Lipoplasty of the neck

Lipoplasty provides a new method of removing subcutaneous fat and contouring the neck. This author reports his experience in 50 cases. A total of 35 patients were done in conjunction with a rhytidoplasty, and 15 patients had lipoplasty as an isolated procedure. The series could be divided into halves. After 25 cases, several undesirable results were noted, including discomfort (15 of 25), nodularity (6 of 25), and contour irregularities (3 of 25). Modifications were made in the technique and postoperative treatment, including a smaller-diameter cannula, more extensive dissection with feathering, multiple incisions and cross-tunnels, and the postoperative use of massage and ultrasound and an elastic head garment. Subsequent patients had reduced morbidity and improved operative results. A detailed account of the operative procedure is discussed. Photographic documentation of results is given. This author's initial experience with lipoplasty of the neck indicates early problems, solutions, and results. The technique is viewed as a useful addition to the armamentarium of the plastic surgeon.     

Lipoplasty claims experience of U.S. insurance companies

An analysis of medical liability claims for lipoplasty (liposuction) from January of 1985 through June of 1998 compared the insurance industry experience of plastic surgeons with that of other physicians. The Data Sharing Project database of the Physician Insurers Association of America, a trade association of professional liability companies owned and operated by medical professionals that collectively insure approximately 60 percent of America's private practice physicians, was queried. Of the nearly 45,000 total entries in the database, 292 were claims for adverse events related to lipoplasty or liposuction. These raw data were stratified by physician specialty, severity of complication, practice location, patient gender, indemnity payment, and other insurance industry-relevant variables.To simplify interspecialty comparisons, we normalized the claims rate to incidents per 100 insured physicians. The indexed lipoplasty claims rate was 3.0 per 100 insured plastic surgeons and 4.1 for other surgeons; the indexed lipoplasty claims rate for nonsurgical specialists was 2.5 per 100 insured dermatologists and 2.3 for other nonsurgeons. The higher claims rate for surgeons most likely reflects the wider scope of full-service aesthetic surgery performed by surgical specialists. Nearly two-thirds of claims (65.4 percent) during the 13-year survey period were the result of hospital-based lipoplasty; 20.9 percent were office-based claims. The prevalence of hospital-based claims may be a consequence of both historical bias introduced by hospital-based specialty surgery in the early years and prudent patient safety considerations during performance of complex or prolonged procedures in more recent years.Two-thirds of the claims (67 percent) arose from informed-consent or breach-of-contract issues, far higher than the 26 percent aggregate claims norm. The mean indemnity payment was $94,534 per lipoplasty claim; claims paid against board-certified specialists averaged $83,350. Consistent with national lipoplasty demographics, 87 percent of claims were brought by women and 13 percent were brought by men. Seven fatalities (three women and four men) were noted; cause of death is not recorded in this type of database.     

Characteristics of the electrolyte balance of the blood of healthy newborn calves and calves with diarrhea

Cows and newborn (just after the birth, and on the 1st, 3rd, 5th and 10th days after it) calves were tested for the peculiarities of the electrolyte blood composition and acid-base balance under normal and diarrheic conditions. The values of Na+/K+, Cl-/HCO3-, Pn/Ca2+ ratios in the blood serum of sick animals remain unchanged, which testifies to the deep disturbances of the water-salt metabolism in tissues.     

Observations on parasitic gastroenteritis and bronchitis in grazing calves: Untreated calves

Pott J. M., Jpones R. M. and Cornwell R. L. 1978. Observations on parasitic gastroenteritis and bronchitis in grazing calves: untreated calves. International Journal for Parasitology8: 331–339. The epidemiology of parasitic gastroenteritis (p.g.e.) and incidental observations on lungworm infection were studied on two equal-sized paddocks of permanent pasture on a Kent farm in 1970. Groups of 10 Friesian calves were exposed for the first time to each paddock in May and grazed until the end of October. Faeces were monitored, body weights recorded and clinical signs observed. Herbage samples were examined for larvae throughout the year. Five ‘cumulative’ tracer calves exposed at the commencement were removed at monthly intervals and 5 ‘short term’ tracer calves exposed at successive monthly intervals for 1 month were killed for worm counts. A similar pattern of events occurred on both paddocks. Moderate herbage larval levels of Ostertagia and Cooperia fell to almost zero during April/May but rose quickly in July to high levels in August/September. Lower levels continued until the end of the year. Faecal egg excretion began in the test calves at the end of May, showed peaks in July and September and fell to low levels in October. D. viviparus larval excretion occurred in most calves with greater counts on Paddock 2. Clinical signs of p.g.e. complicated by lungworm infection occurred in August/September. Body weight gain which was initially rapid levelled off in June due partly to drought in addition to the parasitic infection. Weight loss occurred in August and there were 2 deaths on Paddock 1 and one on Paddock 2. Survivors gained weight again in September/October.Worm burdens in tracer calves showed quite heavy infections with Ostertagia and Cooperia as early as June/July. Massive infections complicated by lungworm disease accompanied clinical signs and death. There was evidence that aquisition of resistance to Cooperia and Dictyocaulus was acquired more readily than to Ostertagia. Inhibition of development of Ostertagia and Cooperia also became evident at the end of the trial period.     

Stress relaxation of human ankles is only minimally affected by knee and ankle angle

Comprehensive characterization of stress relaxation in musculotendinous structures is needed to create robust models of viscoelastic behavior. The commonly used quasi-linear viscoelastic (QLV) theory requires that the relaxation response be independent of tissue strain (length). This study aims to characterize stress relaxation in the musculotendinous and ligamentous structures crossing the human ankle (ankle-only structures and the gastrocnemius muscle–tendon unit, which crosses the ankle and knee), and to determine whether stress relaxation is independent of the length of these structures. Two experiments were conducted on 8 healthy subjects. The first experiment compared stress relaxation over 10 min at different gastrocnemius muscle–tendon unit lengths keeping the length of ankle-joint only structures fixed. The second experiment compared stress relaxation at different lengths of ankle-joint only structures keeping gastrocnemius muscle–tendon unit length fixed. Stress relaxation data were fitted with a two-term exponential function (T=G₀+G₁e^?λ₁t+G₂e^?λ₂t). The first experiment demonstrated a significant effect of gastrocnemius muscle–tendon unit length on G₁, and the second experiment demonstrated an effect of the length of ankle-joint only structures on G₂, λ₁ and λ₂ (p<0.05). Nonetheless, the size of effects on stress relaxation was small (ΔG/G<10%), similar to experimental variability. We conclude that stress relaxation in the relaxed human ankle is minimally affected by changing gastrocnemius muscle–tendon unit length or by changing the lengths of ankle-joint only structures. Consequently quasi-linear viscoelastic models of the relaxed human ankle can use a common stress relaxation modulus at different knee and ankle angles with minimal error.     

Liquid supplementation of grazing cows and calves

One hundred and one Angus cows (average weight 614 kg) and their bull calves (average weight 213 kg) grazing improved summer pastures were used to determine cow and calf intake of liquid supplement, and its effect on forage intake and performance. Forty-seven pairs had access to a 410 g CP/kg DM molasses-based liquid supplement in an open feeder and 54 pairs were not supplemented. The study was conducted in southwestern Montana from July 28 to October 3, 1997. Cows consumed significantly more supplement (0.3 kg/day) than calves (0.1 kg/day) but both consumed 0.5 g/kg bodyweight per day. Supplemented cows gained 0.12 kg/day more (p<0.05) than unsupplemented cows; however, there was no difference (p>0.10) in body condition score change. Average daily gain by supplemented calves was 30% greater (p<0.01) than average daily gain by unsupplemented calves. Forage intake (g/kg body weight) by both supplemented cows and calves was 64% greater (p<0.01) than forage intake by unsupplemented cows and calves. There was no difference (p>0.10) in milk intake between supplemented and unsupplemented calves. There was no difference (p>0.10) in time spent at the supplement feeder between cows and calves, averaging 5.0 min/day. Time at the feeder was lowest for 7-year-old cows, intermediate for 6- and 8-year-old cows, and highest for 9-year-old cows (p<0.10). There was no difference (p>0.10) in supplement feeding bouts/day between age groups of cows. Calf liquid supplement intake (g/kg body weight) and time spent at the supplement feeder were similar to intake and time spent at the feeder by cows. Liquid supplementation increased forage intake and average daily gain by cows and calves grazing improved forages in late summer. The cost for additional weight gained by the supplemented calves was US$ 0.33/kg and October cattle prices in Montana were US$ 1.64/kg. Liquid supplementation was cost effective under the conditions of this study.     

Shape discrimination in sheep and calves

Sheep and calves have been trained, using an operant conditioning method in which they pressed panels with their muzzles in order to obtain food, to discriminate between simultaneously presented shapes. In the discrimination task the animals faced two response panels upon which were projected the shapes to be discriminated. Only presses on the panel associated with the correct shape were reinforced, and after each reinforcement the position of the positive stimulus was randomly varied. The results obtained demonstrated that sheep and calves can discriminate between a variety of similar shapes.     

Endocrine characteristics of cloned calves

To examine the possible link between endocrine status and perinatal problems related to cattle cloning, plasma concentrations of cortisol, adrenocorticotropic hormone (ACTH) and components of the insulin-like growth factor (IGF) system were compared between 13 somatic cell cloned and seven control Japanese Black calves (five produced by artificial insemination [AI] and two produced from in vitro fertilized embryos [IVP]) immediately after birth. Five cloned calves required delivery by cesarean section (C-section), while all of control calves were delivered by spontaneous vaginal delivery. The C-section delivered clones were heavier at birth, followed by vaginally delivered clones and IVP controls, and AI controls were the lightest. The neonatal mortality (death within the 1st week) of C-section delivered clones was also high (4/5) compared to that of vaginally delivered clones (1/8) or controls (0/7). Plasma concentrations of cortisol and IGF-I were lower in the clones than control calves although the plasma ACTH level was not different between the groups. A striking difference was observed in plasma IGF binding protein (IGFBP) profile in which cloned calves had a greater relative abundance of IGFBP-2 compared with controls. Observed differences suggest that insufficient prepartum rise in plasma cortisol of cloned calves failed to initiate the switch to an adult mode of the IGF system during late gestation and therefore parturition was not spontaneous. Inappropriate developmental changes in endocrine system may be partly responsible for the fetal overgrowth and perinatal complications associated with the cloning technology.