specific and its results cannot be generalized, it gives a method and an order of magnitude. It shows that it is difficult to save money without decreasing the quality of the operation. The price list of the French national health care system, and the price of the surgeon himself are discussed.


Subject(s)
Ambulatory Surgical Procedures/economics , Anesthesia, Local/economics , Health Care Costs , Minor Surgical Procedures/economics , Skin Diseases/surgery , Sutures/economics , France , Hospitals, Public/economics , Humans , Skin Diseases/economics
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