Known as lipoplasty ("fat modeling"), liposculpture or suction lipectomy ("suction-assisted fat removal") is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs, buttocks, to the neck, backs of the arms and elsewhere. The fat is usually removed via a cannula (a hollow tube) and aspirator (a suction device).

Liposuction is not a low-effort alternative to exercise and diet. It is a form of body contouring with significant attendant risks[1] and is not a weight loss method. The amount of fat removed varies by doctor, method, and patient, but the average amount is typically less than 10 pounds (5 kg).

There are several factors that limit the amount of fat that can be safely removed in one session. Ultimately, the operating physician and the patient make the decision. There are negative aspects to removing too much fat. Unusual "lumpiness" and/or "dents" in the skin can be seen in those patients "over-suctioned". The more fat removed the higher the surgical risk.

As shown previously, reports of people removing 50 pounds (22.7 kg) of fat are exaggerated. However, the contouring possible with liposuction may cause the appearance of weight loss to be greater than the actual amount of fat removed. The procedure may be performed under general or local ("tumescent") anesthesia. The safety of the technique relates not only to the amount of tissue removed, but to the choice of anesthetic and the patient's overall health. It is ideal for the patient to be as fit as possible before the procedure and to have given up smoking for several months.

Relatively modern techniques for body contouring and removal of fat date back to French surgeon, Charles Dujarier. A tragic case that resulted in gangrene in the leg of a French model in a procedure performed by Dr. Dujarier in 1926 set back interest in body contouring for decades to follow.

Liposuction evolved from work in the late 1960s from surgeons in Europe using primitive curetage techniques which were largely ignored, as they achieved irregular results with significant morbidity and bleeding. Modern liposuction first burst on the scene in a presentation by the French surgeon, Dr Yves-Gerard Illouz, in 1982. The "Illouz Method" featured a technique of suction-assisted lipolysis using blunt cannulas and high-vacuum suction and demonstrated both reproducible good results and low morbidity. During the 1980s, many U.S. surgeons experimented with liposuction, developing some variations, and achieving mixed results.

In 1985, two U.S. dermatologists described the tumescent technique, which added high volumes of fluid containing a local anesthetic allowing the procedure to be done in an office setting under intravenous sedation rather than general anesthesia. Concerns over the high volume of fluid and potential toxicity of lidocaine with tumescent techniques eventually led to the concept of lower volume "super wet" tumescence.

In the late 1990s, ultrasound was introduced to facilitate the fat removal by first liquefying it using ultrasonic energy. After a flurry of initial interest, an increase in reported complications tempered the enthusiasm of many practitioners.

In 2005-6, two new, FDA-approved technologies introduced laser-assisted liposuction. One technology employs a laser at high frequency, the other, a cold laser at low frequency. What the two laser technologies have in common is a refinement in the preparation of fat cells for removal that allows for a less invasive procedure. For patients, this can mean a smaller incision, and easier, more precise use of the cannula. The patient benefit, according to clinical trials and studies conducted by the medical technology firms and by surgeons employing the new technologies, is less tissue trauma and abbreviated wearing of the compression garment or girdle worn compared to other methods of liposuction.

Overall, the advantages of 30 years of improvements have been that more fat cells can more easily be removed, with less blood loss, less discomfort, and less risk. Recent developments suggest that the recovery period can be shortened as well.

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Yohimbe combined with deprenyl

Version 4.0, March 2002

I have also tried deprenyl (selegeline, Jumex) with yohimbe. Deprenyl is a MAO inhibitor, and I had read that MAO inhibitors don't go well with yohimbe, so I was careful with the dosages. I had previously tried deprenyl alone, and found it to have an amphetamine-like effect at dosages of more than 2.5 milligrams (half a standard Jumex tablet). I don't feel the amphetamine-like effect anymore with up to 5 milligrams. But for me, deprenyl also detracts from the yohimbe when combined with it.

I have always found deprenyl's pro-sexual effects overrated. It's a dopaminergic substance, and dopamine is, to a certain extent, responsible for sexual desire. But dopamine overstimulation strongly interferes with erectile function and leads to a (reversible) shrinkage of the male organ. That's why cocaine, and amphetamines may make you horny, but also make erections and orgasms more difficult to achieve.

Deprenyl is not as bad as amphetamine and methamphetamine in making erections more difficult. It may even be that a 25-year-old would not feel any erectile impediment. But for a man of about 50, the anti-erection effect is probably stronger than the pro-libido effect,unless there is a clear dopamine deficit (as with Parkinson's patients).

One can counterbalance the anti-erection effect of deprenyl with Viagra. In fact, I have been told that drug users now regularly mix cocaine with Viagra to avoid shrinkage.

But why combine yohimbe and deprenyl when this is no better than yohimbe alone (and definitely worse than the combination of yohimbe with Viagra)?

As deprenyl is an MAO inhibitor, it may possibly aggravate the negative side effects of yohimbe. Yohimbine is an alpha-2-receptor blocker; it frees systemic adrenaline and noradrenaline. Adrenaline and noradrenaline (epinephrine and norepinephrine) function as hormones and as neurotransmitters. The adrenaline and noradrenaline displaced by the yohimbe from alpha-2-receptors lead to mental agitation as well as increased heart rate.

This effect is countered by the enzyme monoamine oxidase (MAO), which breaks down adrenaline and noradrenaline, leading to relaxation after states of agitation. MAO inhibitors interfere with monoamine oxidase's capability to deaminate and destroy adrenaline and noradrenaline. In combination with yohimbe, this means that the agitated state lasts until the yohimbine has cleared from the alpha-2-receptors. With unimpaired monoamine oxidase, the agitation caused by the displacement of adrenaline from alpha-2-receptors should be countered by the breakdown of free adrenaline and noradrenaline.

Combining deprenyl with yohimbe will likely prolong the negative side effects of yohimbe, such as heart palpitation, nervousness, and sleeplessness, while doing little or nothing to enhance the pro-sexual effects.

What we would really like with yohimbe is increased MAO activity, not diminished MAO activity, so we could go to sleep after having enjoyed yohimbe's pro-sexual effects. Therefore, we don't want deprenyl, but some sort of 'anti-deprenyl' .

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Female genital cutting

Female genital cutting (FGC) (also known as female genital mutilation (FGM) or female circumcision) refers to "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons."[1] It is not the same as the procedures used in gender reassignment surgery or the genital modification of intersexuals. FGC is practiced throughout the world, but the practice is concentrated more heavily in Africa, Indonesia, and the Middle East. The World Health Organization (WHO) separates FGC procedures into four categories: Type I, II, III, and IV. There is much controversy surrounding Type III (Infibulation) due to concerns regarding the safety and consequences of the procedure. In the past several decades, there have been pushes by global health organizations, such as the WHO, to end the practice of FGC. However, due to its importance in traditional and religious life, the practice remains in many societies.

Cook states that historically, the term female circumcision was used, but that "this procedure in whatever form it is practised is not at all analogous to male circumcision." Shell-Duncan states that the term female circumcision is a euphemism for a variety of procedures for altering the female genitalia.[3] Some advocates of male circumcision argue that the term female circumcision results in unwanted associations between the two practices.

Because the term female genital mutilation has been criticized for increasing the stigma associated with female genital surgery, some groups have proposed an alteration, substituting the word "cutting" for "mutilation." According to a joint WHO/UNICEF/UNFPA statement, the use of the word "mutilation" reinforces the idea that this practice is a violation of the human rights of girls and women, and thereby helps promote national and international advocacy towards its abandonment. They state that, at the community level, however, the term can be problematic; and that local languages generally use the less judgmental "cutting" to describe the practice. They also feel that parents understandably resent the suggestion that they are "mutilating" their daughters. In this spirit, in 1999, the UN Special Rapporteur on Traditional Practices called for tact and patience regarding activities in this area and drew attention to the risk of "demonizing" certain cultures, religions, and communities. As a result, they claim, the term "cutting" has increasingly come to be used to avoid alienating communities.

In 1996, the Uganda-based initiative REACH (Reproductive, Educative, And Community Health) began using the term female genital cutting, observing that female genital mutilation may "imply excessive judgment by outsiders as well as insensitivity toward individuals who have undergone some form of genital excision."[7] While some international organizations, such as the UN and the WHO, continue to use the earlier term of female genital mutilation, a number of agencies, like UNICEF, now use the term female genital mutilation/cutting (FGM/C).

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Monoamine oxidase-B inhibition in the treatment of Parkinson's disease.

Movement Disorders Center, University of Florida, McKnight Brain Institute, Gainesville, FL 32610, USA. fernandez@neurology.ufl.edu

Inhibitors of monoamine oxidase (MAO) with selectivity and specificity for MAO type B prolong the activity of both endogenously and exogenously derived dopamine, making them an option either as monotherapy in early Parkinson's disease or as adjunctive therapy in patients treated with levodopa who are experiencing motor complications. In addition to symptomatic benefits, experimental data suggest that MAO-B inhibitors may be neuroprotective through MAO-B inhibition and other mechanisms that have yet to be clearly defined. The two available MAO-B inhibitors approved for use in the United States, rasagiline and selegiline, each provide symptomatic relief as monotherapy and as adjunctive therapy, and have shown potential disease-modifying effects in experimental models and clinical studies. Selegiline in a conventional tablet formulation is less bioavailable than rasagiline, resulting in limited potency. It also has amphetamine metabolites that may produce adverse effects and interfere with any putative disease-modifying effects. The oral disintegrating tablet formulation of selegiline allows pregastric absorption, minimizing first-pass metabolism, thereby increasing selegiline bioavailability and reducing the concentration of amphetamine metabolites. Rasagiline, more potent than selegiline, exhibits disease-modifying effects in experimental models and lacks amphetamine metabolites. Both the symptomatic and potential disease-modifying effects of rasagiline are under investigation. A third agent with MAO-B inhibition properties, safinamide, is in phase III development. Although not yet approved, safinamide may offer the added advantage of combined MAO-B and dopamine reuptake inhibition.

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Treatment effects of selegiline transdermal system on symptoms of major depressive disorder: a meta-analysis of short-term, placebo-controlled, efficacy trials.

Worldwide Drug Development, Burlington, VT.

Objective: Selegiline transdermal system (STS) is efficacious for the treatment of major depressive disorder (MDD). This meta-analysis explores treatment effects of STS for individual symptoms of MDD derived from line-item analyses of the 28-item Hamilton Rating Scale for Depression (HAM-D28) and the Montgomery-Asberg Depression Rating Scale (MADRS). Methods: Change in score from baseline to end of treatment for each item of the HAM-D28 and MADRS was assessed using a multilevel model for meta-analysis of continuous outcome data from all five short-term, randomized, placebo-controlled efficacy trials conducted during preapproval clinical development of STS for MDD. Utilizing a random-effects model with trial effects fixed and adjusting for baseline scores, confidence intervals (95%) were computed for treatment differences between STS and placebo. Results: STS exhibited significant treatment effects on core depression symptoms (HAM-D Bech-6 items: depressed mood, guilt, work and activities, retardation, psychic anxiety, general somatic symptoms), reverse vegetative symptoms (oversleeping, overeating), motoric retardation, suicide, and genital symptoms (libido). Significant STS treatment effects were also noted for each MADRS item except for reduced sleep and appetite. The most prominent MADRS effects were improvement in sadness, lassitude, and poor concentration. Conclusions: STS, an monoamine oxidase inhibitor antidepressant that potentiates the three major monoamine neurotransmitters (serotonin, norepinephrine, and dopamine), has beneficial therapeutic effects for a spectrum of individual symptoms rated by the HAM-D28 and MADRS. Analyses of specific symptoms assessed by depression rating scales can offer guidance to clinicians in individualizing drug therapy based on presenting symptoms.

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Cinnamomum cassia

Cassia (Cinnamomum aromaticum, synonym C. cassia) is an evergreen tree native to southern China and Vietnam. Like its close relative, Cinnamon (Cinnamomum zeylanicum, also known as "true cinnamon" or "Ceylon cinnamon"), it is used primarily for its aromatic bark, which is used as a spice, often under the culinary name of "cinnamon". The buds are also used as a spice, especially in India and in Ancient Rome.

The Cassia tree grows to 10-15 m tall, with greyish bark, and hard elongated leaves 10-15 cm long, that have a decidedly reddish colour when young.

Cassia is a close relative to the cinnamon (Cinnamomum verum, Cinnamomum zeylanicum, or "true cinnamon"), Saigon Cinnamon (Cinnamomum loureiroi, also known as "Vietnamese Cinnamon"), Camphor laurel (Cinnamomum camphora), Malabathrum (Cinnamomum tamala) and Cinnamomum burmannii (also know as "Indonesian Cinnamon") trees. As with these species, the dried bark of cassia is used as a spice. Cassia's flavour, however, is less delicate than that of true cinnamon; for this reason the less expensive cassia is sometimes called "bastard cinnamon".[1]

Whole branches and small trees are harvested for cassia bark, unlike the small shoots used in the production of cinnamon; this gives cassia bark a much thicker and rougher texture than that of true cinnamon.

Most of the spice sold as cinnamon in the United States and Canada (where true cinnamon is still generally unknown) is actually cassia. In some cases, cassia is labeled "Chinese cinnamon" to distinguish it from the more expensive true cinnamon (Cinnamomum zeylanicum), which is the preferred form of the spice used in Mexico and Europe. "Indonesian cinnamon" can also refer to Cinnamomum burmannii, which is also commonly sold in the United States, labeled only as cinnamon.

Cassia (Cinnamomum aromaticum) is produced in both China and Vietnam. Up to the 1960s Vietnam was the world's most important producer of Saigon Cinnamon, a species which has a higher oil content than Cinnamomum aromaticum, and consequently has a stronger flavor. Saigon Cinnamon is so closely related to cassia that it was often marketed as cassia (or, in North America, "cinnamon"). Of the three forms of Cassia, it is the form which commands the highest price. Because of the disruption caused by the Vietnam War, however, production of another form of cassia, Cinnamomum burmannii, in the highlands of the Indonesia on island of Sumatra was increased to meet demand, and Indonesia remains one of the main exporters of cassia today. Indonesia Cassia has the lowest oil content of the three types of Cassia and consequently commands the lowest price. Saigon Cinnamon, only having become available again in the United States since the early 21st century, has an intense flavour and aroma and a higher percentage of essential oils than Indonesian cassia. Cinnamomum aromaticum has a stronger and sweeter flavor, similar to Saigon Cinnamon, although the oil content is lower. In China Cassia is known as Tung Hing.

Cassia bark (both powdered and in whole, or "stick" form) is used as a flavouring agent, for candies, desserts, baked goods, and meat; it is specified in many curry recipes, where cinnamon is less suitable. Cassia is sometimes added to true cinnamon but is a much thicker, coarser product. Cassia is sold as pieces of bark (as pictured below) or as neat quills or sticks. Cassia sticks can be distinguished from true Cinnamon sticks in the following manner: Cinnamon sticks have many thin layers and can easily be made into powder using a coffee or spice grinder, whereas Cassia sticks are extremely hard, are usually made up of one thick layer and can break an electric spice or coffee grinder if one attempts to grind them without first breaking them into very small pieces.

Cassia buds, although rare, are also occasionally used as a spice. They resemble cloves in appearance and flavor