Bilateral immediate two-stage breast reconstruction in patients with unilateral breast cancer: Outcomes analysis and risk assessment

IntroductionContralateral prophylactic mastectomy has the potential to decrease the occurrence of cancer and reduce psychological burden. However, it is known that complications after bilateral mastectomy are higher compared with unilateral mastectomy. Our goal was to evaluate outcomes of immediate breast reconstruction in patients undergoing bilateral mastectomy and to compare complication rates between therapeutic and prophylactic sides.Patients and MethodsElectronic medical records of patients with unilateral breast cancer who underwent bilateral mastectomy and immediate reconstruction with expanders were reviewed. Postoperative complications were compared between therapeutic and prophylactic mastectomy sides.ResultsSixty-two patients were analyzed. The overall complication rate after both stages was 23.9% on the therapeutic side and 16.5% on the prophylactic side. Infection was the most common complication on both sides. All infections on the prophylactic mastectomy side were successfully treated with intravenous (IV) antibiotics (salvage rate of 100%), whereas 35.7% of infected tissue expander/implants on the therapeutic mastectomy side were explanted despite treatment.ConclusionCareful counselling of patients undergoing elective contralateral prophylactic mastectomy is essential as complications can develop in either breast after reconstruction.     

Compulsive Conditioned Sexual Responding of Male Japanese Quail in Extinction

Archives of Sexual Behavior - Previous experiments showed that following acquisition of an association between a terry-cloth object conditioned stimulus (CS) and a live female unconditioned...     

脂多糖对胆汁分泌的影响

[目的 ]通过脂多糖对胆汁分泌的影响实验 ,初步探讨引起肝功能障碍及肝内结石形成的机理 .[方法 ]在麻醉状态下 ,直接往实验动物肝内注入脂多糖等实验药物 ,测定相关数据 .[结果 ]脂多糖对胆汁分泌有抑制作用 ,并对胆汁酸、磷脂浓度有降低作用 ,而对胆红素、钙的浓度无显著作用 .[结论 ]脂多糖对胆汁分泌有明显作用 ,对诱发肝功能障碍及形成肝内胆结石有一定的影响     

双苄基异喹啉季铵类化合物的合成及肌肉松驰活性

目的：获得起效快、复原快的肌肉松驰剂。方法：1类化合物以汉防乙甲素为原料,经季铵化制得。Ⅱ类以阿曲库铵的结构为模板,对其1－取代基进行结构改造而得,所有目的化合物的结构经IR、^1HNMR、MS鉴定。结果：设计合成了未见文献报道的11个两类双苄基异喹啉季铵类化合物。结论：初步药理试验表明,目的化合物1c的起效剂量、起效时间与汉肌松相当。     

蛛网膜下腔再出血(附11例报告)

? Objective:To explore the molecular mechanism of G1arrest of thymocytes and splenocytes in mice induced by whole body irradiation(WBI) .Methods:Flow cytometry(FCM) and dotblotwere used to analyze MDM2 m RNA and protein expressions of thymocytes and splenocytes in Kunming mice after whole body irradiation (WBI) with x- rays.Results:The expressions of MDM2 protein of thymocytes in mice increased from 4h to 8h after 2 Gy WBI.There were no significant changes of MDM2 m RNA level of thymocytes and splenocytes from0 to48h after75m Gy or2 Gy WBI.No changes of MDM2 m RNA level were also found in thymocytes or splenocytes of mice4h after0～ 6Gy WBI.Conclusion:These results suggest that ionizing radiation could induce MDM2 protein expression and make G1arrest cells reentering cell cycle. 〔     

Early and late visual prognosis in solar retinopathy

Background: Solar retinopathy was observed in a total of 86 eyes of 58 patients following the solar eclipse over Turkey in April 1976. The visual prognosis and the presence of late complications were evaluated at the early and late periods. Methods: Of the 58 patients, 34 (51 eyes) presented during the first week and came for follow-up examination in the succeeding week, also after 1, 3, 12 and 18 months. After that they were examined at yearly intervals (mean 4.2 years). Twenty-four patients (35 eyes) presented during the period between 1 and 11 years post-eclipse and were followed up for a mean period of 3.4 years. After a period of 15 years, all of the patients were invited for re-examination and nine patients (14 eyes) attended. Results: The improvement in visual acuity was observed to have taken place mostly during the first 2 weeks to 1 month after the eclipse. Further improvement in visual acuity was not observed in any of the eyes after the 18-month examination. The improvement in visual acuity was more prominent and earlier in the eyes that had visual acuity of 0.2 or better initially. Only the eyes with initial visual acuity equal to or better than 0.4 had a chance to improve their acuity to 10/10. Having observed the 51 eyes for mean period of 4.2 years and the 35 eyes for 3.4 years, no change in visual acuity was observed. Among the total of 86 eyes, 9 were found to have pseudolamellar macular holes. Conclusion: Correlation was found between initial visual acuity and the funduscopic appearance after the 2nd week. Fluorescein angiography was not found to be a conclusive test in solar retinopathy. No late complications were observed.     

MRI and MRS in HMG-CoA lyase deficiency

3-Hydroxy-3-Methylglutaryl coenzyme A lyase (HMG-CoA) deficiency is a rare inborn error of leucine catabolism. The disease is characterized by recurrent episodes of metabolic acidosis, hyperammonemia without ketosis, hypoglycemia, lethargy, hepatomegaly, and seizures. This study has evaluated the magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings of three patients with HMG-CoA deficiency. The common findings on all of the MRI scans were multiple, coalescent, marked lesions in periventricular white matter and arcuate fibers, most prominently in frontal or periatrial regions that were superimposed on diffuse, slightly hyperintense subcortical white matter signal. Involvement of the caudate nucleus and the dentate nucleus were observed in the reported patients. MRS studies by both STEAM and PRESS spectra of all patients revealed a decrease in N-acetylaspartate and elevation in both myoinositol and choline. A pathologic peak at 1.33 ppm, which is compatible with lactate, and a particular peak at 2.42 ppm in all patients were also found. The combination of both MRI and MRS findings could be considered as being specific in patients with HMG-CoA lyase deficiency.     

Ultrastructural effects of cigarette smoke on rat testis

The purpose of this study was to investigate the ultrastructural changes taking place in the testicular tissue of adult male Wistar rats following exposure to cigarette smoke. Twenty rats were exposed to smoke in a smoking machine for 2 h daily for 60 days; 10 control rats were placed in the machine for the same amount of time but were exposed to room air. After ether anesthesia and dissection of the animals, the testes were removed and fixed in 2.5% glutaraldehyde. The sections were examined under a transmission electron microscope. Evident degeneration and dissociation of the spermatogenetic cells were common findings. Basal lamina of the tubuli seminiferi contorti was thickened and significantly irregular. Cigarette smoke inhalation damaged the seminiferous epithelium. The primary spermatocytes as well as Sertoli cells appeared to be targets for the smoke. The results indicated that cigarette smoke inhalation could cause specific lesions in the development of spermatozoon, and it might be either directly or indirectly toxic to spermatogenesis.     

Ischaemia-reperfusion injury of the peripheral nerve: An experimental study

Although the neuropathology of ischaemic fibre degeneration is relatively well known, its pathogenesis is poorly understood. One of the presumed mechanisms is oxidative stress, causing the breakdown of the blood-nerve barrier (BNB) and ending in lipid peroxidation. We evaluated the effect of ischaemia and reperfusion on the sciatic-tibial nerve of the rat and investigated the biochemical, pathological, and functional evidence of BNB disruption and lipid peroxidation. The distal portion and trifurcation of the sciatic nerve were rendered ischaemic by clamping the femoral vessels for 3 h and followed by varying durations of reperfusion. Reperfusion resulted in an increase in lipid peroxidation beginning from the first hour and increasing until the seventh day, followed by a gradual decline over the following weeks. Nerve oedema and ischaemic fibre degeneration (IFD) consistently became more severe and prominent with reperfusion, indicating that oxidative stress damages the BNB and causes IFD. Results of functional testing by the sciatic function index correlated with other parameters as walking track analysis results got worse as reperfusion periods increased. Impairment of walking patterns was more striking after the first day and continued up to the third week. These data indicate that severe ischaemia of the peripheral nerve results in reperfusion injury, functional impairment, and disruption of the BNB. Microvascular events, which may occur during reperfusion, may be important in amplifying the nerve fibre degeneration that initiated during ischaemia.     

3-硝基丙酸预处理诱导沙土鼠脑缺血耐受与海马星形胶质细胞的激活

目的：探讨海马区星形胶质细胞的激活与3－硝基丙酸（3－NPA）预处理诱导脑缺血耐受的关系。方法：阻断沙土鼠双侧颈总动脉造成前脑缺血模型，通过HE染色和免疫组化观察海马锥体细胞死亡和星形胶质细胞的反应。结果：对照组海马CA1区已失去正常结构，锥体细胞大部分丧失，存活神经元计数显低于假手术组。3－NPA预处理组存活神经元减少，但高于对照组，假手术组海马CA1区仅见少量胶质原纤维酸性蛋白（GFAP）阳性细胞，染色较弱，突起不明显，对照组海马CA1区GFAP阳性细胞增多，多为弱阳性。3－NPA预处理组海马CA1区GFAP阳性细胞数目明显增多，染色较深，突起增粗。结论：星形胶质细胞形态和机能的改变可能与3－硝基丙酸预处理诱导脑缺血耐受有关。