BackgroundThe latissimus dorsi (LD) flap procedure remains a popular and useful breast reconstruction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment.

MethodsA.

retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time (i.e. the size of the seroma did not increase) were observed without treatment. The measured outcomes included the incidence of seromas, the volume and duration of postoperative wound drainage, and other demographic characteristics.

ResultsTwenty-four patients (53.3%) developed a seroma at the donor site. Of these, 21 patients (87.5%) did not require treatment, and the seroma resolved over time. The mean duration of a sustained seroma was 6.8 ± 1.4 weeks (range: 4-9 weeks).

ConclusionsThis study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatment.

Objective To study the improved zygomatic reduction in the prevention of injury in the frontal branch of facial nerve.Methods Sixty-two patients with protrusion zygomatic complex,received treatment in our hospital from March 2008 to April 2010,were chosen in our study; 32 were given improved zygomatic reduction,and the other 30 were performed traditional zygomatic reduction.The clinical data of these patients,injury of the frontal branch of facial nerve and incidence of complication in these patients were compared between the 2 groups.Results No one suffered from injury of the facial nerve in the 32 patients given improved zygomatic reduction,but 3 suffered from nerve injury (mid injury in 2 and heavy injury in 1) in patients received traditional zygomatic reduction; 3 patients could not move the eyebow,2 suffered from sensory disability,and 1 had no wrinkle of forehead in patients received traditional zygomatic reduction.Patients given improved zygomatic reduction did not have the above complications.Conclusion Improved zygomatic reduction can effectively prevent injury in the frontal branch of facial nerve.

OBJECTIVETo investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats.

METHODS12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed.

RESULTSThe weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (< 0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P < 0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P > 0.05).

CONCLUSIONSWhen the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.

Animals ; Botulinum Toxins, Type A ; administration & dosage ; pharmacology ; Injections, Intramuscular ; Male ; Mandible ; drug effects ; growth & development ; Masseter Muscle ; Rats ; Rats, Wistar

Objective To evaluate the effect of denervation of masseter muscle on the development of mandible.Methods Twenty-four 28-day-old Wistar rats were randomly divided into operative(n=9),sham-operative(n=9)and control(n=6)groups.The main trunk and initial branches of the masseter nerve on the right side were resected in the operative group.The nerve was exposed,but not resected in the sham-oporative group.The control group was only anaesthetised.CT scan and 3D reconstruction were performed when the rats were 75 d old.Seven cephaiometric points were selected and digitized and selected 7 linear distances were measured.The rots were killed with an overdose of 10% chloral hydrate after the CT scan.Masseter muscles on each side were obtained and weighted immediately.Results The mass of the mandible of the operative side was significantly lighter than that of the non-operative side in the operative group(P<0.05).No significant variances on length of the mandible Ⅰ,Ⅱ and Ⅲ,and height of the mandible Ⅰ were found among the 3 groups(P>0.05).Compared with the control group,the operative group showed shorter height of the mandible Ⅱ and width of the mandible,and the operative and sham-operative groups showed shorter height of the mandible Ⅲ(P<0.05).Conclusion Changes on mandibular height Ⅱ and bilateral width after denervation of masseter muscle are noted and no influence on mandibular length is found.

OBJECTIVETo explore the effect of malignant transformation of the L839P, a new mutation site of the PDGFRA gene, on the pathogenesis of gastrointestinal stromal tumors.

METHODSAll recombinant plasmids were stably transfected into CHO cells by liposomes. Western blotting was used to detect the expression of PDGFRA protein. The cell growth curve was plotted by cell counting. Flow cytometry was used to detect the cell cycle and apoptosis of CHO cell, respectively. The stably transformed cells were inoculated subcutaneously into the back of nude mice and the mice were used to observe the tumorigenesis. Transient transfection of the mutant-type plasmids of PDGFRA gene and the wild-type plasmids of kit gene into the CHO cells was performed. Western blot was used to detect the expression of kit protein and its phosphorylated forms.

RESULTSPDGFRA protein expressed in the negative control, experimental group and positive control, except the empty vector. The growth curve showed that it was accelerated in the experimental group and positive control. The ratios of cells in proliferative phase were 28.4% (blank), 24.5% (negative control), 43.8% (experimental group) and 40.9% (positive control). Their apoptotic indexes were 1.8%, 1.9%, 1.5% and 1.6%, respectively. After three weeks, tumors were observed in the nude mice of experimental group and positive control, inoculated with the stably transformed cells. Moreover, the expression of phosphorylated protein of kit was enhanced after cotransfection of the mutant-type plasmids of PDGFRA and the wild-type plasmid of kit.

CONCLUSIONThe PDGFRA mutant L839P is a gain-of-function mutation and has obviously malignant transforming effect on normal cells, and may activate kit protein accelerating the tumorigenesis. Gastrointestinal stromal tumors;

Animals ; Apoptosis ; CHO Cells ; Cell Cycle ; Cell Proliferation ; Cell Transformation, Neoplastic ; Cricetinae ; Cricetulus ; Gastrointestinal Stromal Tumors ; etiology ; genetics ; pathology ; Mice ; Mice, Nude ; Mutation ; Plasmids ; Proto-Oncogene Proteins c-kit ; metabolism ; Receptor, Platelet-Derived Growth Factor alpha ; genetics ; metabolism ; Transfection

OBJECTIVETo discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.

METHODSFrom July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.

RESULTSNo severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.

CONCLUSIONSMost of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandible ; abnormalities ; surgery ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; prevention & control ; Young Adult

OBJECTIVETo observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation.

METHODSFifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization.

RESULTSIn the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA.

CONCLUSIONIPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.

Animals ; Female ; Male ; Phototherapy ; adverse effects ; methods ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rejuvenation ; Skin ; metabolism ; radiation effects ; Transforming Growth Factor beta1 ; genetics ; metabolism ; radiation effects

OBJECTIVETo perform a Meta-analysis on peginterferon with interferon in treatment of HIV patients coinfected with refractory genotype HCV.

METHODSA literature search of Medline was conducted to identify eligible randomized controlled trials. Meta analysis was conducted to evaluate peginterferon and interferon in treatment of coinfected HCV genotype 1 or 4 in HIV patients.

RESULTSix trials of 88 matched the selection criteria. Total 1,131 patients with coinfection of HCV genotype 1 or 4 and HIV were included. Sustain viral response was higher in patients treated with peginterferon plus ribavirin compared with that of interferon plus ribavirin (26 % compared with 8 %) or peginterferon alone (26 % compared with 13 %). Severe adverse effects and withdrawal rates were similar for patients treated with peginterferon and patients treated with interferon.

CONCLUSIONPeginterferon plus ribavirin in treatment of patients with coinfection of genotype 1 or 4 HCV and HIV can achieve higher sustain viral response and the likelihoods of serious adverse effects and withdrawal rates are similar to other therapies.

Adult ; Antiviral Agents ; administration & dosage ; Drug Therapy, Combination ; Female ; Genotype ; HIV Infections ; complications ; drug therapy ; immunology ; Hepacivirus ; classification ; genetics ; Hepatitis C, Chronic ; complications ; drug therapy ; virology ; Humans ; Interferon-alpha ; administration & dosage ; Male ; Polyethylene Glycols ; administration & dosage ; Randomized Controlled Trials as Topic ; Recombinant Proteins ; Ribavirin ; administration & dosage

No abstract available.
Zygoma

OBJECTIVETo introduce a method to reduce the volume of medial gastrocnemius for calf reduction.

METHODSTibial nerve and nerve branches were dissected and explored at popliteal region for morphometry in 20 cadaver-legs. The length, width and the origination position of the nerve to the medial gastrocnemius were measured and recorded. During surgery, the nerve to the medial gastrocnemius muscle were explored and cut off. The circumference and the shape of the leg were measured and recorded.

RESULTSThe nerve innervating the medial gastrocnemius originates from the tibial nerve which lies in the fat tissue of popliteal space. In 8 cases (40%) there is only 1 branch to the medial gastrocnemius, and in 4 cases (30%) there are 2 branches. In other 4 cases (30%) the medial sural cutaneous nerve originate from the nerve to the medial gastrocnemius. The nerve to the medial gastrocnemius muscle branch off at (- 6.6 +/- 13.7) mm; the width is (2.3 +/- 0.4) mm; the length is (42 +/- 12) mm. Neurectomy of the nerve to the medial gastrocnemius was performed in 16 cases. After operation, the circumference of the leg was reduced (3.5 +/- 1.1) cm averagely and the curve of the medial line of the calf was reduced. There is no obvious swelling in these cases and the patients were able to walk immediately after operation. The function of the leg was not obviously influenced.

CONCLUSIONSNeurectomy of the nerve to the medial gastrocnemius muscle was a safe and effective method for calf reduction.

Adult ; Bariatric Surgery ; Female ; Humans ; Leg ; surgery ; Male ; Muscle Denervation ; Muscle, Skeletal ; innervation ; Sural Nerve ; surgery ; Young Adult