Objective To evaluate a new technique for breast reduction. Methods The subcutaneous fat of the breasts was removed by liposuction. Two circular incisions, an inner circle that represents the new areola perimeter and the outer circle that defines the outside extent of the skin de epithelized, were designed. The de epithelized skin worked as a dermal cloak to position the nipple and cover the remaining glandular tissue with supporting. Results This technique was used in 9 cases. All the breasts kept a satisfactory shape. The areola and scar tended to widen within 3 months. Conclusion This technique is easy to perform, and effective for breast reduction.

objective: To design a new technique which might be used to reconstruct the orbicularis oris muscle effectively. Methods: The superficial and deep layers of orbicularis oris muscle on the lateral side of the cleft were dissected and sutured to the correspondent layers on the medial side respectively. A small muscle flap from the medial nasal labial bundle below the columella was rotated laterally and sutured with the nasal bundle on the lateral side in 10 cases of cleft lip. Results: Satisfactory results were obtained in all the cases. The postoperative scar was minimal. The lip appearance was satisfactory at rest as well as in motion. Conclusion: This technique is effective in reconstruction the orbicularis oris muscle of cleft lip.

Objective To explore the differences in the expression of inhibin(INH)receptors and activin (ACT)receptors in the follicular/luteinic phase in normal human ovaries and their relationship with female endocrine hormone levels.Methods Real time PCR and immunohistochemistry were used to determine the expression of inhibin receptors(INHR)genes,activin receptors(ACTR)genes.Serum estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),INHB,ACTA levels were determined by a solid quantitative sandwich enzyme immunoassay technique(Sandwich ELISA)in 21 women during follicular phase and another 21 women during luteinic phase,the correlations between each gene and each hormone were analyzed.Results(1)ACT type Ⅰ and Ⅱ receptors genes(ACTR Ⅰ A,ACTR Ⅰ B,ACTRⅡA,ACTR Ⅱ B)and INH receptor β-glycan genes were expressed higher in the follicular phase than in the luteinic phase:ACTR Ⅰ A(0.50±0.17 vs 0.36±0.18;P＜0.05),ACTR Ⅰ B(0.050±0.019 vs0.036±0.020;P＜0.05),ACTRⅡ A(0.10±0.04 vs 0.07±0.04;P＜0.05),ACTR Ⅱ B(0.28±0.10vs 0.19±0.11;P＜0.05),β-glycan(0.26±0.10 vs 0.17±0.09;P＜0.01).(2)The intensities of ACTR I A,ACTR Ⅱ A,β-glycan immunostaining in human normal ovaries in the follicular phase were significantly stronger compared to those in luteinic phase.In the follicular phase β-glycan expression was positively correlated with serum E2,FSH,LH,INHB levels.The correlation coefficient was 0.53(P＜0.05).0.74(P＜0.01),0.85(P＜0.01)and 0.76(P＜0.01)respectively.Conclusion In normal human ovary in the follicular phase INH and ACT bind their receptors and down-regulate or up-regulate FSH,thus influencing the follicular development.

OBJECTIVETo present a new dermal-fat flap for the correction of hemifacial atrophy.

METHODSAn upper chest dermal-fat flap was created with its upper margin 1 cm cranial to the clavicle. The platysma pedicle of the dermal-fat flap, 5 cm in width, was dissected subcutaneously through a skin incision caudal to the mandibular margin. The platysma pedicle was turned over at the mandibular margin so that the dermal-fat-flap could be transposed fitly to the atrophic face.

RESULTSEight cases were treated by this technique. Good results were achieved.

CONCLUSIONThis flap is suitable for the correction of hemifacial atrophy for its good blood circulation and a large amount of tissue.

Adipose Tissue ; transplantation ; Adolescent ; Adult ; Aged ; Child ; Facial Hemiatrophy ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo investigate the survival mechanisms of the reverse-flow flap.

METHODSA skin flap measuring 8.0 cm x 2.5 cm based on the left deep circumflex iliac vessel (DCIV) was designed and elevated on the rat's dorsum with 4.0 cm of it's length crossing the midline. The flap was served as the reverse-flow flap model. The survival area, the dynamic microcirculation including flow direction, microvessel number, caliber, pressure and vasculature were assessed respectively at 6 hour, 24 hour, 48 hour, 72 hour, 7 day and 14 day after operation.

RESULTSThe average gradient of perfusion pressure was 0 kPa before operation and was 4.9 KPa postoperatively between the proximal and the distal site of the flap. By anastomosis of bilateral DCIV, the blood flow run in a reversed pattern in the region distal to the midline. No venous valves were observed. Distal congestion developed in 20% of the flaps within 72 h. After that, the number and caliber of venous anastomosis increased with pressure dropping in the midline region. The axial vessels extended its branches progressively along the dilated anastomotic rami. As a result, the vasculature of the flap became similar to that of the conventional axial flap by the 14th day. With these changes, flap congestion was alleviated gradually and subsided within 7 days. All the flaps survived completely.

CONCLUSIONSAnastomosis connecting the two axial vessels is the circulation route of the reverse-flow flap. By the gradient pressure between the proximal and distal region, blood is driven reversely. Within 72 h, the distal part is susceptible to congestion. In this period, increasing number and caliber and decreasing pressure of anastomosis is important mechanism to support the circulation. After that, the new vasculature similar to the conventional axial flap provides the flap with reliable and permanent blood supply.

Animals ; Female ; Male ; Microcirculation ; physiopathology ; Rats ; Rats, Wistar ; Surgical Flaps ; blood supply

Objective Evaluation of cerebral blood flow in patients with transient ischemic attack (TIA) using cerebral CT perfusion imaging.Methods CT perfusion scan was performed on a consecutive series of 20 patients with clinical definite TIA.Following their initial CT scan at acute stage of TIA, patients underwent two repeat CT perfusion scanning of region of interest at acute stage and one month after symptom remission.Results Mild to moderate decrease in regional cerebral blood flow (rCBF) and unchanged or mildly decrease in regional cerebral blood volume (rCBV) were observed at acute stage in the majority cases.Normal cerebral perfusion was found in 12 cases and mild to moderate decrease of rCBF in 8 cases one month after TIA.During the one-year follow-up period, all of 12 cases with normal cerebral perfusion did not have recurrence while among 8 cases with mild to moderate decrease of rCBF at initial scan, 6 cases had recurrent TIA or cerebral infarction and 2 cases did not have recurrence.Patients with more severe cerebral perfusion defects usually had a shorter interval time between two attacks.Conclusions Intensive intervention should be performed on patients with severe and long lasting decrease of cerebral perfusion.