Novel Percutaneous Areola Reduction.

We present a novel percutaneous areola reduction technique that, to our knowledge, has never been used or published in the past. This technique is a useful solution to the downsides of the current most commonly used technique for areola reductions that uses a circumareolar incision. Our current technique utilizes a percutaneous approach, which is a minimally invasive procedure, and produces a virtually scarless result.

Gynecomastia: an outcome analysis.

BACKGROUND: Gynecomastia refers to the presence of femalelike mammary glands in a male. This disorder can lead to significant psychologic stress and self-consciousness. This study consists of a chart review of 174 patients treated surgically between July 1, 1976, and February 27, 2001. RESULTS: Operative procedures were excision, excision with suction-assisted lipectomy (SAL), SAL, skin excision (skin) and skin excision with SAL. Overall complication rate was 20%. No significant difference in complication rates was found between grades or procedures. Revision rates between grades were I = 10.3%, II = 14.5% and III = 34.8% (P < 0.001). In grade III, gynecomastia revision rates for excision +/- SAL was 29% and skin +/- SAL was 38.1% (P = 0.644). Of the 8 revisions in the skin-sparing procedures, 6 were revised with a scar-forming procedure. Therefore, 77% of patients with grade III gynecomastia were adequately treated with a skin-sparing procedure. CONCLUSION: Skin-sparing operations should be the initial procedure chosen for most grade III gynecomastia patients.

Sensitivity and specificity of clinical testing for carpal tunnel syndrome.

OBJECTIVE: The present study evaluated the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of carpal tunnel syndrome (CTS). METHODS: There were 29 carpal tunnel syndrome (CTS) subjects (mean age 48 years) and 30 control subjects (mean age 45 years). The six clinical tests included Tinel's sign, wrist flexion with fingers extended, wrist flexion with fingers flexed, wrist extension, combined wrist extension/median nerve pressure and combined wrist flexion/median nerve pressure. RESULTS: The highest sensitivity and highest negative predictive value was found with wrist flexion with pressure (96%) and wrist extension with pressure (94%) at 60 s. The highest specificity was found with wrist flexion with fingers flexed for 30 s (95%). The highest positive predictive values were found with the wrist flexion with fingers flexed test for 30 s (91%) and the wrist extension test for 30 s (90%). CONCLUSION: No one test possesses all the qualities necessary to be the ideal clinical test for the detection of carpal tunnel syndrome.

OBJECTIF: La présente étude a évalué la sensibilité, la spécificité et les valeurs prédictives de six épreuves cliniques dans le diagnostic du syndrome du canal carpien. MÉTHODOLOGIE: Il y avait 29 sujets atteints du syndrome du canal carpien (SCC) (âge moyen de 48 ans) et 30 sujets témoins (âge moyen de 45 ans). Les six épreuves cliniques incluaient le signe de Tinel, la flexion du poignet les doigts dépliés, la flexion du poignet les doigts fléchis, l'extension du poignet, l'extension du poignet combinée à la pression du nerf médian et la flexion du poignet combinée à la pression du nerf médian. RÉSULTATS: La sensibilité la plus élevée et la valeur prédictive la plus négative ont été découvertes au moyen de la flexion du poignet avec pression (96 %) et de l'extension du poignet avec pression (94 %) pendant 60 s. La spécificité la plus élevée a été établie avec la flexion du poignet les doigts fléchis pendant 30 s (95 %) et avec l'épreuve d'extension du poignet pendant 30 s (90 %). CONCLUSION: Aucune épreuve ne possède toutes les qualités nécessaires pour constituer l'épreuve clinique idéale permettant de déceler le syndrome du canal carpien.