Local anesthetic was included only for the terminal portion of the tumescent mixture, wherever the subcostal regions were infiltrated. The amount injected varied from 1,000 to 8,000 ml depending on the size, site, and area. This approach has clinically shown less tissue edema in the postoperative period than with conventional physiologic saline used in place of the Ringer's lactate solution. Tumescent infiltration was achieved with hypotonic lactated Ringer's solution, adrenalin, triamcinalone, and hyalase in all cases during the last one year of the series.
Regional anesthesia with conscious sedation was preferred, except where liposuction targeted areas above the subcostal region (the upper trunk, lateral chest, gynecomastia, breast, arms, and face), or when the patient so desired. Concurrent limited or total-block lipectomy was performed in 70 of 296 cases (23.6%). In 296 (63%) of the 470 cases, the total volume of aspirate exceeded 5 l (range, 5,000-22,000 ml). Between September 2000 and August 2005, 470 cases of liposuction were managed.
Clinically, a total volume comprising 5,000 ml of fat and wetting solution aspirated during the procedure qualifies for megaliposuction/large- volume liposuction. Safety and aesthetic issues define large- volume liposuction as having a 5,000- ml aspirate, mega- volume liposuction as having an 8,000- ml aspirate, and giganto- volume liposuction as having an aspirate of 12,000 ml or more. The advent of the tumescent technique in 1987 allowed for safe total corporal contouring as an ambulatory, single-session megaliposuction with the patient under regional anesthesia supplemented by local anesthetic only in selected areas. Safe total corporal contouring with large- volume liposuction for the obese patient. At 45 min, when the glass of water had emptied completely from the stomach, total intestinal water volume was 77 ± 15 mL distributed into 16 ± 3 pockets of 5 ± 1 mL each. Twelve minutes after ingestion of water, small bowel water content rose to a maximum value of 94 ± 24 mL contained within 15 ± 2 pockets of 6 ± 2 mL each.
The fasted small bowel contained a total volume of 43 ± 14 mL of resting water. The mean gastric volume returned back to baseline 45 min after the drink. The gastric water volume declined rapidly after that with a half emptying time (T50%) of 13 ± 1 min. Upon drinking, the gastric fluid rose to 242 ± 9 mL. The fasted stomach contained 35 ± 7 mL (mean ± SEM) of resting water. The images were processed for gastric and intestinal total water volumes and for the number and volume of separate intestinal water pockets larger than 0.5 mL. The drink volume, inclusion criteria, and fasting conditions matched the international standards for BA/BE testing in healthy volunteers. After ingesting the water, they were scanned at intervals for 2 h. Twelve healthy volunteers underwent upper and lower abdominal MRI scans before drinking 240 mL (8 fluid ounces) of water. This study aimed to quantify the volume and number of water pockets in the upper gut of fasted healthy humans following ingestion of a glass of water (240 mL, as recommended for bioavailability/bioequivalence (BA/BE) studies), using recently validated noninvasive magnetic resonance imaging (MRI) methods. Previous imaging studies offered a snapshot of water distribution in fasted humans and showed that water in the small intestine is distributed in small pockets. However, little is known about the time courses and distribution of water volumes in vivo in an undisturbed gut.
The rate and extent of drug dissolution and absorption from solid oral dosage forms is highly dependent upon the volumes and distribution of gastric and small intestinal water. Mudie, Deanna M Murray, Kathryn Hoad, Caroline L Pritchard, Susan E Garnett, Martin C Amidon, Gordon L Gowland, Penny A Spiller, Robin C Amidon, Gregory E Marciani, Luca Quantification of gastrointestinal liquid volumes and distribution following a 240 mL dose of water in the fasted state.
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