A fifteen-year experience of buttock contouring with combination of silicone implant, liposuction, and structural fat grafting

Buttock augmentation is one of the most popular procedures to shape and augment the gluteal region. The major literature regarding this topic accentuates the role of the implant in gluteal shaping. The goal of this study is to present our personal experience and approach while emphasizing the role of implant positioning and structural fat grafting to yield a more satisfied buttock contouring. Gluteal implants were placed with various orientation mostly the more spherical portion facing inferiorly to simulate the round shape of the midportion of the gluteal region as an alternative to its classical positioning. Patients were analyzed based on the projection as well as the shape and contour of buttocks. Gluteal contouring with rationale positioning of the gluteal implants combined with structural fat grafting may play a role to yield a more satisfied buttock contouring.     

EGCG-mediated autophagy flux has a neuroprotection effect via a class III histone deacetylase in primary neuron cells

Prion diseases caused by aggregated misfolded prion protein (PrP) are transmissible neurodegenerative disorders that occur in both humans and animals. Epigallocatechin-3-gallate (EGCG) has preventive effects on prion disease; however, the mechanisms related to preventing prion diseases are unclear. We investigated whether EGCG, the main polyphenol in green tea, prevents neuron cell damage induced by the human prion protein. We also studied the neuroprotective mechanisms and proper signals mediated by EGCG. The results showed that EGCG protects the neuronal cells against human prion protein-induced damage through inhibiting Bax and cytochrome c translocation and autophagic pathways by increasing LC3-II and reducing and blocking p62 by using ATG5 small interfering (si) RNA and autophagy inhibitors. We further demonstrated that the neuroprotective effects of EGCG were exhibited by a class III histone deacetylase; sirt1 activation and the neuroprotective effects attenuated by sirt1 inactivation using sirt1 siRNA and sirtinol. We demonstrated that EGCG activated the autophagic pathways by inducing sirt1, and had protective effects against human prion protein-induced neuronal cell toxicity. These results suggest that EGCG may be a therapeutic agent for treatment of neurodegenerative disorders including prion diseases.     

Non-alcoholic steatohepatitis associated with small intestinal diverticulosis and bacterial overgrowth

A patient with hepatic histological features of steatohepatitis in association with small bowel diverticulosis and bacterial overgrowth is described. A similar histological picture in the liver is well recognised in association with bacterial overgrowth in excluded loops of small intestine. Jejunal diverticulosis should be considered as a correlate of para-alcoholic hepatitis.     

Renal fungus ball in a patient with retroperitoneal fibrosis: Unique complication in a rare disease

Candida fungus ball is a rare presentation of urinary tract infections among adult patients and is associated with considerable morbidity. Because clinical signs are not specific, diagnosis is often delayed. Furthermore, treatment is occasionally difficult, and the approach to such cases varies widely among different centers. In this report, we describe a patient with retroperitoneal fibrosis who developed a renal fungus ball. Management of this challenging case is discussed, and review of the literature is presented.     

Current review of trapeziometacarpal osteoarthritis (rhizarthrosis)

Trapeziometacarpal (TMC) joint is the secondly affected joint for osteoarthritis in the hand. TMC joint arthritis affects most commonly postmenopausal women after the fifth decade of life, due to hormonal and structural factors. Rhizarthrosis may lead to a clinical spectrum from subtle symptoms to advanced symptoms such as; severe pain, limitation of range of motion, muscular weakness, bony deformities, and end up ultimately with disability. Regardless of the etiopathogenesis; a variety of non-surgical and surgical methods have been used for the treatment of rhizarthrosis, depending on the age of the patient, symptomatology and the stage of the disease. The main goals of the treatments are as follows; relief of pain, conservation or restoration the stability and mobility of the TMC joint with the optimal preservation of the strength of surrounding musculature. In this article, the current methods, which have been used for the treatment of TMC joint osteoarthritis, will be mainly reviewed, together with concise up-to-date information on both its diagnosis and the anatomy of the TMC joint.     

Validation of the smallest pocket echoscopic device's diagnostic capabilities in heart investigation

We hypothesized that, based on greyscale imaging and color Doppler capabilities, a new pocket ultrasound device (PUD) could accurately record cardiologic diagnostic findings. One hundred patients referred for conventional clinical indications underwent a standard echocardiography. Subsequently, a second physician blinded to the results performed an evaluation using the PUD on the same patients. Study end-points were echocardiographic window quality; left ventricular (LV) morphology; function; hypertrophy; right ventricular, atrial and vena caval morphologies; aortic and mitral valvulopathies; and pericardial structure. Using a scale of three grades, concordance in image quality proved good with a kappa coefficient (κ) of 0.71. Concordances between systems were excellent for LV function and morphology (κ = 0.91 and 0.96). Concordance for LV hypertrophy was good (κ = 0.74). Concordances for mitral regurgitation grades were 0.90, 0.95 and 1.00, respectively. In conclusion, a new PUD enabled scanning examinations, which showed good concordance of basic and qualitative diagnostic capability to standard echocardiographic instruments. (E-mail:patricia.reant@chu-bordeaux.fr)