The unfavorable breast contours resulting from a reductive mastoplasty and mastopexy influenced the authors into developing a technique that provided reduction of the breast base and axillary pole, convenient medial position of the lateral pole, and substantial conification of the breast tissue to help project the areolomamillary complex to the apex of that cone. From March 1987 to December 1994, 205 operations were performed with this technique, which consists of the construction of three glandular flaps and maximum preservation of the skin covering. The results obtained proved to be very satisfactory and more lasting.

Adolescent↗

PubMedDate not supplied

Pectoralis major muscle flap: a new support approach to mammaplasty, personal technique.

Despite the significant evolution of mammaplasty techniques, some undesirable changes on the operated breasts result in evident dissatisfaction for both patients and doctors. The main reason is that the breast has a tendency to resume its previous shape months after the operation. In pursuit of a procedure that would avoid this untoward morphologic evolution, we set to work on the development of a new approach of broad fixation to maintain the breast shape and to avoid ptosis by using the inferior third of the pectoralis major muscle. The authors report their experience with 46 consecutive cases of breast reduction and mastopexy operated between March 1994 and November 1995, studying the surgical procedure employed, its advantages, limitations, and possible complications.

Adolescent↗

PubMedDate not supplied

Breast milk and neonatal necrotising enterocolitis.

In a prospective multicentre study on 926 preterm infants formally assigned to their early diet, necrotising enterocolitis developed in 51 (5.5%). Mortality was 26% in stringently confirmed cases. In exclusively formula-fed babies confirmed disease was 6-10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk. Pasteurised donor milk seemed to be as protective as raw maternal milk. Among babies born at more than 30 weeks' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk; it was 20 times more common in those fed formula only. Other risk factors included very low gestational age, respiratory disease, umbilical artery catheterisation, and polycythaemia. In formula-fed but not breast-milk-fed infants, delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis. With the fall in the use of breast milk in British neonatal units, exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year. About 100 of these infants would die.

Enterocolitis, Pseudomembranous↗

PubMedDate not supplied

Estrogen regulated proteases and antiproteases in ovarian and breast cancer cells.

Cathepsin D (cath-D), an estrogen-regulated protease appears mostly to increase the number of tumor cells rather than their invasion or motility through the extracellular matrix. Estradiol is mitogenic but in vitro it also inhibits invasion and motility. In this review, we discuss the mechanism of this inhibition and the hormonal regulation of other proteases and protease inhibitors possibly involved in the control of tumor cell invasion by estrogens.

Breast Neoplasms↗

PubMedDate not supplied

Milk feeding and changes in intestinal permeability and morphology in the newborn.

The contrasting effects of natural versus cow's milk formula (CMF) on upper gastrointestinal development in the newborn were studied. The passive intestinal permeability of neonatal human infants and guinea pigs was measured using the nonmetabolisable markers lactulose and mannitol. Mucosal morphology was examined in guinea pigs by light microscopy. Nineteen full-term human infants and 63 guinea pigs were studied during the 1st week of extrauterine life. The naturally fed infants showed a decline in intestinal permeability to lactulose following the onset of feeding. This was not shared by those fed CMF. The CMF-fed guinea pigs showed a persistently higher intestinal permeability than the naturally fed animals throughout the 1st week of life. No differences were observed in the villous heights or crypt depths between feeding groups, but both showed an increase in intraepithelial lymphocyte number during the 1st week. Cow's milk formula may cause a persistently higher intestinal permeability, or natural feeding may promote a decline in permeability in the enterally fed newborn.

Animals↗

PubMedDate not supplied

Reference values for radial bone width and mineral content using single photon absorptiometry in healthy children aged 4 to 10 years.

Bone width and mineral content were measured in 420 healthy Cambridge children aged 4 to 10 years using single photon absorptiometry. The results are expressed first in the form of standard centile charts, with additional prediction charts which provide body-size-adjusted estimates for the measurements, and interpretation centiles for comparing these estimates with the actual measurements. The values obtained are similar to those reported for American children aged five to six years after adjusting for body-size differences. We suggest that appropriate application of these prediction charts will facilitate the use of single photon absorptiometry in monitoring and treating children who have disorders of bone growth and mineralization.

Absorptiometry, Photon↗

PubMedDate not supplied

[Role of surgery in the treatment of dissections of the extracranial internal carotid artery. Apropos of a case, review of the literature].

The authors report about one operated case of spontaneous dissection of the extracranial internal carotid artery close to the bifurcation. The persistence of a floating thrombus in a 60% stenosis after a six-week treatment with heparin led to establishing the indication for surgery. The surgical indication remains exceptional, considering the natural history of dissections and the frequency of repatency of the arterial lumen. This type of surgery is mainly for sequellae such as stenosis, thrombi or saccular aneurysms, whose emboligenic potential leads to operating (exeresis and graft on the internal carotid artery) if the anatomical location of the lesion makes it possible.

Adult↗

PubMedDate not supplied

Modulation of class II histocompatibility antigen expression by maternal serum.

Human maternal serum has been shown to down-regulate the expression of MHC class II antigen in three distinct circumstances. Cord blood mononuclear cells, incubated in the mother's own serum, showed significant modulation of class II antigen expression. This was also the case for unrelated donor lymphocytes, incubated in pooled maternal serum. One neoplastic line (Daudi) was further shown to down-regulate class II antigen expression. In this last case, the down-regulating effect persisted over a 10-day period during which maternal serum was renewed regularly. Retroplacental serum was more MHC class II-inhibiting than peripheral serum. This down-regulating effect does not apply to maternal lymphocytes. The inhibitory effect is thought to be due to a factor, yet to be defined, included in the maternal IgG fraction. Regular assays made throughout pregnancy showed that the class II inhibiting component appears early (5th week), reaches its peak value at the 12th week, and disappears 2 or 3 weeks after delivery.

Antigen-Antibody Complex↗

PubMedDate not supplied

Characterization of human coronary artery atherosclerotic plaque fluorescence emission.

Preliminary trials using fluorescence guidance of laser ablation in femoral arteries have been successful. There have, however, been few studies of the characteristics of fluorescence emissions from coronary arteries. A large series of fluorescence emission spectra from human coronary artery specimens was examined. Analysis included: fluorescence emission during excitation with ultraviolet and visible light; histologic correlations between plaque content and thickness, averaged spectra and fluorescence intensity ratios; and differences in specific plaque morphology with excitation of the same coronary specimens at 325 or 458 nm. Ratios of fluorescence emission intensity at selected wavelengths were calculated for both 325 and 458 nm excitation (13 wavelengths, 78 ratios for 325 nm; 11 wavelengths, 55 ratios for 458 nm). The following were found: atherosclerotic lesions in human coronary arteries were characterized by an increase in normalized fluorescence intensity at longer wavelengths when excited with either ultraviolet or visible light; calcific plaque content greater than 10% in lesions more than 1 mm thick was identified by increased normalized fluorescence intensity at 443 nm during excitation at 325 nm; and fatty plaque content correlated with fluorescence intensity ratios during 325 nm excitation, whereas fibrous and calcific content correlated well with fluorescence ratios during 458 nm excitation. It is concluded that characteristic fluorescence emission has the potential to correctly identify and characterize plaque morphology in human coronary arteries.

Coronary Artery Disease↗