Browse Health
Plastic Surgeon, Cosmetic Surgeon
15 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score Rankings
Baylor College of Medicine (1995)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
One of America's Leading Experts on:
Rhinoplasty
Top Ten Doctors (2012)
Preston Village
Plastic Surgery

Affiliations ?

Dr. Lam is affiliated with 5 hospitals.

Hospital Affilations

Score

Rankings

  • Harris Methodist H E B
    1600 Hospital Pkwy, Bedford, TX 76022
    • Currently 4 of 4 crosses
    Top 25%
  • Texas Health Harris Methodist Hospital Southwest Fort Worth
    6100 Harris Pkwy, Fort Worth, TX 76132
    • Currently 4 of 4 crosses
    Top 25%
  • Texas Health Harris Methodist Hospital Azle
    108 Denver Trl, Azle, TX 76020
    • Currently 3 of 4 crosses
    Top 50%
  • Texas Health Presbyterian Hospital Of Dallas *
    8200 Walnut Hill Ln, Dallas, TX 75231
    • Currently 3 of 4 crosses
    Top 50%
  • Harris Continued Care Hospital
    1301 Pennsylvania Ave, Fort Worth, TX 76104
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Lam has contributed to 67 publications.
    Title Office Managers' Forum.
    Date February 2011
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    This article is a summary of the key elements presented during the conference held as part of the Practice Management and Development course sponsored by the Multi-Specialty Foundation in Las Vegas, Nevada in 2009. This article represents an amalgam of perspectives from practices across the United States. The Office Managers' Forum brought together the office managers and surgeons from practices across the United States as panelists. The panelists answered a multitude of practice management questions that included wide-ranging topics such as accounting and financing, staff well being, working with a spouse, hiring and firing, staff meetings, accreditation, motivation, and problems and perks specifically associated with a facial plastic surgery practice.

    Title Fat Harvesting Techniques for Facial Fat Transfer.
    Date January 2011
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Fat grafting has become popular as a stand-alone technique or as part of a combined procedure for facial rejuvenation, as volume restoration has increasingly become recognized as an important component in overall facial aging. Many facial plastic surgeons who are experienced in operating only in the head and neck region are unaccustomed to working elsewhere in the body. Accordingly, this article sets out to detail the specific technique for safe and effective lipoharvesting for facial fat transfer. In addition, site-specific considerations for the lower abdomen, inner/anterior/outer thighs, triceps, inner knee, buttock, and lower back are also discussed.

    Title Over 8 Years Experience on Severe Acute Poisoning Requiring Intensive Care in Hong Kong, China.
    Date December 2010
    Journal Human & Experimental Toxicology
    Excerpt

    In order to obtain up-to-date information on the pattern of severe acute poisoning and the characteristics and outcomes of these patients, 265 consecutive patients admitted to an intensive care unit in Hong Kong for acute poisoning from January 2000 to May 2008 were studied retrospectively. Benzodiazepine (25.3%), alcohol (23%), tricyclic antidepressant (17.4%), and carbon monoxide (15.1%) were the four commonest poisons encountered. Impaired consciousness was common and intubation was required in 67.9% of admissions, with a median duration of mechanical ventilation of less than 1 day. The overall mortality was 3.0%. Among the 257 survivors, the median lengths of stay in the intensive care unit and acute hospital (excluding days spent in psychiatric ward and convalescent hospital) were less than 1 day and 3 days, respectively. Factors associated with a longer length of stay included age of 65 or older, presence of comorbidity, Acute Physiology and Chronic Health Evaluation II score of 25 or greater, and development of shock, rhabdomyolysis, and aspiration pneumonia, while alcohol intoxication was associated with a shorter stay. This is the largest study of its kind in the Chinese population and provided information on the pattern of severe acute poisoning requiring intensive care admission and the outcomes of the patients concerned.

    Title Interactive Effects of Nurse-experienced Time Pressure and Burnout on Patient Safety: a Cross-sectional Survey.
    Date December 2010
    Journal International Journal of Nursing Studies
    Excerpt

    Global nursing shortages have exacerbated time pressure and burnout among nurses. Despite the well-established correlation between burnout and patient safety, no studies have addressed how time pressure among nurses and patient safety are related and whether burnout moderates such a relation.

    Title Clostridium Perfringens Liver Abscess with Massive Haemolysis.
    Date November 2010
    Journal Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine
    Excerpt

    Liver abscesses are commonly caused by Enterobacteriaceae and anaerobes. This report is of a patient with liver abscess with massive haemolysis and multiorgan failure caused by Clostridium perfringens. Despite the reportedly high mortality rate and poor prognostic factors, the patient eventually recovered with prompt treatment.

    Title Management of the Asian Upper Eyelid.
    Date November 2010
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Relating the rejuvenation of the eye in terms of the Asian face, this article covers the unique set of strategies for this population that include understanding cultural and aesthetic aspects of the Asian patient, anatomy of the Asian patient, and techniques that would be appropriate based on these cultural and anatomic considerations. Along with strategic planning, a detailed surgical technique is presented with graphic examples, in addition to a brief guide to postoperative care.

    Title Management of the Aging Upper Eyelid in the Asian Patient.
    Date October 2010
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Successful management of the aging upper eyelid region in the Asian patient requires a unique skill set and clinical experience. The surgeon must exhibit a thorough understanding of the unique anatomy of the Asian eyelid and its variations and of the cultural expectations of the patient and must possess a unique set of surgical skills such as de novo creation of the supratarsal crease as well as complementary procedures such as fat transfer used for volume augmentation of the periorbital region. The modern approach outlined here summarizes the key elements necessary to restore the youthful appearance of the upper eyelid region in a natural and ethnically consistent fashion.

    Title Volumetric Rejuvenation of the Periorbital Region.
    Date October 2010
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Volumetric rejuvenation of the periorbital region is based on an analysis of the aesthetics of the attractive youthful eye contrasted with the typical characteristics of aging. Traditional rejuvenation techniques emphasized fat and skin removal leading to "done" appearing results. The incorporation of volume with these techniques based on the specific analysis of volume loss produces more natural appearing true rejuvenation.

    Title Considerations in Non-caucasian Facial Plastic Surgery. Preface.
    Date June 2010
    Journal Facial Plastic Surgery Clinics of North America
    Title A New Paradigm for the Aging Face.
    Date June 2010
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Fat transfer has become the primary method for facial rejuvenation in my clinical practice for all ethnicities. This technique can be effectively used to address panfacial volume loss so long as artistry, technical skill, and an in-depth understanding of fat grafting changes over the years are well applied and understood. Fat grafting can replace many traditional facial rejuvenation techniques or serve as an important adjunct to excisional and lifting procedures to temper the degree of excision and lifting that are required.

    Title Hair Restoration in the Ethnic Patient and Review of Hair Transplant Fundamentals.
    Date June 2010
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Superior hair restoration requires the application of universal principles along with variations that apply to specific ethnic populations. This article serves as a primer on basic tenets of hair restoration, with additional attention given to the uniqueness and differences in technique and design that are warranted for a wide range of races and ethnicities. This article also gives prospective surgeons an insight on how to undertake further study and shore up their deficiencies so as to refine knowledge gaps and ensure patient safety and excellent surgical outcomes.

    Title Supratarsal Crease Creation in the Asian Upper Eyelid.
    Date June 2010
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Supratarsal crease fixation in the Asian patient can provide a more open-eyed, awake look without compromising their ethnic appearance. A conservative supratarsal crease height and conservative to no removal of postseptal fat help to ensure this natural-appearing result. With the full-incision method, consistently excellent results have been achieved with durable crease fixation despite a prolonged recovery time. The supratarsal crease fixation provides an excellent method for the younger patient seeking cosmetic eyelid enhancement. However, for the aging Asian patient, the complexity of the strategy is greater.

    Title How to Create High-performing Teams.
    Date April 2010
    Journal Facial Plastic Surgery : Fps
    Excerpt

    This article is intended to discuss inspirational aspects on how to lead a high-performance team. Cogent topics discussed include how to hire staff through methods of "topgrading" with reference to Geoff Smart and "getting the right people on the bus" referencing Jim Collins' work. In addition, once the staff is hired, this article covers how to separate the "eagles from the ducks" and how to inspire one's staff by creating the right culture with suggestions for further reading by Don Miguel Ruiz (The four agreements) and John Maxwell (21 Irrefutable laws of leadership). In addition, Simon Sinek's concept of "Start with Why" is elaborated to help a leader know what the core element should be with any superior culture.

    Title Short-scar Purse-string Facelift.
    Date January 2010
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Despite the variety of novel facial rejuvenation technologies available today, the reference standard for correction of the senescent jaw line and neck remains rhytidectomy. This article describes the purse-string facelift, a vertical facelift that moves away from traditional techniques that use a horizontal vector of subcutaneous muscle-aponeurotic system repositioning. The vertical facelift can counterbalance the effects of gravity and natural facial aging and can reposition the facial soft tissues into a more youthful position more directly and correctly. Rather than multiple, separate sutures to support the suspended tissues, the purse-string technique offers two distinct advantages: operative expediency and a tenacious suture anchor based on the periosteum of the posterolateral zygomatic arch.

    Title Correction of Pollybeak and Dimpling Deformities of the Nasal Tip in the Contracted, Short Nose by the Use of a Supratip Transposition Flap.
    Date January 2010
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    To discuss our experiences with the use of a supratip transposition flap to simultaneously correct pollybeak deformity and nasal tip dimpling.

    Title Increased Vascular Permeability Precedes Cellular Inflammation As Asthma Control Deteriorates.
    Date December 2009
    Journal Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
    Excerpt

    Airway microcirculation is abnormal in asthma but the role of vascular changes in asthma deteriorations remains poorly defined. We prospectively assessed the vascular changes accompanying worsening of asthma control by using an inhaled corticosteroid (ICS) dose-reduction model.

    Title Complications Following Fat Transfer.
    Date June 2009
    Journal Oral and Maxillofacial Surgery Clinics of North America
    Excerpt

    Traditionally, strategies for facial rejuvenation have emphasized correction of tissue ptosis and laxity with suspensory and excisional techniques, such as face-lifting and blepharoplasty. Volume loss plays a significant role in facial aging and, until recently, had not received appropriate attention. Facial fat grafting to correct volume loss has become a crucial component of facial rejuvenation in the authors' respective practices.

    Title Partial-incision Technique for Creation of the Double Eyelid.
    Date June 2009
    Journal Aesthetic Surgery Journal / the American Society for Aesthetic Plastic Surgery
    Excerpt

    Three principal techniques exist with which to create the Asian double eyelid: the suture, partial-incision, and full-incision methods. The partial-incision method is reliable and long-lasting without many of the drawbacks of the full-incision method.

    Title The Influence of Whey Protein and Glycomacropeptide on Satiety in Adult Humans.
    Date April 2009
    Journal Physiology & Behavior
    Excerpt

    Protein is often considered the most satiating macronutrient. The objective was to determine the short-term effect of mixtures of whey protein and glycomacropeptide (GMP) versus a carbohydrate control on satiety in healthy adult humans. The study was a randomised crossover Latin Square design. On 4 separate days, fifty healthy subjects (19 males and 31 females) received a subject-specific breakfast (08:00 h), a preload drink (12:00 h) and lunch (12:30 h). The preload drink was presented as a milkshake with either maltodextrin carbohydrate (control), whey protein isolate (WPI) with no GMP, WPI with naturally present 21% GMP or WPI with naturally present 21% GMP plus added GMP. Satiety was assessed using visual analogue scales (VAS) and by determining ad libitum food intake during a cafeteria style meal offered 30 min after the preload. The VAS indicated that the lower GMP treatment induced a greater feeling of fullness immediately after consumption of the preload compared with the other treatments. Energy and macronutrient intake at lunch did not differ significantly (p>0.05) between treatments although subjects chose to eat foods higher in carbohydrate and lower in protein after the protein preloads. Women consumed the least amount of protein after the protein preloads whereas no difference was found in men. There was some evidence that whey proteins and their components enhance satiety over a short-term period compared to carbohydrate but there was no consistent effect of either whey protein alone or glycomacropeptide.

    Title Pseudallescheria Boydii or Aspergillus Fumigatus in a Lady with an Unresolving Lung Infiltrate, and a Literature Review.
    Date July 2008
    Journal Respirology (carlton, Vic.)
    Excerpt

    A 53-year-old lady with blood-stained sputum and pleuritic pain had a lingular opacity on CXR which failed to resolve. A bronchial aspirate and transbronchial biopsy revealed features of bronchocentric granulomatosis with dichotomous branching hyphae suggestive of Aspergillus infection. However, subsequent fungal culture grew Pseudallescheria boydii. This case demonstrates the similarity of clinical and histological features caused by these two fungi. This appears to be the first reported case of pulmonary pseudallescheria with a bronchocentric granulomatous response.

    Title Autologous Fat Grafting for Cosmetic Enhancement of the Perioral Region.
    Date February 2008
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    The role of volume loss in the progression of facial aging is widely accepted as an important cause. The aging appearance of the perioral region and lower face is significantly affected by this volume loss, which contributes to the development of labiomental folds, the loss of definition of the jawline, and worsening of skin texture, among other manifestations. Autologous fat transfer can effectively replace this lost volume and contribute to any facial rejuvenation plan. Fat can replace larger volumes than off-the-shelf fillers and provides a potentially permanent solution.

    Title Aesthetic Strategies for the Aging Asian Face.
    Date October 2007
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Aging that manifests in the Asian face is remarkably different, yet in many ways similar, to that of the white face. These dissimilarities and similarities are highlighted in this article along with overall strategies to approach the aging Asian face. This article focuses almost exclusively on the judgment and thinking that are required when approaching the Asian patient. More specifically, one issue that is covered is the cultural aspect that pertains to patient motivation and perspectives on cosmetic enhancement. The other equally important aspect that is addressed is elaboration of a new paradigm on what constitutes a youthful face, especially as that model relates to the Asian face.

    Title Injectable Poly-l-lactic Acid (sculptra): Technical Considerations in Soft-tissue Contouring.
    Date October 2006
    Journal Plastic and Reconstructive Surgery
    Excerpt

    BACKGROUND: Poly-L-lactic acid gained U.S. Food and Drug Administration approval for use in human immunodeficiency virus-related facial lipoatrophy in August of 2004. Since that time, it has become available for use in the United States for human immunodeficiency virus facial lipoatrophy patients and for off-label uses in other areas for soft-tissue contouring. This article is intended to enumerate reconstitution, injection techniques, management, and avoidance of complications. METHODS: The authors have pooled their experiences to arrive at a consensus opinion for recommendations on treatment protocols for injectable poly-L-lactic acid use. RESULTS: This article prescribes techniques to achieve safer, consistent results while minimizing risks of complications with injectable poly-L-lactic acid. Although the product has been used widely in Europe since 1999, physicians in the United States have only recently begun to explore the uses of Sculptra as a volumizing agent in the face and the body. U.S. physicians have benefited from the European experience with this product, including early problems secondary to overaggressive use, low-volume reconstitution, higher volume injection of product at one session, and inadequate time between injection sessions. CONCLUSIONS: The authors therefore have opted for a more conservative approach in their treatment recommendations. Higher volume dilution (8 to 12 cc), fewer vials used at each session, injections placed in the subcutaneous plane without any product being placed in the dermis, adequate time between injection sessions (at least 6 weeks), and postinjection patient massage should decrease the risks and avoid the potential complications associated with poly-L-lactic acid soft-tissue augmentation.

    Title Aesthetic Facial Surgery for the Asian Male.
    Date May 2006
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Cosmetic surgery of the Asian face has become increasingly popular in the Far East and the West. The Asian male identity has undergone an evolution in Western media toward a more positive change. The standards of beauty have also changed, being defined by more multicultural models and styles of dress than before. To undertake cosmetic surgery of the Asian face, particularly of the Asian male, requires a different psychological understanding of the individual as well as an entirely different surgical technique in most cases. This brief article does not delve into the technical details of each procedure but concentrates on the salient differences in how to approach the Asian male patient for each of the different procedures, including Asian blepharoplasty, augmentation rhinoplasty, lip reduction, dimple fabrication, otoplasty, facial contouring and aging face procedures, and hair restoration.

    Title Secondary Rhinoplasty of the Asian Nose: Correction of the Contracted Nose.
    Date October 2004
    Journal Aesthetic Plastic Surgery
    Excerpt

    The contracted nose is a unique entity that follows primary rhinoplasty in the Asian patient. The proposed reasons for this complication are capsular contraction from a silicone nasal implant, pressure necrosis of the lower lateral cartilage resulting from the nasal implant, and infection after alloplastic implantation. The two principal anatomic constituents that must be addressed at the time of secondary rhinoplasty are the lower lateral cartilages and the skin envelope. The lower lateral cartilages should be derotated, projected, and transfixed with an extended spreader graft. Additional onlay grafting may be required to provide greater nasal tip derotation and projection. A transcolumellar incision situated at the columellar-labial angle permits undermining of the upper lip skin to release tension on the incision. If the nasal tip retraction is severe, then the skin envelope may be insufficient to provide coverage to the new cartilaginous framework. In this case, a paramedian forehead flap is recommended to provide adequate tissue coverage. Correction of alar-columellar disparity should be undertaken with composite grafting only after 6 months have transpired to gauge the ultimate relation between the alae and columella. Infection that arises after correction of the contracted nose can be devastating. It should be treated aggressively, but tailored to the severity of the infection. Wound tension along the columella may predispose to skin necrosis and consequent cartilage exposure, which should be managed in turn with prostaglandin emollients to accelerate wound healing and to prevent infection.

    Title Toward a Global Beauty: the Art of Cai Guo-qiang.
    Date September 2004
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title A Cadaveric Analysis of the Ideal Costal Cartilage Graft for Asian Rhinoplasty.
    Date September 2004
    Journal Plastic and Reconstructive Surgery
    Excerpt

    Augmentation rhinoplasty of the Asian nose may be effectively accomplished with alloplastic materials. However, certain circumstances mandate the use of autologous grafts (e.g., dorsal augmentation that exceeds 8 mm and patient intolerance of alloplastic implants). Septal and auricular cartilages are inadequate for dorsal augmentation of the Asian nose. The use of costal cartilage for autologous augmentation in select Asian patients has proven to be a reliable method in more than 500 operative cases during a 10-year period. This study was designed to evaluate the ideal costal cartilage graft for augmentation rhinoplasty. Forty-two preserved cadavers were studied for the relationship of the individual rib cartilages to the surrounding tissue and for the length and caliber of each costal cartilage. The seventh rib was found to be the ideal rib graft by virtue of its safe location and overall size for grafting. The seventh rib is situated over the abdominal cavity, so the risk of pneumothorax is insignificant. The internal thoracic artery and vein descend in close apposition behind the first to sixth ribs but begin a course medial to the ribs inferior to this point, and therefore vascular injury during seventh-rib harvesting is unknown. The seventh rib also provides the greatest overall available length (90.7 mm, right; 89.6 mm, left) and thickness (17.6 mm, right; 17.5 mm, left). Despite the more conspicuous location of the incision required to harvest the seventh rib, the limited 3-cm incision that is used has healed favorably in almost all cases. The other major drawback for seventh-rib harvesting is the dissection required through the overlying rectus abdominis muscle, but little technical difficulty or postoperative morbidity is added with muscle dissection. The seventh rib is advocated as the ideal choice for augmentation rhinoplasty and potentially other recipient sites.

    Title The Basic Science of Botulinum Toxin.
    Date July 2004
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Understanding the basic science of botulinum toxin should serve as a fundamental first step for clinical therapy. This article endeavors to cover many aspects of basic research that also have clinical import. The two principal toxins of the clostridial family, Clostridium tetani and C botulinum, are described in detail. The five clinical manifestations of botulism poisoning are also outlined, and structural aspects and the mechanism of action of botulinum toxin are then presented. Finally, the immunologic and pharmacologic principles that define the various serotypes of botulinum toxin are set forth.

    Title Julien Bourguet: Father of Cervical Rhytidectomy.
    Date June 2004
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title A New Paradigm for the Aging Asian Face.
    Date June 2004
    Journal Aesthetic Plastic Surgery
    Excerpt

    Traditionally, Asians have been thought to age more gracefully than Caucasians. The resistance to aging in the Asian patient was credited to the thicker dermis of Asian skin that contains greater collagen and the darker pigment that protects against photoaging. Although these statements are true, the authors propose a new paradigm that explains how the illusion of Asian youthfulness may be understood. The "baby model" purports that the Asian face has many attributes similar to an infant, including a wider and rounder face, higher eyebrow, fuller upper lid, lower nasal bridge, flatter midface, apparently more protuberant lips, and more receded chin. These commonalities between the infant and the Asian compel the viewer to perceive the Asian face as more youthful. However, the Asian face is subjected to a greater amount of gravitational force due to weaker skeletal support, heavier soft tissue, larger amount of malar fat, thicker skin, and a weaker chin. Facial rejuvenative surgery should always be cognizant of the propensity of the Asian skin to unfavorable healing, need for greater tissue suspension, and more conspicuous temporal alopecia. Asian aesthetics that differ and converge with Western ideals are reviewed so that the Western surgeon in particular can comprehend the Asian conception of youthful beauty.

    Title Practical Considerations in the Treatment of Capillary Vascular Malformations, or Port Wine Stains.
    Date May 2004
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Port wine stains (PWSs) represent the most common type of vascular malformation. With the advent of pulsed-dye laser therapy, treatment of these lesions has become achievable with minimal prospect of adverse scarring. Although many scientific articles have heralded the favorable outcomes in patients who have undergone pulsed-dye laser treatments, few articles address the practical considerations (pre-, intra-, and postoperative) that must be followed to ensure success. This article presents the 10-year experience of the senior author (EFW) in the management of port wine malformations and the clinical insights that have been gleaned from that extensive experience. Introductory remarks are made as to the nature of PWSs, related syndromes, and the evolution of treatment; practical management guidelines are then discussed.

    Title Edward Talbot Ely: Father of Aesthetic Otoplasty.
    Date May 2004
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title A Systematic Approach to Rhinoplasty of the Japanese Nose: a Thirty-year Experience.
    Date March 2004
    Journal Aesthetic Plastic Surgery
    Excerpt

    The Japanese nose exhibits a combination of leptorrhine and mesorrhine features that mandates an innovative treatment strategy. Unlike elsewhere in Asia, the Japanese nose often has adequate dorsal height, and at times even dorsal convexity, but maintains a more retruded and amorphous tip configuration. The proposed systematic approach to Japanese rhinoplasty is divided into four categories: (1) dorsal augmentation with or without tip augmentation, (2) dorsal reduction with tip augmentation, (3) tip augmentation only, and (4) dorsal reduction only. The use of autologous and alloplastic materials to achieve the desired aesthetic objectives is described herein. A layered auricular graft technique is outlined for tip surgery, and a unique nasal implant design is discussed.

    Title Perspective: Rejuvenation of the Periocular Region: a Unified Approach to the Eyebrow, Midface, and Eyelid Complex.
    Date March 2004
    Journal Ophthalmic Plastic and Reconstructive Surgery
    Title Midfacial Rejuvenation Via a Minimal-incision Brow-lift Approach: Critical Evaluation of a 5-year Experience.
    Date March 2004
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    OBJECTIVE: To evaluate the surgical technique, cosmetic results, and complications of patients who underwent a midface-lift via a minimal-incision brow-lift performed by the senior author (E.F.W.). SETTING: Private, ambulatory surgical center. DESIGN: A retrospective review of 325 midface-lifts performed over a 5-year period by a single surgeon.Patients A total of 325 consecutive patients who underwent a midface-lift, with or without concurrent rhytidectomy and other adjunctive procedures, and who completed 3 months of follow-up were reviewed for perioperative complications. One hundred patients who had complete photographic and chart records and who had a minimum of 6 months of follow-up were randomly selected for photographic rating and chart review. Of the patients who had a minimum of 1 year of follow-up, 50 were randomly selected to determine if midfacial elevation led to any evidence of lateral-canthal distortion. MAIN OUTCOME MEASURES: Midfacial elevation was assessed in 3 facial zones by 3 independent evaluators. Zone I represents the malar-infraorbital complex; zone II, the nasolabial sulcus; and zone III, the jawline. The zones were rated on a scale from 0 to 2 (0, no improvement; 1, mild improvement; and 2, marked improvement). Change in the lateral-canthal position was measured in the vertical and horizontal axis for each eye. All complications were recorded. RESULTS: The 3 independent evaluators correlated well in their scores (kappa = 0.643) and found that most patients showed the best improvements in zone I, with 70% of patients showing marked improvement (P<.001). Moderate improvement was noted in zone III (marked improvement, 30%; mild improvement, 50%; and no improvement, 20%). Little or no improvement was noted in zone II (marked improvement, 4%; mild improvement, 60%; and no improvement, 36%). Patients who underwent a rhytidectomy along with a midface-lift showed better elevation in zone III. However, patients who underwent a brow/midface-lift alone also showed favorable improvement along the jawline (zone III). Although the postoperative lateral-canthal position revealed statistically significant vertical elevation of the lateral canthus on the right side, this finding did not correlate with any perceived clinical significance by the reviewer or patient (P<.01). Temporary morbidity included 2 subperiosteal abscesses and 3 frontal and 1 buccal facial nerve neuropraxias that resolved by 6 months. Permanent complications included 1 case of unilateral cranial nerve V2 paresthesia. Five patients had alopecia requiring scar revision. Many of these complications, including subperiosteal abscess and alopecia, have subsequently been avoided by minor technique modifications. CONCLUSION: The technique of midface-lift via transbrow approach is a safe, reliable method of midfacial rejuvenation and avoids the unnatural lateral-canthal distortion previously described in the literature.

    Title Multipathway Risk Assessment on Disinfection By-products of Drinking Water in Hong Kong.
    Date February 2004
    Journal Environmental Research
    Excerpt

    The lifetime cancer risk and the hazard index of trihalomethanes (THMs) through oral ingestion, dermal absorption, and inhalation exposure from tap water in 19 districts in Hong Kong are estimated. The most dominant THMs are chloroform and bromodichloromethane (BDCM) in Hong Kong tap water. Among the three different pathways, residents have a higher risk of cancer through oral ingestion than through the other two pathways. The lifetime cancer risks through oral ingestion and dermal absorption for BDCM make the highest percentage contribution (59%) to total risks, followed by chloroform (24%). The chloroform and BDCM are at or above the negligible risk level of 10(-6) by a factor of 10 or more in most districts. Among the 19 districts, people living in Sai Kung have the highest risk of cancer due to the THM exposure through the multipathways, mainly because of the exposure to BDCM and dibromochloromethane (DBCM). The total cancer risk analysis indicates that each year approximately 10 out of the seven million Hong Kong residents could get cancer from the daily intake of water.

    Title Augmentation Rhinoplasty of the Asian Nose with the "bird" Silicone Implant.
    Date February 2004
    Journal Annals of Plastic Surgery
    Excerpt

    Augmentation rhinoplasty of the Asian nose has a long legacy of safety in the Orient. The silicone implant design that is proposed resembles a bird in configuration and represents an intermediary form between the traditional I- and L-shaped implants. A pronounced lobular component often poses problems in the nasal tip: This implant exhibits a more diminutive proximal tip segment. Therefore, augmentation of the nasal dorsum and tip can be accomplished safely and successfully with the technique described for carving and inserting the implant. If complications should arise (e.g., infection, extrusion, mobility, or displacement), the implant can be removed simply and quickly because of the capsular formation around the implant. Infection occurred in only 3% of patients in this series and was managed easily with implant removal, oral antibiotics, and reinsertion. Displacement can be addressed with implant removal and reinsertion, and was also observed in 3% of patients. Mobility and extrusion have not been encountered. This technique has proved to be a safe, simple, reliable, and reversible technique in 1,079 rhinoplasties performed during a 10-year period.

    Title Management of an Arteriovenous Malformation.
    Date November 2003
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    Arteriovenous malformations represent a unique challenge to the facial plastic and reconstructive surgeon. Unlike other vascular anomalies, such as hemangiomas or capillary vascular malformations (or port-wine stains), true arteriovenous malformations are rare aberrations in vascular morphogenesis. Their rarity and high propensity toward bleeding and recurrence combined with the potential for life-threatening rupture may make the occasional surgeon who dares to resect these lesions rightfully less than intrepid in his endeavor.

    Title Midfacial Rejuvenation Via an Endoscopic Browlift Approach: a Review of Technique.
    Date October 2003
    Journal Facial Plastic Surgery : Fps
    Excerpt

    The middle third of the face has remained a particularly challenging area for facial plastic surgeons to rejuvenate. Many approaches have been advocated, but no one favored technique predominates. The surgical technique of the senior author is reviewed, which has been successfully employed for the past 7 years and which has proven an effective technique in restoring midfacial youth without concomitant lateral-canthal distortion or significant morbidity. The intended objectives of this article are for the reader to understand the specific details of how to perform this technique and the rationale proposed for how a natural midface elevation is achieved by this method.

    Title A Systematic Histologic Analysis of Nonablative Laser Therapy in a Porcine Model Using the Pulsed Dye Laser.
    Date August 2003
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    BACKGROUND: To our knowledge, no systematic analysis of nonablative laser therapy has been performed. OBJECTIVE: To alter the parameters (fluence, spot size, pulse duration, and use of cooling spray) for the pulsed dye laser to determine the precise settings that would yield the most favorable dermal remodeling in a porcine model. METHODS: Research was conducted in an animal laboratory at Albany Medical College. An anesthetized Yucatan miniature pig was subjected to a pulsed dye laser at various parameters. After 10 weeks, the laser-treated areas were harvested and processed for blinded, randomized, histologic evaluation. Negative (nontreated skin) and positive (ablative carbon dioxide laser-treated skin) controls were compared with the nonablative pulsed dye laser-treated areas. MAIN OUTCOME MEASURES: Quantitative assessment of collagen band width and cells per high-power field and qualitative assessment of epidermal and dermal changes. RESULTS: A significant difference (P<.001) in collagen band width was evident when nonablative laser-treated skin and carbon dioxide ablative laser-treated skin specimens were compared with untreated skin specimens, but no significant (P =.18) difference existed between the nonablative and ablative modalities. Similarly, cellular hypertrophy, as measured by high-power field, corroborated the previous findings. Furthermore, a higher fluence, a larger spot size, and a longer pulse duration proved statistically significant for increased collagen band width (P =.01, P<.001, and P<.001, respectively), and a larger spot size and a longer pulse duration exhibited significance for cells per high-power field (P =.02 and P =.009, respectively), with a trend toward significance for higher fluence (P =.09). Overall, the dermis was considerably thicker for nonablative and ablative laser-treated areas compared with untreated skin, but this could not be quantified because the depth exceeded the punch biopsy instrument. The epidermis remained unchanged. CONCLUSIONS: The nonablative pulsed dye laser has demonstrated favorable histologic evidence of dermal remodeling, and its effects were similar to histologic changes seen with the carbon dioxide ablative laser, both of which were statistically significant compared with untreated skin, as seen in this preliminary animal model.

    Title A Psychological Profile of Children with Hemangiomas and Their Families.
    Date August 2003
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    OBJECTIVE: To assess the psychosocial impact of hemangiomas and their treatment on children with the disease and their families. DESIGN: Thirty-nine children who were treated for hemangiomas were examined by a questionnaire that addressed the emotional attitudes of the parent and child toward the disease and the related treatment. SETTING: Two private ambulatory surgery centers (in Latham and Charleston). RESULTS: Overall, the survey found a negative effect on the child's family, with considerable fear caused in part by adverse public commentary or attitudes--which was ameliorated by education from the primary care provider and specialist. However, the family's perception was that the child was not deeply affected by his or her condition and that treatment (laser, intralesional corticosteroids, oral corticosteroids, surgery, or a combination) did not change the child's emotional response to the disease. However, most parents observed that their child was too young to appreciate his or her malady. CONCLUSION: Given earlier intervention for children with late-involuting hemangiomas and the advent of more effective therapies, our survey did not seem to indicate that the children experienced significant emotional trauma from their condition; nevertheless, their families experienced appreciable emotional and psychological distress.

    Title Johann Friedrich Dieffenbach: the Many-sided Odysseus.
    Date August 2003
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title Beauty: Egon Schiele: Expressive Sensuality.
    Date June 2003
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title Computer-aided Image-guided Endoscopic Sinus Surgery in Unusual Cases of Sphenoid Disease.
    Date April 2003
    Journal Rhinology
    Excerpt

    The vital neurovascular structures that border the sphenoid sinus make extensive sphenoid sinus surgery hazardous despite the advent of endoscopic sinus surgery (ESS). Computer-aided image-guided endoscopic sinus surgery (CAIGESS) has facilitated safer surgery by providing real-time analysis of complex, three-dimensional anatomic landmarks. We present 6 cases of atypical sphenoid disease, which greatly benefited from the unique superiority of CAIGESS in avoding surgical complications. Two cases of cerebrospinal-fluid (CSF) leak with concomitant meningoencephalocele of the sphenoid sinus were successfully managed with this technique. An inverting papilloma originating from the sphenoid sinus was successfully exenterated using CAIGESS. One patient, who experienced a lateral-rectus muscle palsy from sphenoid sinusitis, underwent successful sinusotomy with CAIGESS. Another patient, who had refractory left-sided sphenoid sinusitis despite 2 ESS procedures, was found to have an obliquely oriented intersinus septum which misled the previous surgeons to enter mistakenly the contralateral sphenoid sinus. CAIGESS allowed accurate identification and removal of the intersinus septum and relief of the sinusitis. Finally, a sphenoid-sinus mucocele that developed after a prior pituitary surgery was safely decompressed with CAIGESS. This surgical approach offers a new and effective adjunct to ESS in selected revision or difficult sinus cases and has proven invaluable in complicated sphenoid cases where the surrounding neurovascular anatomy could otherwise be jeopardized.

    Title Anatomic Considerations in Aesthetic Rhinoplasty.
    Date March 2003
    Journal Facial Plastic Surgery : Fps
    Excerpt

    A thorough understanding of nasal anatomy and physiology remains critical when approaching the nose to correct any contour or functional deficiencies. This article reviews the salient, anatomic features of the nose that are relevant to the rhinoplasty surgeon and further highlights basic surgical techniques that illustrate the anatomy germane to aesthetic surgery. The external anatomy of the nose is discussed in regard to the skin/ soft-tissue envelope, the superficial musculoaponeurtic system/muscular layer, the bony/ cartilaginous framework, and the dynamic tip-support mechanisms. The discussion of internal nasal anatomy concerns functional aspects of the nose, particularly the valvular components and the septum-turbinate complex.

    Title A Systematic, Graduated Approach to Rhinoplasty.
    Date March 2003
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Rhinoplasty may be viewed as one of the most technically demanding procedures in facial plastic surgery and requires a level of sophistication derived from diligent study, repetitive execution, and critical review. During the preoperative evaluation, the physician must exercise a systematic approach that includes a thorough investigation into the psychological and physical aspects of the individual patient. A systematic, graduated approach should be undertaken in every rhinoplasty in which the three cornerstones-planning, simplicity, and flexibility-are recalled. Planning entails a thoughtful and critical analysis of what surgical techniques may be best enlisted to achieve the envisioned aesthetic effect. Simplicity argues in favor of performing only those surgical procedures needed to accomplish the task at hand to minimize the variables that arise from protracted, ill-defined surgery. Flexibility implies that the surgeon be capable of modifying his plan if unforeseen operative events disrupt the proposed course of action. All three principles reflect the authors' philosophy about the surgical approach to rhinoplasty, that is, the discretionary use of endonasal (nondelivery and delivery) and external incisions as warranted by circumstance.

    Title A Philosophy and Strategy for Surgical Hair Restoration: a 10-year Experience.
    Date February 2003
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Three principal strategies have evolved for surgical hair restoration: follicular grafting, scalp reduction, and flap rotation. OBJECTIVE: Although grafting techniques have assumed a preeminent rank as the cornerstone of modern hair-replacement therapy, scalp reduction and rotation methods should not be entirely dismissed. METHODS: Over the past 10 years of clinical experience, the authors have relied on all three methods of hair restoration, carefully tailoring the optimal surgical approach to the patient's expressed concerns and particular regional hair deficit. RESULTS: We have found that scalp reduction and rotation provides a considerable density of hair unmatched by any grafting technique for the vertex and frontotemporal regions, respectively. CONCLUSION: Also we have concluded that the former yields the most natural result for a patient with significant crown baldness who desires hair restoration in that area. However, micro- and minigrafting still represent the overwhelming majority of our operative cases. This article attempts to review the surgical methodology and philosophy that have guided our approach to hair restoration.

    Title Mikamo's Double-eyelid Blepharoplasty and the Westernization of Japan.
    Date November 2002
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title Women, Light, and Solitude.
    Date November 2002
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title John Orlando Roe: Father of Aesthetic Rhinoplasty.
    Date June 2002
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title Transtympanic Penetrating Injury to the Internal Auditory Canal.
    Date August 2001
    Journal The Annals of Otology, Rhinology, and Laryngology
    Title Bilateral Submandibular Gland Infection Presenting As Ludwig's Angina: First Report of a Case.
    Date May 2001
    Journal Ear, Nose, & Throat Journal
    Excerpt

    We diagnosed and treated a case of Ludwig's angina in a 45-year-old man who had edema of the floor of mouth and the tongue along with bilateral submandibular sialadenitis and sialolithiasis. We secured the patient's airway via nasal fiberoptic intubation in the surgical intensive care unit and administered intravenous antibiotics. The edema subsided, and the patient was extubated on the third postoperative day and discharged shortly thereafter. To our knowledge, this is the first reported case of a patient with bilateral submandibular sialadenitis and sialolithiasis presenting as Ludwig's angina. Despite the decreasing incidence of this disease, Ludwig's angina remains an important disease process because a failure to control the airway can have disastrous consequences. Proper diagnosis, airway control, antibiotic therapy, and occasionally surgical management are essential to ensure the safety of the patient.

    Title Sliding Genioplasty for Correction of Chin Abnormalities.
    Date May 2001
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Excerpt

    BACKGROUND: Correction of chin underprojection has a significant effect on facial symmetry. Alloplastic chin implants and sliding genioplasty represent the accepted methods of chin augmentation. While both procedures may be used for retrognathia or microgenia, the sliding genioplasty may also be used in chin asymmetry, prognathia, and vertical height discrepancies. We report our finding from a 5-year review of our experience with sliding genioplasty. OBJECTIVES: To evaluate the results of sliding genioplasties performed by residents and private practitioners, to illustrate the versatility and ease of this procedure, and to confirm the excellent clinical results obtained with minimal complications. DESIGN: Retrospective case review. SETTING: University center and private practice. PATIENTS: Forty-three patients, aged 16 to 52 years (mean age, 21 years), underwent sliding genioplasty alone (8 patients) or with concomitant orthognathic surgery (35 patients). MAIN OUTCOME MEASURES: Patient satisfaction, physician satisfaction, chin movement, bone resorption, and other complications. RESULTS: Mean value of chin advancement was 8 mm in cases of isolated sliding genioplasty and 4 mm when performed with orthognathic surgery. Average setback for prognathic correction (6 patients) was 2 mm. Less than 0.5 mm of bone resorption was encountered. Temporary unilateral mental nerve paresthesia was noted in 1 patient. Thermal injury to the lower lip occurred in 1 patient. Thirty-seven of 43 patients were extremely satisfied with their cosmetic result; 5 patients were very satisfied; and 1 patient was dissatisfied because of the resultant occlusion. Physician satisfaction correlated closely with that of the patients. Follow-up ranged from 6 months to 5 years, with an average follow-up of 2.3 years. CONCLUSIONS: Our findings indicate excellent esthetic results with minimal complications. Unlike alloplastic chin implants, sliding genioplasty allows correction of many chin abnormalities, including underprojection, overprojection, chin asymmetries, and/or vertical-height abnormalities. This underused technique is simple and effective and should be included in the options of the facial plastic surgeon.

    Title Cranioplasty in Acoustic Neuroma Surgery.
    Date August 2000
    Journal The Laryngoscope
    Excerpt

    OBJECTIVES: To measure the incidence of postoperative headaches after retrosigmoid resections of acoustic neuromas and to evaluate the impact of cranioplasty on the prevention and management of these headaches. STUDY DESIGN: A prospective evaluation was performed on 30 consecutive patients who underwent a cranioplasty after retrosigmoid excision of their acoustic neuroma. The results were compared with 30 historical control patients who underwent the same procedure but did not have reconstruction with a cranioplasty. The patients were evaluated by review of office records and via telephone questionnaire. METHODS: One group of patients (30 patients) had no cranioplasty, and the other group of 30 patients had primary reconstruction with a titanium mesh-acrylic cranioplasty. All 60 patients were asked to report on the duration and severity of their headaches by means of a standard questionnaire, grading their symptoms on a scale of 1 to 4. The data were subjected to chi2 and Student t test statistical analyses. RESULTS: New-onset, postoperative headaches occurred in 27% of patients, 23% in the cranioplasty group compared with 30% in the group without cranioplasty (a difference that was not statistically significant [P = .158]). However, there was a statistically significant difference in the severity of the headaches (P<.03). The headaches in the cranioplasty group were less severe and were not disabling. There were no complications, infections, or extrusions related to the cranioplasty. CONCLUSIONS: Cranioplasty has not been able to eliminate postoperative headaches. However, the use of cranioplasty has significantly decreased the severity of postoperative headaches after retrosigmoid excision of acoustic neuromas.

    Title Acute Pulmonary Hemorrhage Following a Honeybee Sting: a Case Report.
    Date December 1999
    Journal Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
    Excerpt

    A generalized allergic reaction to or anaphylaxis from honeybee sting may involve the skin with erythema, puritus, urticaria, or angioedema; the respiratory tract with laryngeal edema, and brochospasm; the cardiovascular system with myocardial depression, hypotension, and shock; and the gastrointestinal system with nausea, vomiting, and incontinence. Acute pulmonary hemorrhage following a honeybee sting has never been reported. We describe a previously healthy 14-year-old girl who developed acute pulmonary hemorrhage, hypotension, and generalized skin rash after a single honeybee sting on her right fourth finger. Her serum immunoglobulin E (IgE) was high (360 IU/mL). Chest X-ray revealed perihilar alveolar infiltrative lesions. Metabolic acidosis and hypoxemia were also found. After treatment with antihistamines, dopamine, corticosteroids, bronchodilaters, fluid replacement, and mechanical ventilation, her condition improved dramatically. A hypersensitivity reaction to honeybee venom is the most likely explanation for this unusual case of acute pulmonary hemorrhage.

    Title Premenstrual Asthma: Report of a Case with Hormonal Studies.
    Date October 1999
    Journal Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
    Excerpt

    We report a 39-year-old female non-smoker who has history of asthma since the age of 29 and history of allergic rhinitis at age 13. No symptomatic characteristics of premenstrual tension were reported. Forced expiratory peak flow rate (PEFR) readings showed striking falls 24 hours before menses, with the peak flows dropping from a baseline of 350 L/min to 200 L/min. The patient received 10 mg prednisolone daily which was increased to 40 mg prednisolone in the menstrual week in an attempt to maintain a normal peak flow. Daily peak flow readings and every other day hormonal studies of progesterone and estrogen both demonstrated a positive correlation between the serum progesterone and the peak flow readings. The addition of intramuscular progesterone (75 mg daily) to the bronchodilators eliminated the premenstrual dips in peak flow, and daily doses of prednisolone were reduced to 5-10 mg. We suggest that a rapid fall in serum progesterone may play an important role in the pathogenesis of premenstrual asthma.

    Title Transforming Growth Factor-alpha and Rhinitis.
    Date July 1999
    Journal The Laryngoscope
    Excerpt

    OBJECTIVES: Transforming growth factor-alpha (TGF-alpha) has been implicated in diverse physiologic and pathophysiologic functions including immunological, inflammatory, and neoplastic processes. TGF-alpha has been localized in the hyperproliferative, inflammatory environment of chronic otitis media, cholesteatoma, and asthmatic airways. TGF-beta1, which must be present with TGF-alpha to transform fibroblasts, has been found in rhinitic mucosa and in asthma in prior studies. The authors sought to identify whether TGF-alpha also played a role in the inflammatory cascade and fibrosis of rhinitis. STUDY DESIGN: A nonrandomized, prospective study was carried out in which samples of inferior turbinate and nasal polyps from rhinitic and nonrhinitic patients were subjected to immunohistochemistry and Western blotting to determine the presence of TGF-alpha. METHODS: Twenty-seven subjects undergoing surgery for rhinitis, obstructive sleep apnea, nasal fracture, and rhinoplasty were recruited for this study, the latter three groups acting as controls. Immunohistochemical and Western blotting techniques were employed to identify the presence of TGF-alpha in inferior-turbinate and nasal-polyp samples of rhinitic subjects. RESULTS: Immunohistochemistry demonstrated the selective staining of TGF-alpha in the basement membrane and extracellular matrix, including lymphatic, vascular, and glandular structures, in most turbinate samples and the absence of staining in corresponding controls. Further, TGF-alpha was isolated to a discrete 30-kD band in both inferior turbinate and polyp tissues by Western blotting without staining in the corresponding controls. CONCLUSIONS: These results suggest that TGF-alpha may play a role in the inflammatory derangement of rhinitis.

    Title Immunohistochemical Localization of Type-ii (at2) Angiotensin Receptors with a Polyclonal Antibody Against a Peptide from the C-terminal Tail.
    Date September 1997
    Journal Regulatory Peptides
    Excerpt

    A polyclonal antibody has been prepared against a synthetic peptide derived from the C-terminal tail of the cloned rat AT2 angiotensin receptor, corresponding to amino acid residue 341-351. The antibody was of high titer and displayed monospecific activity toward the synthetic peptide in the ELISA assay. Western blot analysis indicated that the antiserum recognised only a single protein band with a mean apparent molecular mass of 75.4 kDa in the rat adrenals. Immunohistochemical studies with affinity purified antibody localised immunoreactive AT2 angiotensin receptor in medulla cells of the adrenals. Immunoreactivity was also observed in pyramidal tract, but no specific immunoreactivity can be detected in regions of rat brain that are known to express AT2 angiotensin receptors, including inferior olive, locus coeruleus and cerebellum.

    Title Acinetobacter Pericarditis with Tamponade in a Patient with Systemic Lupus Erythematosus.
    Date September 1997
    Journal Lupus
    Excerpt

    We describe a case of active systemic lupus erythematosus (SLE) complicated with a large amount of pericardial effusion with diastolic collapse of right ventricle suggestive of tamponade. Isolates from surgical drainage of pericardial fluid showed Acinetobacter baumannii exhibiting multiple antibiotics resistance. Despite the high frequency of both pericardial involvement and of infection complications in SLE, septic pericarditis and tamponade is considered rare. Most of the reported cases of septic pericarditis in SLE were due to Staphylococcal aureus, and Acinetobacter baumannii has never been reported before.

    Title Association of Ankylosing Spondylitis with Iga-multiple Myeloma: Report of a Case and Pathogenetic Considerations.
    Date December 1989
    Journal Taiwan Yi Xue Hui Za Zhi. Journal of the Formosan Medical Association
    Excerpt

    Multiple myeloma has rarely been reported in patients with ankylosing spondylitis. We observed a patient with a 20-year history of ankylosing spondylitis, who subsequently developed IgA myeloma. This association may not be simply coincidental. It has been proposed that the protracted stimulation of immunocytes by inflammatory lesions on the mucosal surfaces of the gastrointestinal, respiratory, and biliary tracts, where lymphocytes are already committed to IgA production, may be implicated in the pathogenesis of IgA myeloma in some patients. Ankylosing spondylitis is a chronic inflammatory disease, probably resulting from the interaction of a genetic predisposition involving HLA-B27 with an environmental event such as enteric bacterial infection. We propose that ankylosing spondylitis and IgA myeloma occurring concomitantly in our patient implies a possible pathogenetic relationship. In ankylosing spondylitis, persistent reticuloendothelial stimulation, due to chronic subclinical gastrointestinal infection, may lead to IgA-producing plasma cell activation and proliferation, and subsequent IgA myeloma development.

    Title Weight Decay Backpropagation for Noisy Data.
    Date
    Journal Neural Networks : the Official Journal of the International Neural Network Society
    Excerpt

    We present a formal evaluation of the effect of weight decay training for backpropagation on noisy data sets. Weight decay training is suggested as an implementation for achieving a robust neural network which is insensitive to noise. We investigate the noisy situations of noisy training set-clean test set, clean training set-noisy test set, and noisy training set-noisy test set. Statistically speaking, there is strong evidence indicating that the noisy situation of noisy training set-clean test set provides more accurate prediction than the other two noisy situations. This finding suggests the relative importance of maintaining to-be-predicted cases noise-free for neural network classification. Furthermore, experimental results show that weight decay training is at least as good as standard backpropagation in noisy situations and, in some data sets, weight decay training outperforms standard backpropagation by a significant difference. However, for clean data sets there is no significant difference between weight decay training and standard backpropagation. Another interesting finding in this study is the effect of the number of training epochs on weight decay training and standard backpropagation in noisy situations. Weight decay training can achieve convergence after a short training. For the same short training, weight decay training usually outperforms standard backpropagation. When additional training has a significant effect on performance, it is to improve standard backpropagation but deteriorate weight decay training.

    Title Revision Rhinoplasty for the Asian Nose.
    Date
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Revision rhinoplasty of the Asian nose requires a combination of cultural sensitivity and unique surgical strategies to achieve a successful outcome. Cultural sensitivity means understanding some of the folkloric motivations to undergo rhinoplasty and divergent ethnic standards of beauty. Basic techniques for Asian rhinoplasty are reviewed as a prerequisite knowledge for revision rhinoplasty of the Asian nose, specifically a combination technique of expanded polytetrafluoroethylene for bridge augmentation and autogenous cartilage tip grafting. Revision Asian nose surgery oftentimes involves removal of a previously placed solid silicone implant, which remains the most popular option for augmentation rhinoplasty in Asia. Strategies for revision rhinoplasty in the Asian nose are then reviewed.

    Title Facial Fat Grafting: the New Paradigm.
    Date
    Journal Archives of Facial Plastic Surgery : Official Publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies
    Title Limitations, Complications, and Long-term Sequelae of Fat Transfer.
    Date
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    Facial fat transfer has become one of the most potent methods for facial rejuvenation. The two notable problems that have limited its widespread acceptance are the perceived absorption and dissipation of the transplanted fat and the risk of difficult complications such as lumps and bulges along the periorbital expanse. This article discusses these concerns and the long-term sequelae, particularly derivative benefits beyond volume contour changes such as textural improvements in the skin, ongoing improvements in the appearance of the grafted fat after months to years, and other structural changes.

    Title Volume Restoration and Facial Aesthetics.
    Date
    Journal Facial Plastic Surgery Clinics of North America
    Excerpt

    This article discusses the rationale for the use of volume restoration to restore natural, youthful contours to an aging face. Topics discussed include the discrepancy that can exist between patients' stated wishes and optimal results and the concepts of framing the eye, creating highlights, and restoring facial shape and volume.

    Title Asian Rhinoplasty.
    Date
    Journal Seminars in Plastic Surgery
    Excerpt

    Rhinoplasty for the Asian patient mandates an entirely different strategy than for the Occidental nose. The objective for Asian rhinoplasty is augmentation rather than reduction in which the dorsum is raised and the nasal tip projection and definition are enhanced. The watchword today is ethnic preservation rather than effacement for the Asian patient. An ethnically sensitive standard for aesthetic rhinoplasty for the Asian nose is proposed. Also, a thorough discussion of cultural issues that can be important when working with the Asian patient is undertaken to guide a surgeon through every phase of patient care. Finally, the technical details are elaborated on both rhinoplasty and revision rhinoplasty for the Asian nose with an emphasis on correcting previous silicone augmentation rhinoplasty, the most popular choice for material in the Far East but that has failed the author in achieving consistent results.

    Title Fat Transfer for the Management of Soft Tissue Trauma: the Do's and the Don'ts.
    Date
    Journal Facial Plastic Surgery : Fps
    Excerpt

    Fat transfer for the aging face is an increasingly popular method for facial rejuvenation. However, there are inherent risks with fat transfer due to the nature of a fat graft that limits its potential use in the context of soft tissue trauma. This article reviews these limitations and also describes techniques for performing fat transfer to attain safe and long-term aesthetic results in varied clinical settings.

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