VASER Liposuction. How to Get Natural Results with Ultrasound Assisted Liposuction?

Ultrasound assisted liposuction technology is a selective technique to emulsify fatty tissue and improve the removal of fat. This technique can be used on many areas of the body such as: chin neck, back, buttocks, abdomen, legs, arms. Fatty areas, as well as, skin and cellulite can be molded in a process known as ultrasound cavitation. Results can produce significant skin contraction and smoothing of areas. Using this method reduces the need for surgical intervention and requires less energy to achieve similar results. This method is also good for treatment of fibrous scar tissue, producing less bruising and blood loss. The advantages of the VASER ultrasound prepared liposuction in comparison to the mechanical liposuction method are better with fat extraction, less blood loss, and smoother results. While the disadvantages of VASER ultrasound method are possible thermal injuries, the need for larger incisions for protective ports, increased incidence of seromas, slightly increased cost and longer preparation and operative times. However further presentation will show the benefits of this newer generation of liposuction method. Also, various probes for better fat extraction and specific treatment areas will be discussed.

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Hand-assisted laparoscopic nephrectomy in morbidly obese patients

Perspectives in Surgery ◽

10.33699/pis.2020.99.6.271-276 ◽

2020 ◽

Vol 99 (6) ◽

pp. 271-276

Keyword(s):

Body Weight ◽

Surgical Technique ◽

Blood Loss ◽

Hospital Stay ◽

Kidney Cancer ◽

The Body ◽

Laparoscopic Nephrectomy ◽

Morbidly Obese ◽

Obese Patients ◽

Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

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Electrochemotherapy Effectiveness Loss due to Electric Field Indentation between Needle Electrodes: A Numerical Study

Journal of Healthcare Engineering ◽

10.1155/2018/6024635 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

José Alvim Berkenbrock ◽

Rafaela Grecco Machado ◽

Daniela Ota Hisayasu Suzuki

Keyword(s):

Electric Field ◽

In Silico ◽

Treatment Effectiveness ◽

Numerical Study ◽

Specific Treatment ◽

The Body ◽

Membrane Selectivity ◽

Chemotherapy Drugs ◽

Mast Cell Tumor ◽

Anticancer Treatment

Electrochemotherapy is an anticancer treatment based on applying electric field pulses that reduce cell membrane selectivity, allowing chemotherapy drugs to enter the cells. In parallel to electrochemotherapy clinical tests, in silico experiments have helped scientists and clinicians to understand the electric field distribution through anatomically complex regions of the body. In particular, these in silico experiments allow clinicians to predict problems that may arise in treatment effectiveness. The current work presents a metastatic case of a mast cell tumor in a dog. In this specific treatment planning study, we show that using needle electrodes has a possible pitfall. The macroscopic consequence of the electroporation was assessed through a mathematical model of tissue electrical conductivity. Considering the electrical and geometrical characteristics of the case under study, we modeled an ellipsoidal tumor. Initial simulations were based on the European Standard Operating Procedures for electrochemotherapy suggestions, and then different electrodes’ arrangements were evaluated. To avoid blind spots, multiple applications are usually required for large tumors, demanding electrode repositioning. An effective treatment electroporates all the tumor cells. Partially and slightly overlapping the areas increases the session’s duration but also likely increases the treatment’s effectiveness. It is worth noting that for a single application, the needles should not be placed close to the tumor’s borders because effectiveness is highly likely to be lost.

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Cd5+ Diffuse Large B Cell Lymphoma of the Liver Presenting as Cholestatic Transaminitis.

10.21203/rs.3.rs-580354/v1 ◽

2021 ◽

Author(s):

Taroob Jawad Latef ◽

Muhammad Bilal ◽

Sudeep Siddappa Malleshappa ◽

Chandravathi Loke

Keyword(s):

B Cell ◽

Viral Infections ◽

Cell Lymphoma ◽

Early Recognition ◽

Specific Treatment ◽

B Cell Lymphoma ◽

The Body ◽

Large B Cell Lymphoma ◽

High Index Of Suspicion ◽

Large B Cell

Abstract A 72-year-old male with nonspecific symptoms was found to have pancytopenia and transaminitis. The pancytopenia began to improve early in the hospital course without specific treatment. A liver biopsy, obtained later to determine the etiology of the transaminitis, eventually confirmed CD5+ diffuse large B cell lymphoma (DLBCL). DLBCL typically presents with painless lymphadenopathy and constitutional symptoms although it may also present as a rapidly enlarging mass in any part of the body. However, in rarer cases its presentation can be misleading. Conditions such as HLH or viral infections, can confound a patient’s presentation and delay the diagnosis. High index of suspicion is warranted for the diagnosis of DLBCL in atypical cases to prevent mortality associated with late diagnosis. Early recognition and biopsy of involved organ, in the absence of clear etiology, is vital for timely diagnosis and prompt treatment to achieve a favorable cure rate. CD5+ DLBCL may have unusual involvement of extra nodal organs such as the liver and may need further investigations.

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Latent Factors Limiting the Performance of sEMG-Interfaces

10.20944/preprints201804.0044.v1 ◽

2018 ◽

Author(s):

Sergey Lobov ◽

Nadia Krilova ◽

Innokentiy Kastalskiy ◽

Victor Kazantsev ◽

Valeri A. Makarov

Keyword(s):

The Body ◽

Fine Tuning ◽

Fatty Tissue ◽

Latent Factors ◽

Individual Subject ◽

Training Strategy ◽

Real Time Analysis ◽

Signal Processing Algorithms ◽

Gaming Environment

Recent advances in recording and real-time analysis of surface electromyographic signals (sEMG) have fostered the use of sEMG human-machine interfaces for controlling personal computers, prostheses of upper limbs, and exoskeletons among others. Despite a relatively high mean performance, sEMG-interfaces still exhibit strong variance in the fidelity of gesture recognition among different users. Here we systematically study the latent factors determining the performance of sEMG-interfaces in synthetic tests and in an arcade game. We show that the degree of muscle cooperation and the amount of the body fatty tissue are the decisive factors in synthetic tests. Our data suggest that these factors can only be adjusted by a long-term training, which promotes fine-tuning of low-level neural circuits driving the muscles. A short-term training has no effect on synthetic tests, but significantly increases the game scoring. This implies that it works at a higher decision-making level, not relevant for synthetic gestures. We propose a procedure that enables quantification of the gestures’ fidelity in a dynamic gaming environment. For each individual subject the approach allows identifying “problematic” gestures that decrease gaming performance. This information can be used for optimizing the training strategy and for adapting the signal processing algorithms to individual users, which could be a way for a qualitative leap in the development of future sEMG-interfaces.

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Immediate results of spleen-preserving distal subtotal pancreatic resection

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.20211100-106 ◽

2021 ◽

Vol 26 (1) ◽

pp. 100-106

Author(s):

T. S. Mirzaev ◽

D. V. Podluzhny ◽

R. E. Izrailov ◽

Yu. I. Patyutko ◽

E. V. Glukhov ◽

...

Keyword(s):

Blood Loss ◽

Pancreatic Resection ◽

The Body ◽

Pancreatic Tumors ◽

Benign Tumors ◽

Control Group ◽

Intraoperative Blood Loss ◽

Spleen Preserving ◽

Subtotal Pancreatectomy ◽

Malignancy Potential

Aim. To assess the possibility of open spleen-preserving distal subtotal pancreatic resection for tumors of the body and tail of the pancreas.Material and methods. A retrospective comparative analysis of the immediate results of the spleen-preserving interventions in 41 patients was carried out. Mainly benign tumors or tumors with a low malignancy potential of the corpus and (or) the tail of the pancreas were detected. Distal subtotal pancreatectomy with splenectomy was performed in 53 patients with pancreatic tumors of different histogenesis with low malignancy potential (control group).Results. The duration of spleen-preserving distal subtotal pancreatectomy was 12 minutes shorter, compared with the distal subtotal pancreatectomy with splenectomy group (p = 0.180). Significantly lower volume of intraoperative blood loss during spleen-preserving procedure was noted – by 460 ml (p = 0.0001). The level of postoperative complications in the spleen-preserving pancreatectomy group was 15 (37%), while in the group of distal subtotal pancreatectomy with splenectomy was 26 (49%) (p = 0.227), respectively. External pancreatic fistula after spleenpreserving pancreatectomy was noted in 13 (32%) patients, in the other group in 21 (40%; p = 0.429). The duration of hospital stay did not statistically significantly differ in the compared groups and amounted to: 18.6 ± 6.9 and 20.3 ± 5.4 days (p = 0.123), respectively.Conclusion. Open spleen-preserving pancreatectomy is a relatively safe type of surgical treatment for patients with benign tumors and tumors with a low potential for malignancy of the body and/or tail of the pancreas. The surgery is shorter in time, accompanied by a lower level of complications, significantly less intraoperative blood loss, compared with a similar procedure involving splenectomy.

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ANTICHOLINERGIC POISONING: TREATMENT WITH PHYSOSTIGMINE

PEDIATRICS ◽

10.1542/peds.52.3.449 ◽

1973 ◽

Vol 52 (3) ◽

pp. 449-451

Author(s):

Barry H. Rumack

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Acetic Acid ◽

Specific Treatment ◽

Signs And Symptoms ◽

The Body ◽

Sweat Glands ◽

Exocrine Glands ◽

Anticholinergic Syndrome ◽

The Central Nervous System

The increased incidence of poisoning by overdoses of commonly used drugs with anticholinergic properties (Table I) and the general lack of knowledge concerning a specific treatment for these poisons warrants a summary of the problem at this time. Some plants containing anticholinergic alkaloids are also included in this group as they may also be taken intentionally or accidentally. Drugs with anticholinergic properties primanly antagonize acetylcholine competitively at the neuroreceptor site. Cardiac muscle, exocrine glands, and smooth muscle are most markedly affected.1 Action of the inhibitors is overcome by increasing the level of acetylcholine naturally generated in the body through inhibiting the enzyme (choline esterase) which normally prevents accumulation of excess acetylcholine. It does this by hydrolyzing that compound to inactive acetic acid and choline. Agents which inhibit this enzyme, so that acetylcholine accumulates at the neuroreceptor sites, are called anticholine esterases. Physostigmine, one of the anticholine esterases which is a tertiary amine, crosses into the central nervous system and can reverse both central and peripheral anticholinergic actions2. Neostigmine and pyridostigmine are also anticholine esterases but they are quaternary amines and are capable of acting only outside the central nervous system because of solubility and ionization characteristics. The anticholinergic syndrome has both central and peripheral signs and symptoms. Central toxic effects include anxiety, delirium, disorientation, hallucinations, hyperactivity, and seizures.2 Severe poisoning may produce coma, medullary paralysis, and death. Peripheral taxicity is characterized by tachycardia, hyperpyrexia, mydriasis, vasodilatation, urinary retention, diminution of gastrointestinal motility, decrease of secretion in salivary and sweat glands, and loss of secretions in the pharynx, bronchi, and nasal passages.

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Adipokines and Obesity. Potential Link to Metabolic Disorders and Chronic Complications

International Journal of Molecular Sciences ◽

10.3390/ijms21103570 ◽

2020 ◽

Vol 21 (10) ◽

pp. 3570 ◽

Cited By ~ 10

Author(s):

Katarzyna Zorena ◽

Olga Jachimowicz-Duda ◽

Daniel Ślęzak ◽

Marlena Robakowska ◽

Małgorzata Mrugacz

Keyword(s):

The Body ◽

Biologically Active ◽

World Health ◽

Target Cells ◽

Fatty Tissue ◽

Chronic Complications ◽

Overweight People ◽

Cochrane Database ◽

Potential Link ◽

Health Organization

The World Health Organization (WHO) has recognized obesity as one of the top ten threats to human health. It is estimated that the number of obese and overweight people worldwide exceeds the number of those who are undernourished. Obesity is not only a state of abnormally increased adipose tissue in the body, but also of increased release of biologically active adipokines. Adipokines released into the circulating blood, due to their specific receptors on the surface of target cells, act as classic hormones affecting the metabolism of tissues and organs. What is more, adipokines and cytokines may decrease the insulin sensitivity of tissues and induce inflammation and development of chronic complications. Certainly, it can be stated that in an era of a global obesity pandemic, adipokines may gain more and more importance as regards their use in the diagnostic evaluation and treatment of diseases. An extensive search for materials on the role of white, brown and perivascular fatty tissue and obesity-related metabolic and chronic complications was conducted online using PubMed, the Cochrane database and Embase.

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Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

Italian Journal of Medicine ◽

10.4081/itjm.2010.16 ◽

2013 ◽

pp. 16-22

Author(s):

Alessandro Castiglione ◽

Claudia Aimoni ◽

Giovanni Scanelli

Keyword(s):

Differential Diagnosis ◽

Elderly Patients ◽

Neurological Disorders ◽

Sensory Input ◽

Neurological Diseases ◽

Specific Treatment ◽

The Body ◽

Diagnostic Classification ◽

Main Challenge ◽

Clinical Conditions

Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs) and vestibular rehabilitation (physiotherapy and vestibular exercises).

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Panniculitides

10.1093/med/9780199642489.003.0165 ◽

2013 ◽

Author(s):

Cord Sunderkötter ◽

Luis Requena

Keyword(s):

Lupus Erythematosus ◽

Erythema Nodosum ◽

Clinical Symptoms ◽

Subcutaneous Tissue ◽

Excisional Biopsy ◽

The Body ◽

Fatty Tissue ◽

Livedo Racemosa ◽

Clinical Criteria ◽

Lobular Panniculitis

Panniculitis is an inflammation that originates primarily in the subcutaneous fatty tissue (panniculus adiposus). It is associated with rheumatological diseases and with adverse events to rheumatological therapies (e.g. poststeroid panniculitis, erythema nodosum, infective panniculitis). The panniculitides are classified histopathologically into mostly septal panniculitis and mostly lobular panniculitis, according to the major or denser localization of the infiltrate, and also into those with or without vasculitis. Additional criteria involve the composition of the inflammatory infiltrate, the cause, and an underlying or associated disease. The clinical hallmarks of panniculitis are subcutaneous nodules or plaques, often located on the lower limb. A deep excisional biopsy is often required for a more precise diagnosis, given the often sparse and monotonous clinical symptoms. Erythema nodosum is the most common form and a typical example of septal panniculitis. It occurs in response to many different provoking factors, the most common trigger in children being a 'strep throat', in adults sarcoidosis. Clinically, it presents with a sudden symmetrical appearance of painful, tender, warm, erythematous nodes or plaques, usually on the shins, which resemble bruises. Classical and cutaneous polyarteriitis nodosa present a mostly septal panniculitis associated with vasculitis. Here subcutaneous, partially ulcerating nodules are surrounded by livedo racemosa. The mostly lobular panniculitides not associated with vasculitis include lupus panniculitis (lupus erythematosus profundus, typically with ensuing lipoatrophy and predilection for the upper part of the body), panniculitis in dermatomyositis (often calcifiying), cold panniculitis, pancreatic panniculitis, panniculitis due toα‎-antitrypsin deficiency, poststeroid panniculitis (in children after rapid withdrawal of corticosteroids), calciphylaxis (with and without renal failure), and factitious panniculitis (after mechanical, physical, or chemical injuries to the subcutaneous tissue, often self-inflicted). Nodular vasculitis (formerly erythema induratum Bazin) is a lobular panniculitis with vasculitis involving mostly the small blood vessels of the fat lobule. It appears to present a (hyper)reactive response to certain infections (tuberculosis, streptococci, candida) or to cold exposure or chronic venous insufficiency in susceptible females. In conclusion, the panniculitides are a heterogenous group of diseases requiring a systematic work-up and knowledge of certain histological or clinical criteria.

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IN VITRO STUDIES ON ENZYMATIC CLEAVAGE OF STEROID ESTERS IN THE FEMALE ORGANISM

Acta Endocrinologica ◽

10.1530/acta.0.0810839 ◽

1976 ◽

Vol 81 (4) ◽

pp. 839-853 ◽

Cited By ~ 5

Author(s):

Otto Bellmann ◽

Hans-Jürgen Duhme ◽

Erich Gerhards

Keyword(s):

Water Solubility ◽

The Body ◽

Short Chain ◽

Human Myometrium ◽

Vaginal Mucosa ◽

Fatty Tissue ◽

Enzymatic Cleavage ◽

Cleavage Rate ◽

Subcutaneous Fatty Tissue ◽

Long Chain

ABSTRACT The decreasing water-solubility of steroid esters concomitant with increasing chain length of monocarboxylic acids provides a prolonged therapeutic effect of the steroid. Whether a slow release of the steroid from an oily depot in the muscle or a secondary storage of the ester in the body fat ("deep compartment") are responsible for this prolonged action, is open to discussion. The aim of this study was to investigate the steroid ester cleaving enzyme activity of human subcutaneous fatty tissue. The following steroid esters were investigated: Testosterone acetate and oenanthate, metenolone acetate and oenanthate, norethisterone acetate and oenanthate, dehydroepiandrosterone acetate and oenanthate, fluocortolone acetate and caproate. In the 10 000 x g supernatant phase of the female subcutaneous fatty tissue the rate of enzymatic cleavage of the long-chain oenanthates was considerably greater than that of the corresponding short-chain steroid esters. The nature and position of the ester group in the steroid molecule exhibited a marked effect on the rate of enzymatic cleavage of steroid esters. The cleavage rate of long- and short-chain steroid esters in human myometrium and endometrium resembled that in the fatty tissue. On the other hand, the gastric mucosa, rectus musculature, placenta and vaginal mucosa split the short-chain steroid esters more rapidly than the long-chain esters. The marked differences in the relation of the cleavage rate of long- and short-chain steroid esters in the various tissues allow the assumption that long- and short-chain steroid esters are cleaved by different enzymes.

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