ABSTRACT
BACKGROUND: The inverted T (Wise pattern) mastectomy for patients with macromastia or significant breast ptosis has evolved along with generalized techniques for breast reconstruction. We present a review of Wise pattern breast reconstruction along with our technique for direct to implant reconstruction using dermal matrix. METHODS: The literature was reviewed and an analysis of techniques and complications was performed. We present our series of patients incorporating dermal matrix and relatively large implants in direct to implant reconstruction. RESULTS: Of 18 breasts reconstructed only 2 failed. One caused by flap necrosis secondary to smoking and one as a result of preoperative radiation. CONCLUSION: Wise pattern breast reconstruction using relatively large implants and dermal matrix in direct to implant reconstruction is a safe technique in selected patients with macromastia.
ABSTRACT
Noniatrogenic neonatal gastric perforation is a rare and life-threatening condition whose etiology is often unclear. Interstitial cells of Cajal act as gastrointestinal pacemaker cells and express the proto-oncogene c-Kit. Six new cases were identified at our institution which presented with no mechanical, pharmacologic, or otherwise medical-related intervention prior to rupture. The number of interstitial cells of Cajal in nonnecrotic muscularis propria from five random high-power fields per specimen was compared using immunohistochemical stains for c-Kit. The authors show that a lack of interstitial cells of Cajal in the stomach musculature may be implicated in the development of noniatrogenic gastric perforation (p = 0.008). Further large-scale studies, including molecular and genetic analysis, may help to better understand this phenomenon.
Subject(s)
Interstitial Cells of Cajal/pathology , Stomach Rupture/etiology , Case-Control Studies , Cell Count , Female , Humans , Immunohistochemistry , Infant, Newborn , Interstitial Cells of Cajal/metabolism , Male , Proto-Oncogene Mas , Proto-Oncogene Proteins c-kit/metabolism , Rupture, Spontaneous , Stomach Rupture/metabolism , Stomach Rupture/pathologyABSTRACT
Octamer4/3 is a POU transcription factor that regulates pluripotentiality in embryonic stem and germ cells and primordial germ cells. When expressed in post-embryonic life, Octamer4/3 may lead to malignant germ cell tumors (GCT). Thirty samples were selected for this study (26 GCT samples and 4 cryptorchid testes samples) and 16 non-GCT were used as controls. Samples were stained with an anti-Octamer4/3 antibody. All cases of GCT were positive for Octamer4/3, and the non-GCT were negative. This article focuses on pediatric populations where we found that Octamer4/3 immunostaining is a useful diagnostic tool in undifferentiated pediatric tumors.
