Objective To evaluate the methods of correction for secondary deformity after removal of polyacrylamide hydrogel in breast.Methods From June 2006 to December 2007,the Center of Breast Plastic and Reconstruction at Chinese Academy of Medical Sciences admitted and treated 36 patients who experienced deformity after polyacrylamide hydrogel remoral in breasts.The average age of the patients was 27.5 years,and the time of consultation for the correction was from 6 months postoperatively.The patients who had preoperative MRI examinations showed that no visible polyacrylamide hydrogel remained in the breast were included in the study.The patients were classified according to the deformity of the breast and the chest wall tissue.Autologous fat injection grafting,silicon gel implant augmentation,and dermis grafting were performed for treating the deformity of the breasts after polyacrylamide hydrogel removal.Results During 3 to 18 months follow-up,the shape of the breast was improved and no complications such as infection,the sclerotic nodules,implant exposure occurred.35(97.2%) patients were satisfied with the result of the operations.Conclusions The correction for secondary deformity of breast after removal of PAHG should be performed at least 6 months after removal of polyacrylamide hydrogel.The optimal and nature contour of the breast may be recovered by combination of various surgical methods which are carefully selected according to the individual situation.

0.05), respectively; the costs were 640.50yuan and 1 151.21yuan, respectively; the cost-effectiveness ratios were 7.01 and 12.28, respectively; the incremental cost-effectiveness ratio of Group B versus Group A was 220.1. CONCLUSION: The sequential therapy of levofloxacin is preferable in the treatment of lower respiratory infection.

OBJECTIVETo study the expression of stromal cell derived factor-1(SDF-1) and CXC chemokine receptor 4 (CXCR4) in the airway and the effect of budesonide on their expression in mice with asthma.

METHODSThirty BALB/c male mices were randomly divided into three groups: placebo control, untreated asthma, and budesonide-treated asthma. The asthma group were induced by intraperitoneal injection of 10% ovalbumin (OVA ) on days 1, 8 and 15, and then from days 22 to 34, challenged by inhalation of 2% OVA aerosol every other day. The budesonide-treated asthma group received an inhalation of budesonide (1 mg ) before OVA challenge. The pathological changes of the airway were assessed by hematoxylin and eosin staining. The immunohistochemistry was used to estimate the expression of SDF-1 in the lung. RT-PCR was used to evaluate the expression of CXCR4 in the lung.

RESULTSCompared with the control group, SDF-1 and CXCR4 expression in the lung in the untreated asthma group increased significantly (p<0.05). The budesonide-treated asthma group demonstrated significantly decreased SDF-1 (0.426+/-0.052 vs 0.361+/-0.065; p<0.05) and CXCR4 (0.829+/-0.027 vs 0.723+/-0.094; p<0.05) expression in the lung as compared with the untreated asthma group. Both SDF-1 (r=0.744, p<0.01) and CXCR4 (r=0.553, p<0.01)were positively correlated with the thickness of the airway wall.

CONCLUSIONSSDF-1 and CXCR4 may be associated with airway remodeling in mice with asthma. Budesonide can improve airway remodeling, possibly by decreasing the expression of SDF-1 and CXCR4.

Airway Remodeling ; drug effects ; Animals ; Asthma ; drug therapy ; metabolism ; pathology ; Budesonide ; pharmacology ; Chemokine CXCL12 ; analysis ; Male ; Mice ; Mice, Inbred BALB C ; Receptors, CXCR4 ; analysis ; genetics

Objective To evaluate the early and mid-term results of endovascular repair for acute and chronic type B aortic dissection, and to compare the clinical outcomes between the 2 groups. Methods From May 2002 to December 2006, 50 patients with type B aortic dissection were treated by endovascular stent-graft. There were 23 patients in the acute aortic dissection (AAD) group and 27 patients in the chronic aortic dissection (CAD) group. All patients were followed up from 1 to 54 months (average, 17±16 months).The immediate and follow-up clinical outcomes were documented and compared between the 2 groups. Results Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 50 patients. Compared to the CAD group, the AAD group had a higher percentage of pleural effusion (17.4% vs. 0%,P=0.04) and visceral /leg ischemia (26.1% vs 3.7%, P=0.04). Procedure related complications, including endoleak and post-implantation syndrome, occurred more frequently in the AAD group than in the CAD group (21.7% vs 3.7% and 30.4% vs 11.1%, respectively; P=0.08 and P=0.04). Kaplan-Meier analysis showed no difference in the survival rate at 4 years between the 2 groups (86.4% vs 92.3%, P=0.42 by log-rank test). However, the event-free survival rate was higher in patients with chronic dissection than in patients with acute aortic dissection (96.2% vs 73.9%; P=0.02 by log-rank test). Conclusions Endovascular repair with stent-graft was safe and effective for the treatment of both acute and chronic type B aortic dissection. However, both immediate and long term major complications occurred more frequently in patients with acute dissection than in those with chronic dissection.

OBJECTIVETo determine if miniprostheses would form a capsule of significantly different biophysical, biochemical and histologic properties than the conventional silicone implant.

METHODSFour miniprostheses (experimental group) and one big silicone implants (control 1 group) were separately implanted beneath the panniculus carnosus muscle of 30 rabbits. After 3 months, measures related to contracture and capsular histology were performed on anesthetized animals.

RESULTSBaker ranking, capsular incision width and capsular thickness of the control groups were evidently higher than that of experimental groups (P < 0.01). Implant compression of the control groups was evidently lower than that of the experimental group. Histology revealed a thinner, more flexed capsule around the miniprostheses as compared with big silicone implants.

CONCLUSIONSThe miniprostheses form a looser and thinner capsule than the conventional silicone implant.

Animals ; Breast Implantation ; adverse effects ; Breast Implants ; adverse effects ; Contracture ; pathology ; Female ; Postoperative Complications ; pathology ; Rabbits

OBJECTIVETo explore the use of triamcinolone acetonide for the prevention of implant capsular contracture.

METHODS20 rabbits were randomly undivided into 2 groups of 10 animals each. Every 10 ml silicone implant was implanted beneath the panniculus carnosus muscle of one rabbit. At the same time, a modified expander catheter was mounted on the implant. This catheter has many lateral holes and the end was blind. Triamcinolone acetonide (10 mg/3 ml) was infused through the expander pot and catheter as the experimental groups. On the other hand, 3 ml saline was used as the control group at 1, 2, and 3 months. At 6 months, measures related to contracture and capsular histology examinations were performed on anesthetized animals.

RESULTSBaker scores, capsular incision width and capsular thickness of the saline groups were evidently higher than that of triamcinolone acetonide groups (P < 0.01). Implant compression of the saline groups was evidently lower than that of triamcinolone acetonide group. Histology revealed a thinner capsules and less fibrous tissue deposition around the triamcinolone acetonide group, as compared with saline group.

CONCLUSIONSIt is effective to deliver triamcinolone acetonide to reduction of capsular contracture through the catheter and its pot.

Animals ; Breast Implantation ; adverse effects ; Contracture ; etiology ; prevention & control ; Female ; Postoperative Complications ; prevention & control ; Rabbits ; Triamcinolone Acetonide ; therapeutic use

OBJECTIVETo discuss the present status and progress of clinical research on the cognitive effects caused by different types of brain tumors and common treatments.

DATA SOURCESThe data used in this review were mainly from PubMed articles published in English from 1990 to Febuary 2012. Research terms were "cognitive deficits" or "cognitive dysfunction".

STUDY SELECTIONArticals including any information about brain tumor related cognitive deficits were selected.

RESULTSIt is widely accepted that brain tumors and related treatments can impair cognitive function across many domains, and can impact on patients' quality of life. Tumor localization, lateralization, surgery, drugs, radiotherapy and chemotherapy are all thought to be important factors in this process. However, some conflicting findings regarding brain tumor-related cognitive deficits have been reported. It can be difficult to determine the mechanism of these treatments, such as chemotherapy, antibiotics, antiepileptics, and steroids. Future research is needed to clarify these potential treatment effects.

CONCLUSIONSCognitive function is important for patients with brain tumor. Much more focus has been paid on this field. It should be regarded as an important prognostic index for the patients with brain tumor, and neuropsychological tests should be used in regular examinations.

Brain Neoplasms ; physiopathology ; Cognition ; physiology ; Cognition Disorders ; physiopathology ; Glioma ; physiopathology ; Humans

OBJECTIVETo elucidate the relative factors and prognostic impact for angiographic no-reflow phenomenon during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).

METHODSA total of 930 patients with AMI who underwent primary PCI were divided into no-reflow group and normal-reflow group. Factors related to no-reflow were analyzed by logistic regression model and major adverse cardiac events (MACE) in-hospital as well as during long-term follow-up was also observed.

RESULTSNo-reflow occurred in 82 out of 930 patients. Admission glucose level (9.8 +/- 4.3 mmol/L vs. 8.5 +/- 3.5 mmol/L, P = 0.001), peak CK-MB value (369.4 +/- 167.8 U/L vs. 282.3 +/- 161.7 U/L, P < 0.01) and percentage of TIMI flow grade 0 on initial angiogram (69.5% vs. 54.5%, P = 0.009) were significantly higher and pre-infarction angina (19.5% vs. 48.1%, P < 0.01) was significantly lower in no-flow patients than normal flow patients. Logistic regression analyses showed that admission glucose level, absence of pre-infarction angina, TIMI flow grade 0 on initial angiogram and pump failure were independent predictors of no reflow. In-hospital MACE (37.8% vs. 11.3%, P < 0.01) and follow-up MACE (37.5% vs. 17.4%, P < 0.01) were also significantly higher in no-flow patients than normal flow patients. Multivariate Cox regression analysis revealed that no-reflow was an independent predictor of long-term cardiac death (relative risk 3.83, 95% confidence interval 1.71 to 5.57).

CONCLUSIONAdmission glucose level, absence of pre-infarction angina, TIMI flow grade 0 on initial angiogram and pump failure were independent risk factors for no-reflow and no-flow is an independent predictor for increased in-hospital and follow-up MACE.

Aged ; Angina Pectoris ; Angioplasty, Balloon, Coronary ; Blood Glucose ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; therapy ; Prognosis ; Treatment Outcome

OBJECTIVETo evaluate a new technique for breast reconstruction with multiple miniprostheses,

METHODSEach silicone miniprosthesis(10 approximately 15 ml) was implanted one by one beneath the prepared muscle pocket until the desired volume was achieved.

RESULTSSeven patients were treated with the above mentioned technique, including five after gland fibroadenoma excision, one hemangioma excision and one reduction mammoplasty. The results were satisfactory.

CONCLUSIONThe above mentioned technique with the miniprostheses may be another good way for breast augmentation and breast reconstruction with many advantages such as smaller incision, easy intraoperative assessment of the ideal size of the breast, easy handling the technique, perhaps low incidence of capsular contracture.

Adult ; Breast ; surgery ; Breast Implants ; Female ; Humans ; Patient Satisfaction ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome

OBJECTIVETo discuss the complications of breast augmentation with injected polyacrylamide hydrophilic gel (PAHG) in order to avoid further injury by taking treatment at the right moment.

METHODS90 patients with some side-effects after breast augmentation with injected polyacrylamide hydrophilic gel had been undergone the treatment in our hospital from 1999 to 2006. Their clinical data were analyzed.

RESULTSThe major complaints of the patients were feeling pain, multiple indurations, secondary deformity, PAHG displacement, low-grade fever of unknown reason, limitation of upper limb activity, spillage of milk and blood, ulceration and sinus tract of breast, inversion of nipple, infection. All patients were treated by surgical operations to remove the injected PAHG.

CONCLUSIONSThe complications are might not only related to the injected material but also caused by incorrect manipulation during operation. To do suction several times may cause the injected material distributed diffusely and the tissue was badly injured. Operation can remove the PAHG as completely as possible. It is a better treatment for the complications of PAHG injection for augmentation mammaplasty.

Acrylic Resins ; adverse effects ; Adolescent ; Adult ; Breast Implantation ; adverse effects ; Breast Implants ; adverse effects ; Female ; Humans ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Young Adult