scholarly journals Second Generation Self-Inflating Tissue Expanders: A Two-Year Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Jamal Omran Al Madani
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Normal Skin ◽  
Tissue Expansion ◽  
Clinic Visit ◽  
Plastic Shell ◽  
Burn Scar ◽  
Tissue Expanders ◽  
Great Reliability ◽  
Attractive Option

Background. Tissue expansion is a well-established surgical technique that produces an additional amount of normal skin to cover a defect. This technique is appealing because the skin quality and color are from the patient’s own. The widely used injectable expanders are of great reliability but carry the disadvantage of being painful during injection and most of the time require multiple clinic visits. So the idea of self-inflation became attractive and hydrogel expanders were developed and became widely known for being painless during clinic visit and decrease number of visits. The first generation expanders were modified by adding an enclosing plastic shell to decrease the unopposed expansion that occurred in the first generation expanders, which lead to pressure necrosis of the skin flaps. This made it an attractive option for tissue expansion in children and some adult patients. Patients, Materials, and Methods. Charts of 17 patients were retrospectively reviewed, all of them had second generation self-inflating expanders implanted over a 2-year period for one of two purposes, the treatment of giant nevi or burn scars. Results. Fifteen patients were females and 2 were males. The indication was large burn scar in 14 cases (14/17), in which 47/55 expanders were implanted, and giant nevus in 3/17 cases in which 8/55 expanders were implanted. Extrusion of the expander occurred in 8/55 expanders (14.5%), which occurred in 6/14 patients. The highest percentage of extrusion occurred in the neck in which two out of three expanders extruded; otherwise this complication does not seem to be related to the indication, gender, nor age of the patients. It seems to be that it is technical in nature. The patients did not have to get any injections to fill the tissue expanders, which made the expansion process less painful and more convenient. Conclusion. This seems to be currently the largest published review in which second generation expanders were used. Those expanders seem to offer a desirable advantage of being painless for children, also they do not require repeated visits to the surgeon’s clinic, which is of great value for patients living in the periphery.

Second-generation self-inflating tissue expanders: a new dimension in tissue expansion

2019 ◽  
Vol 32 (4) ◽  
pp. 1313
Author(s):  
IbrahimA Soliman ◽  
TarekF Kishk ◽  
DaliaM El Sakka ◽  
AshrafM Al Rahawy
Keyword(s):  
Second Generation ◽  
Tissue Expansion ◽  
Tissue Expanders

The Use of Autologous Fat Transplantation to Remedy the Iatrogenic Lipoatrophic Effect of Tissue Expanders

2005 ◽  
Vol 22 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Riad Roomi
Keyword(s):  
Case Report ◽  
Normal Skin ◽  
Tissue Expansion ◽  
Premalignant Lesions ◽  
Treatment Modalities ◽  
Fat Transplantation ◽  
Autologous Fat ◽  
Tissue Expanders ◽  
Autologous Fat Transplantation ◽  
Arm Circumference

Introduction: Tissue expanders have become a popular modality in plastic and cosmetic surgery. Many victims of burns and severe trauma, premalignant lesions, congenital malformations, unwanted or regretted tattoos over large areas, women undergoing postmastectomy breast reconstruction, or men with extensive male-pattern alopecia may seek treatments that use tissue-expansion techniques. Tissue expansion has been an excellent tool for expanding normal skin to provide good quality, cosmetically appealing, full-thickness skin coverage of defective areas. However, like most treatment modalities, tissue expanders have some undesired pitfalls, sequelae, and complications associated with their use. We used autologous fat transplantation to remedy asymmetrical arm circumference after skin expansion on one arm and report our results in this case report. Case Report and Procedure: The patient is a 16-year-old female who presented with a congenital hairy nevus measuring 6.5 × 5.5 cm in the middle part of the posterolateral aspect of her left arm. Treatment included the use of tissue expanders, followed by excision of the nevus to treat the area. After the treatment, the patient complained that her left arm had become thinner than the right. Circumference of both arms measured at symmetrical points revealed a variance of 3 cm. Autologous fat transplant surgery, with a slight overcorrection that was expected to reduce over time, was offered as a solution. Conclusions: Autologous fat transplantation can be used as an adjunct to tissue expansion to fill the lipo-atrophic defects that may result from tissue expansion. Results: Postoperative follow up revealed sound healing of the wound. Her left arm circumference decreased over the following 6 weeks postoperatively (the overcorrection). The final result was symmetrical arms, both visually and numerically.

Do remittances differ depending on migration pathway and length of stay?

2016 ◽  
Vol 1 (1) ◽  
pp. 105-118
Author(s):  
Anita Pugliese ◽  
Julie Ray ◽  
Neli Esipova
Keyword(s):  
Length Of Stay ◽  
First Generation ◽  
Second Generation ◽  
Global Analysis ◽  
Large Sample ◽  
Migration Pathway ◽  
First Generation Migrants ◽  
Second Generation Migrants

This paper reports the results from Gallup’s global analysis of the likelihood of first-generation migrants, second-generation migrants and the native-born to send financial help in the form of money or goods to others inside or outside their respective country of residence. The findings in this paper are based on more than 450,000 interviews conducted through Gallup’s World Poll in 157 countries in 2012, 2013 and 2014. The sample includes more than 26,000 first-generation migrants and more than 20,000 second-generation migrants. The large sample enables Gallup to analyze first-generation migrants by the duration of their stay in their adopted country and compare their remittance behaviors with second-generation migrants and the native-born.

Marcuse and Habermas's Political Ideas in English

2019 ◽  
pp. 215
Author(s):  
Asaad Abdullwahab AbdulKarim ◽  
Waleed Massaher Hamad ◽  
Salah Ibrahim Hamadi
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Frankfurt School ◽  
Western Thought ◽  
Political Ideas ◽  
Important Impact

Abstract     The Frankfurt School is characterized by its critical nature and it is the result of the Marxist socialist thought as it contributed to the development of the German thought in particular and the Western thought in general through important ideas put forward by a number of pioneers in the various generations of the school and most notably through the leading pioneer in the first generation, Marcuse, and the leading pioneer of the second  generation, Habermas, whose political ideas had an important impact on global thinking and later became the basis of the attic of many critical ideas. In spite of the belief of the school members in the idea of the criticism of power and community, each had his own ideas that distinguish him from the others.

Pharmakotherapie update

2020 ◽  
Vol 25 (1) ◽  
pp. 23-32
Author(s):  
Gerd Laux
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Therapeutische Maßnahmen ◽  
Second Generation Antipsychotics

Für die Therapie schizophrener Erkrankungen sind seit fast 60 Jahren Antipsychotika/Neuroleptika aufgrund ihrer antipsychotischen Wirkung von zentraler Bedeutung. Die Einteilung kann unter verschiedenen Gesichtspunkten erfolgen (chemische Struktur, neuroleptische Potenz, Rezeptorprofil), heute werden üblicherweise unterschieden typische (traditionelle, klassische, konventionelle) Antipsychotika der ersten Generation ‒ »First Generation Antipsychotics« (FGA) ‒ und sog. atypische (»neuere«) Neuroleptika bzw. Antipsychotika der zweiten Generation ‒»Second Generation Antipsychotics« (SGA). Hierzu zählen Aripiprazol, Asenapin, Cariprazin, Clozapin, Olanzapin, Quetiapin, Risperidon, Sertindol und Ziprasidon. Hierbei handelt es sich um keine homogene Gruppe – sowohl neuropharmakologisch (Wirkmechanismus), als auch hinsichtlich klinischem Wirkprofil und dem Nebenwirkungsspektrum bestehen z. T. erhebliche Unterschiede. Neben der Akut-Medikation ist eine Langzeitmedikation bzw. Rezidivprophylaxe mit Antipsychotika für die Rehabilitation vieler schizophrener Patienten im Sinne eines »Stresspuffers« von grundlegender Bedeutung. In Placebo-kontrollierten Studien trat bei Patienten, die über ein Jahr behandelt wurden, bei etwa 30% unter Neuroleptika ein Rezidiv auf, unter Placebo bei mehr als 70%. Für die Langzeitbehandlung bietet sich der Einsatz von Depot-Neuroleptika an, neu entwickelt wurden Langzeit-Depot-Injektionen mit Intervallen von bis zu 3 Monaten. Grundsätzlich ist die niedrigstmögliche (wirksame) Dosis zu verwenden. Im Zentrum der Nebenwirkungen (UAW) standen lange Zeit extrapyramidal-motorische Bewegungsstörungen (EPMS), mit der Einführung von Clozapin und anderen atypischen Antipsychotika der zweiten Generation gewannen andere Nebenwirkungen an Bedeutung. Hierzu zählen Gewichtszunahme, Störungen metabolischer Parameter und ein erhöhtes Risiko für Mortalität und zerebrovaskuläre Ereignisse bei älteren Patienten mit Demenz. Entsprechende Kontrolluntersuchungen sind erforderlich, für Clozapin gibt es aufgrund seines Agranulozytose-Risikos Sonderbestimmungen. Immer sollte ein Gesamtbehandlungsplan orientiert an der neuen S3-Praxisleitlinie Schizophrenie der DGPPN aufgestellt werden, der psychologische und milieu-/sozial-therapeutische Maßnahmen einschließt. Standard ist heute auch eine sog. Psychoedukation, für Psychopharmaka liegen bewährte Patienten-Ratgeber vor.

The Inheritors’ Coming of Age

2018 ◽  
Author(s):  
Elisabeth Schimpfössl
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Coming Of Age ◽  
Next Generation ◽  
Privileged Status ◽  
The Rich

Chapter 7 focuses on the upbringing of the second generation of the Russian bourgeoisie. As the first generation of wealthy Russians grows older, they are becoming more aware of their own mortality and are preparing to hand over their wealth to the next generation. It seems that rich Russians are yet to find a convincing narrative to justify their children’s legitimate entitlement to wealth that does not contradict their own everyday ideology of being self-made. Nevertheless, a two-pronged approach is emerging. First, in line with the shift toward new modesty, children are being encouraged to cultivate a habitus of privilege, as Sherman suggests in the case with wealthy US Americans, which makes them appear morally worthy in an environment marked by extreme inequality. Second, via their philanthropy the rich are supporting institutions and scholars in an effort to strengthen a dynamic capitalist environment in which privileged status is respected.

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