A biological or a synthetic mesh in immediate breast reconstruction? A cohort-study of long-term Health related Quality of Life (HrQoL)

ObjectivesMeshes/matrices are commonly used in immediate breast reconstruction. There are few studies comparing biological and synthetic meshes and it is unknown what type of mesh gives the best long-term results. The aim of this study was to compare long-term health-related quality of life (HrQoL) and patient satisfaction in implant-based immediate breast reconstruction with a biological mesh (Surgisis®) with that of patients reconstructed with a synthetic mesh (TIGR ® Matrix Surgical Mesh).Material and methodsBoth cohorts were prospectively included and consecutively operated. Clinical data was collected. HrQoL was evaluated with EuroQoL-5 dimension – 3 levels questionnaire (EQ-5D-3L) and the Hospital Anxiety and Depression Scale (HADS) and the Breast-Q.Results and conclusionSeventy-one patients were operated on in the biological group and 49 in the synthetic group. The response rates were 75 and 84 per cent, respectively. Mean follow-up time was 74 months and 23 months, respectively. There were no statistical differences in satisfaction and quality of life between the two groups. Complications and radiation seem to lead to a lower satisfaction. Our findings could indicate that biological and synthetic meshes give an equal long-term result as regards patients’ perceived quality of life.     

Acquired Dermal Melanocytosis on the Wrist

A 50-year-old Japanese man had a blue-black patch on the dorsum of his right wrist. Light and electron microscopic study of the lesion revealed dermal melanocytes containing mature melanosomes, predominantly in the upper dermis. This case was diagnosed as acquired dermal melanocytosis confined to the right wrist.     

When work strain transcends psychological boundaries: an inquiry into the relationship between time pressure,irritation, work–family conflict and psychosomatic complaints

Against the theoretical background of the effort–recovery model and the action regulation theory, the author presents a cross‐sectional questionnaire study testing hypotheses about the relationship between work‐related time pressure, cognitive and emotional irritation, work–family conflict and psychosomatic complaints. Subjects were 576 female home care nurses. Results of a path analysis show that the relation of time pressure and psychosomatic complaints is partially mediated by experiencing a work–family conflict; also the relation of time pressure and work–family conflict is partially mediated by cognitive and emotional irritation. It is argued that cognitive and emotional irritation are fruitful concepts for a more comprehensive understanding of the relationship between work stressors and the development of strain‐based work–family conflict. Implications for the prevention of work–family conflict are outlined. Copyright © 2008 John Wiley & Sons, Ltd.     

Correlation with age and sex of flash-evoked electroretinogram and retinal oscillatory potentials recorded with skin electrodes

Electroretinograms and retinal oscillatory potentials to full-field flash stimulation were recorded by dermal electrodes in a population of subjects (1 to 84 yrs) balanced for age and sex (119 females, 133 males), without evidence or history of ocular and/or relevant systemic diseases. The electroretinogram latencies and b-wave amplitude increased, while the a-wave amplitude decreased linearly with age. The oscillatory potential amplitude initially increased, to decrease approximately at the age of 50, with an inverted U-shaped distribution.Presented in part at the XXV ISCEV Symposium, Sarasota (Florida), April 26–30, 1987.     

改良消蚀法制备脱细胞真皮基质微粒及其生物相容性评价

目的:利用改良消蚀法制备一种新型脱细胞真皮基质(Acellular dermal matrix,ADM)微粒,并对其相容性加以评价,为组织工程微粒皮肤的制备奠定研究基础。方法:应用机械法切除猪真皮乳头层,结合消蚀法和冻融法除去网状真皮中的所有细胞制备成ADM,将ADM搅碎成颗粒状,对其做细胞毒性实验和皮下埋藏实验检验其相容性。结果:该方法制备的ADM微粒韧性好,细胞去除完全,胶原三维稍松散但结构完整,无基底膜和乳头层。细胞毒性实验显示其基本无毒性,成纤维细胞在ADM微粒上增殖良好,皮下埋藏试验未见明显排异反应,ADM微粒能诱导血管和成纤维细胞长入。结论:用改良消蚀法制备的ADM微粒抗原性低、相容性好,可以作为组织工程微粒皮肤的支架和填充材料。     

Assessment of anti-inflammatory activity of Poria cocos in sodium lauryl sulphate-induced irritant contact dermatitis

OBJECTIVE: In the present study, we evaluated the anti-inflammatory activity of Poria cocos (PoCo) on experimentally induced irritant contact dermatitis (ICD) in a repeated sodium lauryl sulphate (SLS) irritation model. METHODS: The anti-irritative effect of PoCo was evaluated with a visual score and quantified by non-invasive bioengineering methods, namely chromametry and transepidermal water loss. Three concentrations of PoCo in base cream DAC (amphiphilic emollient; German pharmacopoeia) were tested in a 4-day repetitive irritation test using SLS. RESULTS: A statistically significant anti-inflammatory activity was observed for PoCo by all three methods when applied in parallel to the induction period of ICD. Application of PoCo after induction of ICD once a day for 5 days, starting just at the end of 4 days, was without any effect. CONCLUSION: An anti-inflammatory efficacy of PoCo on the elicitation phase of the ICD induced by repeated SLS test could be observed and quantified by three independent, non-invasive biophysical assessment parameters. This effect can be explained by its influence on pro-inflammatory enzymes, namely phospholipase A2.     

不同种属脱细胞真皮与自体皮复合移植的比较性研究

目的　观察不同种属脱细胞真皮基质 (acellulardermalmatrix,ADM)与自体皮复合移植的效果 ,为异种ADM的临床应用提供理论依据。　方法　本地产白色小猪 6头 ,分为异种 (人 )ADM +自体刃厚皮组 (A组 )、同种异体 (猪 )ADM +自体刃厚皮组 (B组 )、单纯自体刃厚皮组 (C组 )及单纯自体中厚皮组 (D组 )。观察术后 2、4、8、12、2 4周内移植物存活率 ,以及移植皮片收缩程度、移植区组织学变化等情况。　结果　A、B组移植后皮片外观光滑、有弹性 ;两组均获得了满意的皮片成活率 ,并可迅速诱导成纤维细胞、血管内皮细胞等宿主修复细胞的长入 ;两组移植皮片收缩面积有大于C、D组的趋势 (P <0.0 5);术后 2 4周移植区组织与单纯中厚皮移植组织结构一致。　结论　在观察期内(复合移植后 2 4周 ) ,与自体皮复合移植时 ,同、异种ADM具有相近的生物学作用 ,异种来源的ADM可能具有更广阔的应用前景     

The site of airway irritation during induction of anaesthesia

The aim of this investigation was to study the role of the nasal airway in mediating upper airway reflexes during induction of anaesthesia when the commonly used irritant inhalational anaesthetic agent enflurane is used. In a prospective randomised study, 40 ASA 1 & 2 day-case patients undergoing body surface surgery were recruited. Following intravenous induction using propofol, 20 patients received enflurane administered via a laryngeal mask airway (LMA), the anaesthetic vapour therefore bypassing the nasal airway. In the other group, 20 patients received enflurane anaesthesia administered using a face mask, the nasal airway therefore being exposed to inhalation anaesthetic. We were unable to demonstrate any significant (p < 0.05) differences between the two groups in relation to upper airway complications (cough, breath holding, laryngeal spasm, bronchospasm and excitement). Previous work has identified the nose as a possible important reflexogenic site for upper airway reflexes in humans during anaesthesia. We have been unable to demonstrate any difference in upper airway complications when the nasal airway was included or excluded from exposure to irritant anaesthetic vapours, when administered in a clinical setting.     

Medpor与游离真皮脂肪移植修复上颌骨及软组织缺损畸形

目的：寻找一种修复上颌骨及软组织缺损的理想方法。方法：采用Medpor与游离真皮脂肪移植，对不同原因所致的上颌骨及软组织缺损畸形进行整复。结果：临床治疗5例，面部畸形均得到良好矫正。结论：这一手术方法创伤小，可塑性强，且大大降低了软组织移植吸收、坏死等并发症的发生，是修复上颌骨及软组织缺损的可取方法。