There has been a change in the management of infantile haemangioma with the introduction of propranolol. The aim of this study is to retrospectively evaluate a simple treatment for infantile haemangioma at the Red Cross War Memorial Children’s Hospital (RCWMCH) and document the results. While it is known that all haemangiomas undergo involution at some stage, some haemangiomas pose certain problems. These relate mainly to visual axis obstruction and aesthetics. Subjects are children in the first two years of life presenting with haemangiomas. All patients were treated with oral propranolol in conjunction with haemangioma size documentation, using a simple radiological modality, i.e. ultrasound imaging. Patients are followed up and clinical and radiological evaluations are undertaken to observe changes in size and appearance. Propranolol is non-selective β-adrenergic antagonist that is used extensively for the treatment of a multitude of disorders, mainly cardiovascular indications. The main adverse effects include bradycardia, hypotension and bronchospasms. For the purposes of this study, all subjects were routinely examined, especially with regard to the cardiopulmonary systems. Any perceived anomaly was referred to the cardiorespiratory physicians at RCWMCH for further evaluation, which includes all the necessary investigations such as electrocardiograms(ECG) and echocardiograms. Therefore, only fit healthy patients were selected for this study. Patients are educated and fully informed regarding the adverse effect profile of propranolol, and advised of the appropriate route of management.

Includes bibliographical references. / More than three-quarters (77%) of the 40.5 million people living in South Africa are black African, of which more than 40% are urbanised. Black African women living in urban areas have a significantly higher prevalence (62%) of overweight than urban black males (28%) or white females (53%). It was previously thought that obesity in black South African women was not associated with deleterious metabolic sequelae and was termed "healthy" obesity...

The standard surgical treatment of velopharyngeal insufficiency (VPI) includes revision palatoplasty, posterior pharyngeal flap and sphincter pharyngoplasty. These procedures are not without complication and can also be challenging to the occasional cleft surgeon. The greatest complication is iatrogenic obstructive sleep apnoea particularly in high risk patients. With the introduction of posterior pharyngeal wall augmentation, a lesser and simpler surgical procedure, various materials have been used for this purpose with limited success and significant complication rates. Augmentation of the velo-pharynx with autologous fat has been practiced for decades. Autologous fat has multiple advantages compared to other biological and synthetic materials used for augmentation of the velopharynx. Autologous fat is readily available, has low donor site morbidity, does not migrate, injects easily and is non-allergenic. The outcome of fat grafting for VPI is good and stable long term, albeit unpredictable due to the resorption of fat. The procedure may therefore need to be repeated in order to achieve the desired results. The aim of this study is to evaluate and document the outcome of autologous fat grating for the treatment of mild to moderate VPI in children at the Red Cross War Memorial Children's Hospital (RCWMCH). A retrospective folder review was conducted on 9 consecutive patients who underwent velopharygeal fat grating for the treatment of mild to moderate VPI at the RCWMCH from 2010 to 2014. All the patients had had primary palatoplasty performed previously and subsequently developed VPI. Patients were assessed pre- and postoperatively by two cleft surgeons, and an experienced speech and language therapist with the aid of laterl view videofluoroscopy (VF). Pre-operative and post-operative perceptual speech assessments were performed by a dedicated speech and language therapist. Two senior cleft surgeons performed pre-and post-operative videofluoroscopy interpretations. Eleven fat grafting procedures were performed on 9 patients and an average of 5.64 ml (range 1 ml to 7 ml) of autologous fat was transferred to the velopharynx. The average age at the time of operation was 6.5 years (range 3 years to 14 years) with a follow-up period of 18 months (range 7 months to 34 months). Most of the patients (7 out of 9) showed improved speech following fat grafting. There were no complications related to the fat grafting procedure. This small study suggests that fat grafting is an effective, minimally invasive surgical alternative for the treatment of mild to moderate VPI and to our knowledge, is the first reported study from Africa.

The concept suggesting primary excision and immediate grafting as the definitive treatment for a thermal burn is not new (1 ). To avoid the sequelae of local and systemic sepsis, early excision of burn eschar to remove all devitalized tissue has been a widely accepted method of treatment of deep burns since 1929, when Wells performed total excision and grafting of electric burns (2). While the technique has many advantages, it is not without significant complications. Haemorrhage accompanying burn wound excision can be deceptively large, as can the metabolic stress associated with large surgical procedures performed in the post-burn period (3).

This project report presents a laboratory investigation of the dynamic behavior of saturated alluvial silty soils from sites in Oregon and Washington. The focus of the study was to document the liquefaction susceptibility, post cyclic strength, and volumetric strain behavior of the silt soils based on cyclic, undrained triaxial compression testing. A cyclic triaxial testing apparatus with computer control and data acquisition was assembled, calibrated, and used to perform undrained cyclic triaxial testing and post cyclic testing on undisturbed and reconstituted specimens. The results of this investigation are compared with the undrained cyclic triaxial testing data on silty soils published by others. The influence, of grain-size distribution, plasticity index, and overconsolidation ratio (OCR) on the dynamic behavior was identified. Several cyclic resistance curves were prepared that show the cyclic resistance for the silts for OCR values of 1 to 2.5. The cyclic resistance curves observed in the laboratory likely overestimate the in-situ cyclic resistance of the material due to sample disturbance during sampling, transport, and testing. It was observed that OCR has a significant influence on the cyclic resistance of silt soils. Cyclic resistance was observed to increase with increasing plasticity and percent passing the U.S. Standard Number 200 Sieve and percent finer than 2 ��m. It was observed that excess pore pressure measurements recorded at the transducer for fine-grained soils subjected to rapid loading may not accurately represent the actual pore pressures of the soil. Therefore, it is proposed that strain criteria be used, rather than excess pore pressure generation, to define initial liquefaction for fine-grained soils. Post cyclic undrained strength test data shows that the silts are dilative under compressive loading in the triaxial apparatus. Peak strengths were not observed due to the dilative nature of the silty soil tested. Therefore, post cyclic undrained strengths were strain based. The strain based strengths were compared with relationships developed by Baziar and Dobry (1995) and Ishihara (1993) and were found to have a higher residual strength than the sandy soils. Unusually high S[subscript u]/p' ratios were also recorded for the silt soils. This observation highlights the need to obtain post-cyclic strength at a consistent strain. The post cyclic volumetric strain data was compared with the findings of Ishihara and Yoshimine (1992). Plots of volumetric strain versus maximum axial strain were created. These plots were then used to establish a relationship between post cyclic volumetric strain and the factor of safety against liquefaction. The volumetric strain behavior of the silt was observed to be very similar to sand at relative densities of 40 to 80 percent. / Graduation date: 2003

To correct, improve, and maintain tissues, and their functions, are common denominators in tissue engineering and reconstructive plastic surgery. This can be achieved by using autolo-gous tissues as in flaps or transplants. However, often autologous tissue is not useable. This is one of the reasons for the increasing interest among plastic surgeons for tissue engineering, and it has led to fruitful cross-fertilizations between the fields. Tissue engineering is defined as an interdisciplinary field that applies the principles of engineering and life sciences for development of biologic substitutes designed to maintain, restore, or improve tissue functions. These methods have already dramatically improved the possibilities to treat a number of medical conditions, and can arbitrarily be divided into two main principles: > Methods where autologous cells are cultured in vitro and transplanted by means of a cell suspension, a graft, or in a 3-D biodegradable matrix as carrier. > Methods where the tissue of interest is stimulated and given the right prerequisites to regenerate the tissue in vivo/situ with the assistance of implantation of specially designed materials, or application of substances that regulate cell functions - guided tissue regeneration. We have shown that human mammary epithelial cells and adipocytes could be isolated from tissue biopsies and that the cells kept their proliferative ability. When co-cultured in a 3-D matrix, patterns of ductal structures of epithelial cells embedded in clusters of adipocytes, mimicking the in vivo architecture of human breast tissue, were seen. This indicated that human autologous breast tissue can be regenerated in vitro. The adipose tissue is also generally used to correct soft tissue defects e.g. by autologous fat transplantation. Alas 30-70% of the transplanted fat is commonly resorbed. Preadipocytes are believed to be hardier and also able to replicate, and hence, are probably more useful for fat transplantation. We showed that by using cell culture techniques, significantly more pre-adipocytes could survive and proliferate in vitro compared to two clinically used techniques of fat graft handling. Theoretically, a biopsy of fat could generate enough preadipocytes to seed a biodegradable matrix that is implanted to correct a defect. The cells in the matrix will replicate at a rate that parallels the vascular development, the matrix subsequently degrades and the cell-matrix complex is replaced by regenerated, vascularized adipose tissue. We further evaluated different biodegradable scaffolds usable for tissue engineering of soft tissues. A macroporous gelatin sphere showed several appealing characteristics. A number of primary human ecto- and mesodermal cells were proven to thrive on the gelatin spheres when cultured in spinner flasks. As the spheres are biodegradable, it follows that the cells can be cultured and expanded on the same substrate that functions as a transplantation vehicle and scaffold for tissue engineering of soft tissues. To evaluate the in vivo behavior of cells and gelatin spheres, an animal study was performed where human fibroblasts and preadipocytes were cultured on the spheres and injected intra-dermally. Cell-seeded spheres were compared with injections of empty spheres and cell suspensions. The pre-seeded spheres showed a near complete regeneration of the soft tissues with neoangiogenesis. Some tissue regeneration was seen also in the ‘naked’ spheres but no effect was shown by cell injections. In a human pilot-study, intradermally injected spheres were compared with hyaluronan. Volume-stability was inferior to hyaluronan but a near complete regeneration of the dermis was proven, indicating that the volume-effect is permanent in contrast to hyaluronan which eventually will be resorbed. Further studies are needed to fully evaluate the effect of the macroporous gelatin spheres, with or without cellular pre-seeding, as a matrix for guided tissue regeneration. However, we believe that the prospect to use these spheres as an injectable, 3D, biodegradable matrix will greatly enhance our possibilities to regenerate tissues through guided tissue regeneration. / On the day of the defence date the status of article V was In Press.

Thesis (M.E.)--University of Canterbury, 2007. / Typescript (photocopy). "May 2007." Includes bibliographical references (leaves 121-122). Also available via the World Wide Web.

Thesis (M. Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 62-63).

Thesis (Doctoral Engineering)--Norwegian Institute of Technology, 1992. / Includes bibliographical references (p. 8.1-8.9).

Thesis (M.S.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains x, 122 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 116-122).