[Recurrent periprosthetic capsular retraction under the pectoralis major muscle. Treatment, 2 unusual clinical cases]. / Rétraction capsulaire péri-prothétique récidivante sous le muscle grand pectoral: Traitement, deux histoires cliniques curieuses.

Capsular contracture around breast prostheses still represents a challenge, in spite of the numerous papers published on this topic. The etiology and pathogenesis of this condition are perplexing resulting in considerable controversy concerning the rationale for surgical treatment. The authors report two cases of recurrent disease: one patient with recurrent contracture after breast augmentation, the other patient with recurrence after breast reconstruction. Both patients were operated according to an original technique which consists in a square-shaped incision of the pectoralis major muscle via an inframammary approach. This surgical technique allows the prosthesis to sink into deeper layers leading to a better shape of the breast and providing satisfactory skin cover of the prosthesis.

Immunosuppressive effects of (2R,5R)-6-heptyne-2,5-diamine, an inhibitor of polyamine synthesis: II. Beneficial effects on the development of a lupus-like disease in MRL-lpr/lpr mice.

(2R,5R)-6-heptyne-2,5-diamine (MAP; MDL 72175), a potent irreversible inhibitor of L-ornithine decarboxylase (ODC), possesses immunosuppressive activities in vitro as the result of inhibition of lymphocyte polyamine biosynthesis. The effects of MAP were now studied in vivo in MRL-lpr/lpr female mice, an animal model for human systemic lupus erythematosus (SLE). Administration of MAP (0.2% in drinking water; drug intake: 0.25-0.35 g/kg body weight/day) to female mice for 15 weeks, starting 8 weeks after birth, reduced by 47% the number of spleen cells, retarded development of lymphadenopathy and, at that time, markedly prolonged the survival of the mice. At week 23, MAP reduced plasma IgG concentrations by 50% whereas, in contrast, those of IgM were elevated 1.5-fold. No statistically significant effects of MAP were observed on plasma levels of anti-DNA autoantibodies although serum anti-RNP and anti-Sm titres tended downwards during treatment. Neither glomerular lesions nor proteinuria were improved by MAP administration. Finally chronic administration of MAP for 45 weeks prolonged the median survival time from 29.75 to 35.5 weeks.