A Modified Inverted Nipple Correction Technique That Preserves Breastfeeding.

BACKGROUND: An inverted nipple may affect the appearance of the breasts and breastfeeding, but traditional surgical procedures might injure the normal lactiferous ducts and damage sensory functions. OBJECTIVES: The aim of the study was to propose a minimally invasive and reliable method that preserves breastfeeding and corrects grade I and II inverted nipples. METHODS: This was a randomized controlled trial of 230 female patients with unilateral or bilateral inverted nipples and 30 patients with normal nipples who visited the Preconception Counseling Department of our hospital from February 2009 to January 2016. The nipples in the distractor group underwent an operation with a distractor, while the control nipples were treated with daily exercises. The intervention lasted 6 months. The primary endpoint was full-term pregnancy breastfeeding for 4 months. The secondary endpoint was the completion of lactation without obvious complications, such as mastitis and nipple craze. RESULTS: Grade I and II nipples achieved increased height after the distractor was worn for 6 months and at 37 weeks of pregnancy (P < 0.05), while the control nipples achieved only a marginal improvement at 37 weeks of pregnancy. In the distractor group, the success rates were 84.9% and 79.3% for grade I and II nipples, respectively, compared with the control group (52.5% and 38.9%, respectively) (P < 0.05). After treatment with the distractor for 6 months, nipples in the distractor group showed no complications, such as skin numbness or nipple necrosis. CONCLUSIONS: The use of a distractor is a reliable and minimally invasive method for correcting grade I and II inverted nipples while preserving breastfeeding.

Endocrine traits of polycystic ovary syndrome in prenatally androgenized female Sprague-Dawley rats.

Although hyperandrogenism is an important condition and is considered the possible pathogenesis behind polycystic ovary syndrome (PCOS), data supporting this is still scarce. We sought to determine whether or not prenatal androgen exposure leads to PCOS and the possible cellular mechanisms involved. To induce prenatal androgen exposure, pregnant rats were treated with daily subcutaneous injections of free testosterone (T) or dihydrotestosterone (DHT) from embryonic days 16 to 19, and their female offspring were studied as adults. The mRNA expression of the progesterone receptor (PR) in the preoptic area (POA) hypothalamus was higher in the experimental groups than in the control group after ovariectomy and stimulation with estradiol benzoate. The levels of T, P, leutinizing hormone (LH), and estradiol were higher in the experimental groups than in the control groups. The frequency and magnitude of LH secretion was increased in experimental rats as compared with the control group. The anogenital distance of the experimental groups was prolonged and the nipple number was lower than that of the control group. Almost all experimental rats had prolonged or irregular estrous cycles. The experimental groups had fewer corpus luteum and preovulatory follicles and more preantral follicles and antral follicles than the controls. Our findings are consistent with the hypothesis that excess androgen during the prenatal period may cause PCOS. Additionally, we show that hyperandrogenic interference in the release of preovulatory LH surges is mediated by the suppressive effects of androgens on PR expression in POA-hypothalamic tissue.