ABSTRACT
Gram-negative bacterial pathogens produce outer membrane vesicles (OMVs) and this secreted cargo plays a role in host-pathogen interactions. OMVs isolated from Burkholderia cepacia induce the cytotoxicity and pro-inflammatory responses both in vitro and in vivo, but OMV components associated with host pathology have not been characterized. This study analyzed the proteomes of OMVs produced by B. cepacia ATCC 25416 and investigated whether proteins in B. cepacia OMVs were responsible for host pathology in vitro. Proteomic analysis revealed that a total of 265 proteins were identified in B. cepacia OMVs. Of the 265 OMV proteins, 179 (67.5%), 32 (12.1%), 27 (10.2%), 17 (6.4%), and 10 (3.8%) were predicted to be located in the cytoplasm, inner membrane, periplasmic space, outer membrane, and extracellular compartment, respectively. Several putative virulence factors were also identified in B. cepacia OMVs. B. cepacia OMVs slightly induced the cytotoxicity in lung epithelial A549 cells, but there was no difference in cytotoxic activity between intact OMVs and proteinase K-treated OMVs. B. cepacia OMVs stimulated the expression of pro-inflammatory cytokine and chemokine genes in A549 cells, but the expression of these cytokine genes was significantly inhibited in A549 cells incubated with proteinase K-treated OMVs. In conclusion, our results suggest that proteins in B. cepaciaOMVs are directly responsible for pro-inflammatory responses in lung epithelial cells.
ABSTRACT
Gram-negative bacterial pathogens produce outer membrane vesicles (OMVs) and this secreted cargo plays a role in host-pathogen interactions. OMVs isolated from Burkholderia cepacia induce the cytotoxicity and pro-inflammatory responses both in vitro and in vivo, but OMV components associated with host pathology have not been characterized. This study analyzed the proteomes of OMVs produced by B. cepacia ATCC 25416 and investigated whether proteins in B. cepacia OMVs were responsible for host pathology in vitro. Proteomic analysis revealed that a total of 265 proteins were identified in B. cepacia OMVs. Of the 265 OMV proteins, 179 (67.5%), 32 (12.1%), 27 (10.2%), 17 (6.4%), and 10 (3.8%) were predicted to be located in the cytoplasm, inner membrane, periplasmic space, outer membrane, and extracellular compartment, respectively. Several putative virulence factors were also identified in B. cepacia OMVs. B. cepacia OMVs slightly induced the cytotoxicity in lung epithelial A549 cells, but there was no difference in cytotoxic activity between intact OMVs and proteinase K-treated OMVs. B. cepacia OMVs stimulated the expression of pro-inflammatory cytokine and chemokine genes in A549 cells, but the expression of these cytokine genes was significantly inhibited in A549 cells incubated with proteinase K-treated OMVs. In conclusion, our results suggest that proteins in B. cepaciaOMVs are directly responsible for pro-inflammatory responses in lung epithelial cells.
ABSTRACT
Hypothermia is considered a useful intervention for limiting pathophysiological changes after brain injury. Local hypothermia is a relatively safe and convenient intervention that circumvents many of the complications associated with systemic hypothermia. However, successful hypothermia treatment requires careful consideration of several factors including its practicality, feasibility, and associated risks. Here, we review the protective effects-and the cellular mechanisms that underlie them-of delayed and prolonged local hypothermia in rodent and canine brain injury models. The data show that the protective effects of therapeutic hypothermia, which mainly result from the modulation of inflammatory glial dynamics, are limited. We argue that decompressive craniectomy can be used to overcome the limitations of local brain hypothermia without causing histological abnormalities or other detrimental effects to the cooled area. Therefore, delayed and prolonged local brain hypothermia at the site of craniectomy is a promising intervention that may prove effective in the clinical setting.
Subject(s)
Astrocytes , Brain Injuries , Brain , Decompressive Craniectomy , Hypothermia , Microglia , Rodentia , StrokeABSTRACT
OBJECTIVES: This study was conducted to examine the effect of blood mercury on neurobehavioral performance in Korean elementary school students. METHODS: We measured the blood mercury concentration in 1,077 elementary school students from Seoul, Busan, Daegu and Gwangju, then the students underwent computerized neurobehavioral test. RESULTS: The mean concentration of blood mercury of study subjects was 2.10 microg/L. An increased blood mercury was associated with an increased reaction time in digit addition and symbol digit. CONCLUSIONS: The blood mercury concentration of study subjects was very high compared to findings in a foreign country. We found several associations between blood mercury level and neurobehavioral performance.
Subject(s)
Humans , Reaction TimeABSTRACT
OBJECTIVES: This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do. METHODS: The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test. RESULTS: In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor. CONCLUSIONS: Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.
Subject(s)
Bone Density , Cadmium , Crops, Agricultural , Korea , Linear Models , Rivers , Smoke , Smoking , Soil , WaterABSTRACT
OBJECTIVES: This study evaluated the prevalence of asbestos exposure-induced pleural thickening on chest radiograph in repairing shipyard workers. METHODS: A total of 2,114 incumbent and retired workers in a shipyard underwent chest radiograph, questionnaire study, interview, and physical exam from 2005 to 2007. Finally, 1,702 workers were selected and classified into two groups according to asbestos exposure: exposure and non-exposure groups. The characteristics in the exposure group were investigated. RESULTS: The prevalence of pleural thickening on chest radiograph was 5.2 % and 3.1 % in the exposure and non-exposure groups, respectively (p<0.05). In those aged 50 years or above, the prevalence was 17.6 % and 8.7 % in the exposure and non-exposure groups, respectively (p<0.05). The prevalence was 16.5 % and 30.2 % and the odds ratio was 2.34 (95% CI; 1.15-4.77) and 2.95 (95%CI; 1.08-8.07) in the workers with an exposure duration of 20-29 years and more than 30 years, respectively. The prevalence was higher when considering tuberculosis history. CONCLUSIONS: The prevalence was increased with increasing exposure duration was more than 20 years. The authors therefore suggest that this group should be followed up periodically by special program and that a longitudinal study with repairing shipyard workers as the cohort should be undertaken.
Subject(s)
Aged , Humans , Asbestos , Cohort Studies , Odds Ratio , Prevalence , Surveys and Questionnaires , Thorax , TuberculosisABSTRACT
OBJECTIVES: This study evaluated the prevalence of asbestos exposure-induced pleural thickening on chest radiograph in repairing shipyard workers. METHODS: A total of 2,114 incumbent and retired workers in a shipyard underwent chest radiograph, questionnaire study, interview, and physical exam from 2005 to 2007. Finally, 1,702 workers were selected and classified into two groups according to asbestos exposure: exposure and non-exposure groups. The characteristics in the exposure group were investigated. RESULTS: The prevalence of pleural thickening on chest radiograph was 5.2 % and 3.1 % in the exposure and non-exposure groups, respectively (p<0.05). In those aged 50 years or above, the prevalence was 17.6 % and 8.7 % in the exposure and non-exposure groups, respectively (p<0.05). The prevalence was 16.5 % and 30.2 % and the odds ratio was 2.34 (95% CI; 1.15-4.77) and 2.95 (95%CI; 1.08-8.07) in the workers with an exposure duration of 20-29 years and more than 30 years, respectively. The prevalence was higher when considering tuberculosis history. CONCLUSIONS: The prevalence was increased with increasing exposure duration was more than 20 years. The authors therefore suggest that this group should be followed up periodically by special program and that a longitudinal study with repairing shipyard workers as the cohort should be undertaken.
Subject(s)
Aged , Humans , Asbestos , Cohort Studies , Odds Ratio , Prevalence , Surveys and Questionnaires , Thorax , TuberculosisABSTRACT
PURPOSE: For a minor degree of mandibular prognathism, mandibular anterior segmental osteotomy (ASO), usually extracting the bilateral premolars, has been performed frequently to correct malocclusion of the anterior teeth. Preoperative planning using cephalometry and a dental model is very important for such a orthognathic surgery. Depending on the specific preoperative mock surgery with the dental model, ASO, with ipsilateral unitooth extraction, is defined to be feasible and performed for ten patients. The comparisons of its preoperative and postoperative analysis of clinical photographs, dental casts, and lateral cephalograms, for soft tissue profiles, skeletal and dental relationships are described in the following, and its clinical applications are noted. METHODS: From March 1, 2004, to March 31, 2006, We performed 10 mandibular ASO by extraction of ipsilateral unitooth to improve their lower facial profiles and the lip relationships. Patient age ranged from 19 to 33 years, with a mean age of 25.6 years. Two were males and eight were females. RESULTS: All patients were satisfied with aesthetic and occlusal changes postoperatively. Significant and persistent decrease in the SNB and interincisal angle were observed in the postoperative cephalometries. The soft tissue profiles also were improved and near Ricketts's esthetic line. Other combined procedures include nine genioplasties, two rhinoplasties, and one blepharoplasty. One patient complained of transient unilateral inferior mental nerve paresthesia. There were no other significant complications or relapses throughout the follow-up period(6-20 months). CONCLUSION: Mandibular ASO, extracting the ipsilateral unitooth, was performed for ten patients to correct mild mandibular prognathism. The amount of setback of the mandibular anterior portion was 2 to 3mm, and satisfactory results were obtained combined with genioplasties.
Subject(s)
Female , Humans , Male , Bicuspid , Blepharoplasty , Cephalometry , Models, Dental , Follow-Up Studies , Genioplasty , Lip , Malocclusion , Orthognathic Surgery , Osteotomy , Paresthesia , Prognathism , Recurrence , Rhinoplasty , Tooth , Malocclusion, Angle Class IIIABSTRACT
PURPOSE: Mid and lower facial convexity is more common in Oriental people than in Caucasian. Bimaxillary dentoalveolar protrusion is characterized by procumbent teeth, protruding lips, acute nasolabial angle, gummy smile, receding chin, facial convexity. Especially, pure maxillary dentoalveolar protrusion is less frequent than bimaxillary dentoalveolar protrusion. Therefore, it is important to make an accurate decision for the operation throughout the history taking, cephalogram, dental cast to arrive at accurate diagnosis and surgical plan. METHODS: From December 2002 to June 2004, ten patients with maxillary dentoalveolar protrusion and microgenia were corrected by maxillary anterior segmental osteotomy and advancement genioplasty. 10 patients were analyzed by preoperative and postoperative clinical photography, posteroanterior and lateral cephalograms. RESULTS: No major complications were occurred throughout the follow-up period except one of the over- recessed, otherwise most of the patients were satisfied with the result. CONCLUSION: We could correct the occulusal relationship with teeth and improve lower facial profile, asthetically and functionally, by maxillary anterior segmental osteotomy and advancement genioplasty.
Subject(s)
Humans , Chin , Diagnosis , Follow-Up Studies , Genioplasty , Lip , Osteotomy , Photography , ToothABSTRACT
Many Oriental women have prominent mandibular angle and short chin, in other words, 'squared' mandibular face or 'boxy' face. That kind of face is considered to be unattractive and causes big cosmetic problems for those who want to have an ovoid or almond shaped face. A squared mandibular face often needs to be corrected by operative procedure. A reduction mandibular angleplasty by bony angle resection is one of the operative procedures, but it is not always an adequate method. The successful correction of squared mandibular face can be accomplished by horizontal facial reduction and/or vertical facial lengthening procedure. From March 1996 to March 2000, We had operated 117 patients. The patients were divided into 3 groups. Group I had prominent mandibular angle and/or massetric hypertrophy. Patients in this group were operated by reduction angleplasty with/without resection of masseter muscle. Group II had prominent mandibular angle, cheek and mandibular body. In this case, we applied reduction angleplasty, contouring of body, resection of buccal fat pad and/or masseter muscle. Group III had prominent mandibular angle with short face. We used methods used for group II and Le Fort I lengthening and genioplasty. Ancillary procedures were forehead lengthening and reduction maloplasty. Successful correction of squared mandibular face could be performed by accurate analysis of facial profile and reduction mandibular angleplasty with proper ancillary procedures for each group. The results were as follows: 1) We obtained successful correction of squared mandibular face with multiple horizontal facial reduction procedures, which reduced anterior and posterior facial plane. 2) In case of short face, we made better mid-low facial balance with vertical facial lengthening and horizontal facial reduction.
Subject(s)
Female , Humans , Adipose Tissue , Cheek , Chin , Forehead , Genioplasty , Hypertrophy , Masseter Muscle , Prunus dulcis , Surgical Procedures, OperativeABSTRACT
OBJECTIVES: To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. METHODS: Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). RESULTS: The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.63) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). CONCLUSIONS: Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery. In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.
Subject(s)
Female , Humans , Classification , Diagnosis , Education , Jogging , Knee Injuries , Knee , Logistic Models , Occupations , Osteoarthritis , Osteoarthritis, Knee , Prevalence , Rheumatology , Rural Population , Self Care , Smoke , Smoking , Swimming , WorkplaceABSTRACT
Facial contouring surgery is a one of the most common and popular procedure in the field of plastic surgery. The aim of this study is to evaluate the effectiveness of photogrammetric analysis by measuring preoperatively and postoperatively in the patients who were undertaken reduction malarplasty. From January 1995 to May 1999, from thirty patients of reduction malarplasty, Photography of life size - frontal view, lateral view, worm's eye view - were taken. The photograph was analyzed by the same surgeon to reduce an analytic error. The distance between both malar eminences and both zygions was the anatomical landmarks. The differences between pre- and postoperative photographic distance represented the results of the operation. The distance between both malar eminences (ME): preop/postop = 94 - 105 mm/89 - 99 mm. The distance between both zygions(ZY): preop/postop = 125 - 141 mm/ 120 - 135 mm. The reduction values of ME-ME/ZY-ZY are 3 -13 mm / 4 - 12 mm. The photogrammetric analysis of reduction malarplasty was very practical in measuring postoperative changes. We may assume that photogrammetric analysis may be very useful tool on preoperative diagnosis, plan and analysis of result of operation.
Subject(s)
Humans , Diagnosis , Photogrammetry , Photography , Surgery, PlasticABSTRACT
There have been great concerns about the application of distraction osteosynthesis to facial reconstruction, a technique which was proposed by Ilizarov in the early 20th century. Despite of many studies and trials since then, little research has been done concerning the specific response of facial bone to distracting stress. The purposes of this study are to investigate the maximal distraction rates and lengthening amounts which are safe from poor osteogenesis and possible adverse reaction. After corticotomy, eleven Korean mongrel dogs were distracted on their mandible for 28 days at different speeds: A group-3 dogs, 1.0 mm/4 times/day; B group-3 dogs, 1.5 mm/4 times/day; C group-2 dogs, 1.75mm /4 times/day; D group-3 dogs, 2.0 mm/4 times/day respectively, which were then examined in gross architecture, radiologic and histologic changes after 7 weeks fixation. The following results were obtained: dense osseous tissue was observed in new bone with the distraction rate of 2.0 mm/day. With maximum distraction rate and lengthening, most nerve fibers of the inferior alveolar nerve were well myelinated and had relatively normal axon structures in the region of the new bone except for rare findings of minimal disfiguration of axons and demyelination in some areas. There was not any evidence of arthrotic changes in temporomandibular joint under maximum distraction, but some adaptive changes were observed. In conclusion, relatively favorable bone formation was possible at the distraction rate of 2.0 mm per day. Because there was little damage of nerve and joint against maximum lengthening (43.4% of original bone length), this technique can be considered as a useful choice for reconstruction of larger defects on facial bone. However, a more systemized longitudinal analysis is needed to determine the regional effects of distraction and the detailed mechanism of ossification on the mandible.
Subject(s)
Animals , Dogs , Axons , Demyelinating Diseases , Facial Bones , Joints , Mandible , Mandibular Nerve , Myelin Sheath , Nerve Fibers , Osteogenesis , Osteogenesis, Distraction , Temporomandibular JointABSTRACT
The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Subject(s)
Humans , Breast Feeding , Follow-Up Studies , Nipples , Recurrence , SuturesABSTRACT
Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Subject(s)
Humans , Male , Follow-Up Studies , Genioplasty , Jaw , Malocclusion , Osteotomy , Paresthesia , PrognathismABSTRACT
Recently, there is a increasing tendency in microvascular free flap reconstruction. But microvascular free flap transfer requires much time in mastering the suture technique as well as long operation time. Moreover it carrys the risk for thrombosis and total flap failure. So, these factors have inspired the need for quicker and easier methods for microvascular anastomosis. Since the Nakayama`s experimental work on ring-pin anastomotic device, many experimental and clinical works on mechanical anastomosis system have been developed. Authors have tried 3M microvascular anastomotic device in 25 cases of free flap transfer for the last 3 years. The results are as follows: 1) Mean follow-up period was 5.2 months. 2) Mean time for the vein anastomosis was 5.5 minutes. 3) Survival rate of the flap was 100 %. We got a conclusion that 3M microvascular coupling device can be a safe, fast and reliable adjunct for soft and friable venous microvascular anastomosis.
Subject(s)
Follow-Up Studies , Free Tissue Flaps , Survival Rate , Suture Techniques , Thrombosis , VeinsABSTRACT
Recently, there is a increasing tendency in microvascular free flap reconstruction. But microvascular free flap transfer requires much time in mastering the suture technique as well as long operation time. Moreover it carrys the risk for thrombosis and total flap failure. So, these factors have inspired the need for quicker and easier methods for microvascular anastomosis. Since the Nakayama`s experimental work on ring-pin anastomotic device, many experimental and clinical works on mechanical anastomosis system have been developed. Authors have tried 3M microvascular anastomotic device in 25 cases of free flap transfer for the last 3 years. The results are as follows: 1) Mean follow-up period was 5.2 months. 2) Mean time for the vein anastomosis was 5.5 minutes. 3) Survival rate of the flap was 100 %. We got a conclusion that 3M microvascular coupling device can be a safe, fast and reliable adjunct for soft and friable venous microvascular anastomosis.
Subject(s)
Follow-Up Studies , Free Tissue Flaps , Survival Rate , Suture Techniques , Thrombosis , VeinsABSTRACT
The characteristics of modern society's trauma is a propensity for multiple and severe trauma, specially, the fatal damage accompanied by facial bone fracture. We observed the malocclusion owing to delayed prompt treatment If the fractured fragments is crushed severely, it is difficult to make them positioned into the normal anatomical states and to fix them tightly. Post-traumatic malocclusion is usually caused by a delay in treatment and inadequate anatomic reduction. Inadequately treated facial bone fractures result in facial disfiguring and functional impairment of mastication and speech.We performed 27 cases of correction of post-traumatic malocclusion between April 1994 and June 1996. We used various operative techniques such as anterior segmental osteotomy, Le Fort osteotomy, maxillary segmental osteotomy and mandibular sagittal split osteotomy. If the malocclusion was due to disarrangement segmental osteotomy. If that malocclusion was attributed to a malpositioned skeletal bone, we take maxillary segmental osteotomy or mandibular sagittal split osteotomy. We acquired the desirable occlusion first followed by a fixation between the mandible and maxillary skeletal bones with the bite block. The aim in the correction of malocclusion was to create a harmony of centric relation and centric occlusion. After operation, intermaxillary fixation with bite block have many advantages in the treatment of malocclusion.
Subject(s)
Centric Relation , Facial Bones , Malocclusion , Mandible , Mastication , Maxillary Osteotomy , Osteotomy , Osteotomy, Le FortABSTRACT
Hypermastia has always been a serious problem for women, frequently causing physical pain and deformity as well as psychological disorders associated with self image. At present time, there are various techniques of reduction mammaplasty to help women's self esteem. Among these, inferior pyramidal dermal pedicle technique of reduction mammaplsty has some advantages including ease of performance and teaching, good preservation of the neurovascular supply to the nipple, applicability over a wide range of reduction size, and reliable reproducibility. We report ten patients with hypermastia and breast ptosis who underwent reduction mammaplasty and mastopexy using by our modified inferior pyramidal dermal pedicle technique, that is based on the concept of Courtiss & Goldwyn and Georgiade. In conclusion , inferior pyramidal dermal pedicle technique for hypermastia is a valuable technique for the reasons of time-tested simplicity and reliable reproducibility.