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Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate
Rossell-Perry, Percy,Cotrina-Rabanal, Omar,Barrenechea-Tarazona, Luis,Vargas-Chanduvi, Roberto,Paredes-Aponte, Luis,Romero-Narvaez, Carolina Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.3
Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994-2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.
Rossell-Perry, Percy,Schneider, William J.,Gavino-Gutierrez, Arquimedes M. Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.3
Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate.
Percy Rossell-Perry,William J Schneider,Arquímedes M. Gavino-Gutierrez 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.3
Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate.
Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate
Percy Rossell-Perry,Omar Cotrina-Rabanal,Luis Barrenechea-Tarazona,Roberto Vargas-Chanduvi,Luis Paredes-Aponte,Carolina Romero-Narvaez 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.3
Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994–2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.
Interface control of bulk ferroelectric polarization.
Yu, P,Luo, W,Yi, D,Zhang, J X,Rossell, M D,Yang, C-H,You, L,Singh-Bhalla, G,Yang, S Y,He, Q,Ramasse, Q M,Erni, R,Martin, L W,Chu, Y H,Pantelides, S T,Pennycook, S J,Ramesh, R National Academy of Sciences 2012 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.109 No.25
<P>The control of material interfaces at the atomic level has led to novel interfacial properties and functionalities. In particular, the study of polar discontinuities at interfaces between complex oxides lies at the frontier of modern condensed matter research. Here we employ a combination of experimental measurements and theoretical calculations to demonstrate the control of a bulk property, namely ferroelectric polarization, of a heteroepitaxial bilayer by precise atomic-scale interface engineering. More specifically, the control is achieved by exploiting the interfacial valence mismatch to influence the electrostatic potential step across the interface, which manifests itself as the biased-voltage in ferroelectric hysteresis loops and determines the ferroelectric state. A broad study of diverse systems comprising different ferroelectrics and conducting perovskite underlayers extends the generality of this phenomenon.</P>
Interstory-interbuilding actuation schemes for seismic protection of adjacent identical buildings
Francisco Palacios-Quiñonero,Josep Rubió-Massegú,Josep M. Rossell,José Rodellar 국제구조공학회 2019 Smart Structures and Systems, An International Jou Vol.24 No.1
Rows of closely adjacent buildings with similar dynamic characteristics are common building arrangements in residential areas. In this paper, we present a vibration control strategy for the seismic protection of this kind of multibuilding systems. The proposed approach uses an advanced Linear Matrix Inequality (LMI) computational procedure to carry out the integrated design of distributed multiactuation schemes that combine interbuilding linking devices with interstory actuators implemented at different levels of the buildings. The controller designs are formulated as static output-feedback H-infinity control problems that include the interstory drifts, interbuilding approachings and control efforts as controlled-output variables. The advantages of the LMI computational procedure are also exploited to design a fully-decentralized velocity-feedback controller, which can define a passive control system with high-performance characteristics. The main ideas are presented by means of a system of three adjacent five-story identical buildings, and a proper set of numerical simulations are conducted to demonstrate the behavior of the different control configurations. The obtained results indicate that interstory-interbuilding multiactuation schemes can be used to design effective vibration control systems for adjacent buildings with similar dynamic characteristics. Specifically, this kind of control systems is able to mitigate the vibrational response of the individual buildings while maintaining reduced levels of pounding risk.
Microfinance Product Diversification
Koen Rossel-Cambier 한국라틴아메리카학회 2011 라틴아메리카연구 Vol.24 No.3
This paper aims at gaining deeper understanding of the possible effects of combined microfinance (CMF) product delivery. By means of a case-study on the City of Bridgetown (COB), one of the leading credit unions in Barbados, it explores the possible opportunities and challenges dealing with CMF. This case-study suggests that CMF, especially the combination credit-savings, may enhance the cost-efficiency of loan delivery and that it can generate economies of scope for marketing purposes. Savings is at the heart of the growth strategy of the credit union and has contributed to its current large breadth of outreach. The case-study suggests that CMF can also lead to increased costs and new financial risks for MFIs. It brings forward the complex interaction dynamics between different financial products which can lead to a domino effect of cumulative access barriers. Especially unbankable clients, with limited financial capacity, a challenging risk profile and exposed to information asymmetry, are vulnerable to these elements if no appropriate measures are being taken.