Background Measurement of ciliary sulcus distance is important for phakic intraocular lens implantation.Suowei panoramic 50-MHz digital ultrasound biomicroscopy makes it possible for the direct measurement of ciliary sulcus distance.Objective The aim of this study was to investigate the correlation between anterior chamber(AC)angle diameter and ciliary sulcus distance in different AC depth population and offer a clinical guide.Methods The anterior chamber angle diameter and ciliary sulcus distance were measured in 30 right eyes with shallow anterior chamber caused by suspect glaucoma and 30 right eyes with deep anterior chamber dut to the high myopia with Suowei panoramic 50-MHz digital ultrasound biomicroscopy.Three horizontal B-scans with the focal plane approximately at a depth corresponding to the iris plane were acquired for each eye.The differences of the anterior chamber angle diameter and ciliary sulcus distance were calculated and compared between the two groups.The correlation of the anterior chamber angle diameter and ciliary sulcus distance were evaluated in respective group.Results In shallow AC group,the mean angle diameter was(11.49+0.75)mm,the mean ciliary sulcus distance was (10.97±0.86)mm with the mean standard deviation of the difference of(-5.14± 0.55)mm,showing a statistically significant difference(t =-5.092,P =0.000).In shallow AC group,linear regression analysis showed a statistically significant correlation between ciliary sulcus distance and angle diameter(R2=0.593,P=0.000)and the Pearson's correlation coefficient was 0.767.In deep AC group,the angle diameter was(12.69±0.67)mm;while ciliary sulcus distance was(12.31 ± 0.61)mm with the mean slandard deviation(-0.38 ± 0.17)mm,which was statistically significantly different(t=-5.531,P=0.000).The ciliary sulcus distance was found to be linear correlation with the angle diameter(R2 =0.699,P=0.000)and Pearson' s correlation coefficient of 0.836.Conclusions Panoramic ultrasound biomicroscopy is an useful tool to the measurement of ciliary sulcus distance.This study exhibited that the ciliary sulcus distance is significant associated with the anterior chamber angle diameter,which may offer a guide for phakic intraocular lens implantation.

Objective To assess the effect of radioiodine-131 (131Ⅰ) on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of 131Ⅰ on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of 131Ⅰ treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received 131Ⅰ therapy and who did not received 131Ⅰl therapy were 74.9% and 27.1% , respectively ;The lO-yr survival rates(P<0.01)of the two groups were 60.8% % 12.2% , respectively;The difference between them had statistical significance (P<0.01). The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases (P<0.01). The 5-yr (P = 0.01) and 10-yr (P = 0. 002)surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar(P>0.05). Conclusions 131Ⅰ treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologie type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.

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OBJECTIVETo investigate the efficacy, indication, advantage and disadvantage of methods for reduction mammaplasty.

METHODSThirty one cases with breast hypertrophy received reduction mammaplasty using various incisions and pedicles. Based on the follow-up of the cases, the appearance, nipple-areola complex sensory function and scars were evaluated.

RESULTSAmong the skin incision pattern, inverted T, short-horizontal invert T and vertical incision got excellent breast contour (100%), otherwise, periareolar incision got the less scar (100%). The postoperative result of lateral pedicle, lateral inferior pedicle and mammary gland pedicle were satisfactory in terms of the nipple-areola sensation and the amount of mammary tissue removed.

CONCLUSIONSBreast contour and scar formation postoperative are related to incision design, Invert T incision or short-horizontal invert T incision is a good alternative to moderate and large hypertrophies, Periareolar incision is suitable to small hypertrophies. There is a relationship existing between pedicle location and retention of sensation or amount of mammary tissue removed. The inferior pedicle and lateral-inferior pedicle allows better shaping as well as maintaining good sensation.

Adult ; Breast ; surgery ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Young Adult

OBJECTIVETo investigate the feasibility of transaxillary dual-plane breast augmentation with endoscope assistant.

METHODSThe submuscular pockets were separated through a 4 cm transverse incision in the axilla. The pectoralis major muscle were split from the costal margin with the help of a 10 mm, 30 degree endoscope and endoscopic diathermy scissors. Soft cohesive gel microtextured anatomic style silicone implants ranging in size from 185 to 315 g were placed through the axillary incision. The vacuum drainage was used for 3 approximately 5 days.

RESULTS79 patients underwent the dual-plane breast augmentation. Postoperative analgesia requirements were reduced because of muscle strength releasing. The follow-up period was 4 to 6 months with satisfactory results. All the patients had aesthetically natural appearance, with the nipple at the most projected part of the breast. No rippling, lateral displacement, double-bubble deformity, or muscle contraction-associated deformities were seen. There was no complications such as capsular contracture, hematoma, hypertrophic scar, and infection.

CONCLUSIONSDual-plane breast augmentation using textured silicon gel implant can be completed with the endoscope assistance through the axillary incision. The technique combined retromammary and partial retropectoral pocket locations to optimize the benefits of each pocket location while avoiding the drawbacks of extra incision on the breast.

Adult ; Axilla ; surgery ; Breast Implantation ; methods ; Breast Implants ; Endoscopes ; Female ; Humans

BACKGROUNDPhakic intraocular lens (pIOL) implantation has been a popular means for the treatment of high ametropia. Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no perfect system can directly measure it. The present study was to evaluate the accuracy, repeatability and reproducibility of direct sulcus diameter measurements obtained by a full-scale 50-megahertz (MHz) ultrasound biomicroscopy (UBM).

METHODSA fresh cadaver human eye with a scale marker inserted through the posterior chamber plane from 3 o'clock to 9 o'clock meridian and 30 randomly selected eyes from 30 normal subjects were scanned by full-scale 50-MHz UBM in horizontal meridional scan plane. The distance between the scales and the whole length of the marker inside the cadaver eye were measured by the same observer using the "built-in" measurement tools and the indicating error of instrument was calculated. Reproducibility of the measurement was evaluated in 30 eyes by 2 operators using Blander and Altman plot test. Repeatability was evaluated from 10 successive eyes randomly selected from the 30 eyes by one operator.

RESULTSOn a scale of 1 mm, the greatest indicating error was 40 microm; the mean largest indicating error of 1 mm scale from the 10 images was (26 +/- 14) microm; on a scale of 11 mm, the greatest indicating error was 70 microm; the error rate was 0.64%. The mean length of the needle inside the eye of the 10 images was 11.05 mm, with the mean indicating error of 47 microm, the average error rate was 0.43%. For ciliary sulcus diameter measurements in vivo, the coefficient of variation was 0.38%; the coefficients of repeatability for intra-observer and inter-observer measurements were 1.99% and 2.55%, respectively. The limits of agreement for intra-observer and inter-observer measurement were -0.41 mm to 0.48 mm and -0.59 mm to 0.58 mm, respectively.

CONCLUSIONThe full-scale 50-MHz UBM can be a high accuracy and good repeatability means for direct measuring the ciliary sulcus diameter and useful for size determining of posterior chamber pIOL.

Ciliary Body ; diagnostic imaging ; Humans ; In Vitro Techniques ; Lenses, Intraocular ; Microscopy, Acoustic ; methods ; standards ; Reproducibility of Results

OBJECTIVETo assess oral health-related quality of life in patients with fixed appliances.

METHODSOrthodontic patients were asked to complete the scale of general conditions (Chinese version, questionnaire 1) and oral health impact profile (OHIP) -14 (Chinese version, questionnaire 2). Baseline data were collected at first visit and thereafter. The subjects finished questionnaire 2 at the 1st week, 4th week, 12th week and 24th week, respectively, after the fixed appliance was bonded. Data were analyzed to evaluate the various sample groups with different personal information and clinical parameters. Results were collated and analyzed using software package SPSS version 15.0.

RESULTSThe most common negative effect was physical pain [55/222 (27.8%)] and psychological discomfort [40/222 (18.0%)], mainly in the first month. The total scores at five time points were 3, 10, 7, 5 and 4, respectively. No difference was found in quality of life in patients between sixth month with fixed appliance and without appliance (P > 0.05). Age and education status affected the quality of life (P < 0.001).

CONCLUSIONSFixed orthodontic appliance therapy affected patients' oral health-related quality of life during treatment. The quality of life in the first month of treatment was mostly compromised and was improved later.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Malocclusion ; therapy ; Oral Health ; Orthodontic Appliances ; Quality of Life ; Surveys and Questionnaires ; Young Adult

BACKGROUNDGigantomastia is the overdevelopment of the female mammary gland, and it causes great physiological and psychological burdens to patients. A better understanding of the molecular mechanisms involved in gigantomastia is needed to develop less invasive and more effective medical treatments. MicroRNA (miRNA) is a class of small noncoding RNAs that play an important regulatory role at the post-transcriptional level. These miRNAs are known to be involved in many diseases, including breast cancer; however, the relationship between miRNA and gigantomastia is largely unknown.

METHODSWhole genome-wide expression of miRNA and mRNA in gigantomastia was detected using microarray and functional annotation was performed based on the altered expression of miRNAs and mRNAs.

RESULTSWe found many miRNAs and mRNAs to be significantly differentially expressed in gigantomastia compared with normal breast tissues. Functional annotation analysis indicated that APK, Wnt, and Neurotrophin signaling pathways may participate in gigantomastia.

CONCLUSIONThis study addresses the need for better diagnosis and treatment of gigantomastia by providing new insight into the molecular mechanisms underlying this disease.

Adult ; Breast ; abnormalities ; Female ; Gene Expression Profiling ; methods ; Humans ; Hypertrophy ; genetics ; Male ; MicroRNAs ; genetics ; RNA, Messenger ; genetics

OBJECTIVETo introduce the clinical experience of nipple-areolar reconstruction with the modified arrow flap.

METHODSThe arrow flaps were modified for nipple-areolar reconstruction in 12 cases. Among them, 2 cases were treated with combined thin split-thickness skin graft; 4 cases with autologous rib implant and tattoo; 6 cases with tattoo.

RESULTSAll the reconstructed nipples were survived. The reconstructed nipples lost projection 1 month after operation in 2 cases. The other 10 cases retained 50% of the nipple projection 3 months after operation. The results were maintained with satisfactory symmetry during the follow-up period of 6 months to one year.

CONCLUSIONSThe modified flap is easily performed with reasonable design and no need of donor site. The nipple projection can be maintained with good long-term effect.

Adult ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Nipples ; surgery ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo evaluate breast reconstruction with a combined skin flap of the deep inferior epigastric perforator (DIEP) and the transverse rectus abdominis musculocutaneous (TRAM).

METHODSThe DIEP and TRAM united flap was elevated with the vessel pedicle of the deep inferior epigastric perforator on the affected side and the rectus abdominis muscle pedicle on the intact side. The reconstructive breast was shaped after the deep inferior epigastric vessels were anastomosed to the internal mammary vessels or the thoracodorsal vessels ipsilaterally.

RESULTSWe have used the DIEP and TRAM united flaps for breast reconstruction in 17 cases. All of the flaps survived, and the reconstructed breasts were well-shaped with the follow-up of 6-18 months.

CONCLUSIONSThe DIEP and TRAM united flap possesses of advantages such as rich blood supply, abundant tissue volume and easy shaping. It is especially applicable to the cases who have large chest defect and need large volume tissue.

Adult ; Epigastric Arteries ; transplantation ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Rectus Abdominis ; transplantation ; Skin Transplantation ; Surgical Flaps ; blood supply