Clinical experiences with the use of ULTRAPRO® mesh in single-stage direct-to-implant immediate postmastectomy breast reconstruction in 102 patients: A retrospective cohort study.

BACKGROUND: Acellular dermal matrices have been used for direct-to-implant (DTI) breast reconstruction (BR), eliminating the load of the lower pole skin envelope. However, the available allograft matrices add considerable health care costs. This study examined the long-term follow-up of synthetic ULTRAPRO® mesh as a low-cost potential alternative to biological matrices. PATIENTS AND METHODS: A retrospective cohort study was performed between January 2013 and January 2016, involved 112 early-stage breast cancer and/or BRCA 1/2 patients, and evaluated 189 immediate DTI BRs following skin-, areola- or nipple-sparing mastectomy using ULTRAPRO® mesh. Patient characteristics and postoperative complications were recorded, and quality of life was rated by the patients using the EORTC-QLQ-C30-BR23 questionnaire. Aesthetic outcomes and palpability of the implants were evaluated by four breast surgeons on a 5-point Likert scale. All recorded parameters were statistically analysed. RESULTS: Ten patients were lost-to-follow-up, resulting in 102 patients and 174 breast surgery cases analysed. The mean age was 43 years, with 23.4 months of follow-up on average. Forty-six patients (45.1%) had previous radiotherapy with pre-existing scars. In total, 32 complications (18.3%) were recorded, including 12 minor (6.9%) and 20 major (11.4%) complications requiring revision. All median quality of life scores were above 83 points, representing a high score, with an average 4-point rating for the aesthetic outcome and natural consistency of the breast. CONCLUSION: Partially absorbable ULTRAPRO® mesh could be used successfully in DTI BR, offering a safe, less expensive alternative to biological matrices. Adequate indications and patient selection are necessary.

Effect of nano-sized, elemental selenium supplement on the proteome of chicken liver.

The nano-sized (100-500 nm) selenium has higher bioavailability and relatively lower toxicity compared to other selenium forms. The objective of the present study was to compare liver proteome profiles of broiler chicken fed with control diet without Se supplementation and diet supplemented with nano-Se with 4.25 mg/kg DM. Differential proteome analyses were performed by two-dimensional gel electrophoresis (2D-PAGE) followed by tryptic digestion and protein identification by liquid chromatography-mass spectrometry (LC-MS). Seven hundred and eight spots were detected, and 18 protein spots showed significant difference in their intensity (p < 0.05) between the two groups. In response to nano-Se supplementation, the expression of 8 proteins was higher, and 5 proteins were lower in nano-Se supplemented group compared to control group. The functions of the differentially expressed proteins indicate that the high dose of selenium supplementation induced a dietary stress. Selenium supplementation may influence the metabolism of fatty acids and carbohydrates and antioxidant system, and increase the quantity of cytoskeletal actin and the expression of actin regulatory protein as well.

Bilateral juvenile fibroadenosis of the breast: management with subcutaneous mastectomy and silicone implant placement.

Bilateral fibroadenosis is a rare, benign disorder, affecting adolescents or women of childbearing age. Choosing the most optimal therapy that manages both the physical and psychological aspects of the disease is a challenge. The goals of the treatment are complete resection of the lesions with optimal cosmesis. Options range from cryoablation, ultrasound-guided vacuum-assisted eradication and simple excision of the lesions to subcutaneous mastectomy with reconstruction. We present a case of a 25-year-old woman with 37 complex fibroadenomas affecting both breasts who was treated with nipple-sparing subcutaneous mastectomy and silicone implant reconstruction to both the surgeons' and patient's satisfaction.

Leaf width, nrDNA and cpDNA its sequence variation within central European Bulbocodium vernum and B. versicolor (Colchicaceae) populations: are there really two taxa?

The taxonomy of the genus Bulbocodium, in which two European species, a smaller eastern (B. versicolor) and a more robust western (B. vernum) are included, has been controversial since the description of the eastern species in 1821. Nuclear encoded ribosomal DNA ITS1 and the entire chloroplast DNA ITS were sequenced from several European populations, from France to the Ukraine, and the leaf width of mature living individuals was measured and analysed by ANOVA and Tukey-test. Although the studied DNA regions proved to be invariable, leaf width shows extreme variability. We found no correlation between the leaf size of the individuals and the geographical position of the populations, and in addition, the sequenced DNA regions showed total uniformity. Thus, our results do not support the division of the genus Bulbocodium into two taxa, at least in the sampled area. The formerly described size variants can be treated taxonomically at the forma level.

In vitro antimicrobial activity of 3,4-dihydro-s-triazinobenzimidazole derivatives.

Among 31 3,4-dihydro-s-triazinobenzimidazole derivatives tested 12 compounds showed in vitro antimicrobial activity against G+ bacteria. Best results were obtained with substances containing naphthyl or halogenated phenyl group on the triazine ring. The tested derivatives had no significant in vitro antimicrobial activity against either the used G- species or fungi.

Mammaplasty with a periareolar dermal cloak for glandular support.

Analyzing the main surgical element of mammaplasty, almost all procedures incorporate a smaller or bigger dermal flap. The periareolar dermal cloak is a dermis flap corresponding to the skin pattern and pedicled to the nipple areola. The shape of the flap can be tailored as required but 2 cm of the dermis flap around the nipple should not be touched. The periareolar dermal flap has been used as a cloak; this dermal cloak is suitable for positioning the nipple and covering a part of the glandular tissues with support. With fastening of the cloak, a better tone of the breast tissues can be achieved. Mastopexy, reduction mammaplasty presented by technical detail of dermal cloak positioning and glandular support, has been done in 178 breast operations since 1992. The dermal cloak technique was used in 114 cases. The technique, clinical results, advantages, disadvantages, and complications are discussed.

Combination of the vertical and periareolar mammaplasty.

Vertical mammaplasty has been perfected and popularized by Madeline Lejour; this technique is one of the most versatile methods of mammaplasty today. The vertical scar from the nipple areola to the submammary line is often much longer and distorted than the conventional mammaplastys. The length of the vertical scar can be reduced by 2-3 cm by combining the skin pattern of the periareolar and vertical mammaplasty. The aesthetic result can be improved by shortening the vertical scar.

[Cranioplasty using computer-designed implants (preliminary report)]. / Koponyacsontpótlás számítógép segítségével készített implantátummal (Elözetes közlemény).

The co-operation among plastic surgeons and computer experts is presented demonstrating the reconstruction of a cranial bone defect of a patient. The adequacy of manufactured implant for reconstruction of cranial bone defect on the base of classic methods in only approximate. Computer aided design is needed for creating a more sophisticated implant. Cranial CT is digitised and a 3 dimensional model is created. The precise implant, manufactured by a computer directed milling machine, fits ino the bone defect. During the operation the cranial bone defect is explored, the bone edges are identified. The implant is fixed and the skull skin is closed. The authors demonstrate a successful operation of a cranial bone defect of 9 x 6.7 cm, the complicated shape and bone surface was reconstructed by a computer aided and manufactured implant. The co-operation of plastic surgeon and computer experts are essential during the process of implant design. The computer assisted and manufactured implants are suitable for the most sophisticated functional and aesthetic reconstruction of bone defect with complicated surface and irregular pattern.

[Plastic surgery in the context of surgery for breast cancer. Breast reconstruction using the patient's own tissue]. / Az emlödaganatok mütéteinek plasztikai sebészeti vonatkozásai. Emlö-helyreállító mütétek saját szövetek felhasználásával.

The breast reconstructions after mastectomies are overviewed. The criteria of a successful operation are discussed. The result of breast reconstruction with latissimus dorsi and rectus abdominis musculocutaneous flaps are presented. The spectrum of 106 breast reconstructions of from 1987 to 1993 is published. The methods of adequate reconstructions mall, middle size and large breasts are discussed. With the reconstruction of large breasts the best results have been achieved by the transfer of rectus abdominis musculocutaneous flap with micro vascular anastomoses. This flap has the best blood supply and this procedure causes the less damage to the donor area. It is stated that the breast reconstructions with living tissues are superior and preferable.

A neurovascular island flap from the first web space of the foot to repair a defect over the heel: case report.

A case of chronic recurrent trophic ulceration over the heel is presented in which a neurovascular island flap from the first web space was used successfully to repair the calcaneal defect.

Experimental microvascular sleeve anastomoses.

Microvascular sutures are the most essential parrt of microsurgery. The three basic types of anastomosis, i.e. end to end (ETE), end to side (ETS) and end in end (EIE), differ, beside the flow parameters, also in the succession, number and depth of the sutures as well as in the technique of suturing. In clinical microsurgery ETE and ETS anastomoses are applied. Several authors have attempted to telescope the vascular ends into each other to simplify the technique of anastomosis, to reduce the time of operation as well as to eliminate intraluminar suturing [1, 3, 6, 9].