Lack of evidence that obesity is a cause of pilonidal sinus disease.

OBJECTIVE: To find out whether pilonidal sinus is more common among obese people. DESIGN: Retrospective study from hospital records. SETTING: Two university hospitals, Turkey. SUBJECTS: 419 patients who were operated on for pilonidal sinus disease; and 213 age and sex matched patients with benign diseases other than pilonidal sinus disease and who were not morbidly obese acted as controls. MAIN OUTCOME MEASURES: Comparison of body mass index (BMI) in the two groups. RESULTS: Patients with BMI of 25-30 were classified as overweight (61/419, 15% compared with 28/213, 13%), and those with BMI of 30 or more as obese (7/419 compared with 4/213, 2% in each group). Mean (SD) BMI of patients with pilonidal sinus disease was 26.0 (3.9) compared with 25.6 (3.9) in the control group (p = 0.4). CONCLUSION: Obesity alone is not an important factor in the aetiology of pilonidal sinus disease.     

An Uncommon Complication of Secondary Augmentation Mammoplasty:Bilaterally Massive Engorgement of Breasts After Pregnancy Attributable to Postinfection and Blockage of Mammary Ducts

Augmentation mammoplasty is one of the most frequently performed aesthetic operations. Galactorrhea and galactocele formation after augmentation mammoplasty, while the patient is experiencing the hormonal effects, is rarely seen. The cause remains unknown. However, postoperative fibrosis and blockage of the mammary ducts after augmentation mammoplasty is a probable cause of this formation in some patients. In the reported case, the patient described painful massive engorgement of both breasts during the last month of pregnancy and inability to breast-feed after delivery. In her history, she had undergone breast augmentation via the semicircular periareolar transglandular approach. She had experienced an infection at an early stage of her postoperative period and had needed to have both prostheses removed. A second breast augmentation mammoplasty was performed 1 year after the first operation via the same incision. She was content with the result of her second augmentation mammoplasty, up until her third pregnancy, at which time she reported inability to breast-feed after her delivery. At our examination, it was determined that there was massive painful breast engorgement, hyperemia, and inflammation of both breasts attributable to a bilateral galactocele formation. She refused to take any medication (bromocriptine), but approved antibiotic treatment. The patient responded to the antibiotics, and the prostheses therefore were left in place without further complications.     

The Spreader-Splay Graft Combination: A Treatment Approach for the Osseocartilaginous Vault Deformities Following Rhinoplasty

Deformities following primary rhinoplasty may be located at different anatomical regions related to the primary operation. Osseocartilaginous vault deformities such as open roof deformity, over-resected bony and cartilaginous dorsum, excessive width of the middle vault, inverted-V deformity and middle vault collapse are the most frequent ones. Stair-step deformity combined with middle vault problems is uncommon. Patients with these deformities not only have poor aesthetic results, but also have moderate or severe respiratory problems due to the severity of the deformity. Spreader grafts, onlay grafts and biomaterials can be used to correct these deformities. We preferred to use the spreader-splay graft combination for severe osseocartilaginous vault deformities. In this paper we present 3 cases. Two cases had severe open roof deformity, middle vault collapse and over resection of the osseocartilaginous hump, along with severe respiratory problems. The Spreader-splay graft combination was used, along with lateral osteotomy and medialization of nasal bones to treat these patients. One patient had a very severe stair-step deformity due to over resection of the hump and excessive infracturing of nasal bones along with severe respiratory problems due to collapse of the middle vault. This deformity was corrected with proper outfracturing along the old osteotomy site and the use of spreader-splay graft combination. All patients had good aesthetic and functional outcome after the surgery. In conclusion, the spreader-splay graft combination provides a good anatomical restoration to obtain a better respiratory function and aesthetic outcome on severe osseocartilaginous vault deformities following rhinoplasty.     

Entorhinal cortex lesion studied with the novel dye fluoro-jade

We used the fluorescent dye Fluoro-Jade, capable of selectively staining degenerating neurons and their processes, in order to analyze degenerative effects of transecting the hippocampus from its main input, the entorhinal cortex in vivo and in organotypical hippocampal slice culture. Degenerating fibers stained with Fluoro-Jade were present as early as 1 day postlesion in the outer molecular layer of the dentate gyrus and could be detected up to 30 days postlesion. However, the intensity of the Fluoro-Jade staining in the outer molecular layer faded from postlesional day 20 onward. Punctate staining, various cells and neural processes became visible in this area suggesting that degenerating processes were phagocytosed by microglial cells or astrocytes. We conclude that Fluoro-Jade is an early and sensitive marker for studying degenerating neurites in the hippocampal system.     

Rhinomanometrische untersuchungen bei funktionsplastischer chirurgie der nase

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