Nipple-areola reconstruction in autologous breast reconstruction: Chinese patients' perspective.

Twenty-five consecutive patients who had nipple-areola reconstruction (NAR) using a modified S dermal-fat flap technique in the Division of Plastic Surgery, Department of Surgery, Kwong Wah Hospital, between 1995 and 2000 were studied. The nipple projection and sensation (to light touch and pinprick) were assessed by a designated surgeon who was not involved in the reconstructive process. This was followed by a questionnaire on the patients' perception of the various physical characteristics of the reconstructed nipple-areola complex (NAC) when in the nude. They were then asked to rate their satisfaction according to a 4-grade grading scale and whether they would recommend this procedure to other women with a similar condition. There was no major complication associated with this procedure. The mean projection of the reconstructed nipple at 18 months was 3.27 mm. The mean projection of the opposite normal nipple was 8 mm. The sensation to light touch and pinprick were 28% and 50% of the normal side, respectively. The majority of the patients were pleased with the reconstruction despite gradual loss of nipple projection and inadequate return of sensation. All patients would recommend this procedure to other women with similar disease. The creation of a NAC on the reconstructed breast mound seemed to enhance patients' satisfaction in this study.

The radish Rfo restorer gene of Ogura cytoplasmic male sterility encodes a protein with multiple pentatricopeptide repeats.

A single radish nuclear gene, Rfo, restores Ogura (ogu) cytoplasmic male sterility (CMS) in Brassica napus. A map-based cloning approach relying on synteny between radish and Arabidopsis was used to clone Rfo. A radish gene encoding a 687-amino-acid protein with a predicted mitochondrial targeting pre-sequence was found to confer male fertility upon transformation into ogu CMS B. napus. This gene, like the recently described Petunia Rf gene, codes for a pentatricopeptide repeat (PPR)-containing protein with multiple, in this case 16, PPR domains. Two similar genes that do not appear to function as Rfo flank this gene. Comparison of the Rfo region with the syntenic Arabidopsis region indicates that a PPR gene is not present at the Rfo-equivalent site in Arabidopsis, although a smaller and related PPR gene is found about 40 kb from this site. The implications of these findings for the evolution of restorer genes and other PPR encoding genes are discussed.

Skin involvement in invasive breast carcinoma: safety of skin-sparing mastectomy.

BACKGROUND: There is concern about the oncological safety of preserving most of the breast skin in skin-sparing mastectomy (SSM). Most supportive evidence for SSM evaluates the local recurrence rate on clinical follow-up. METHODS: The skin and 10 mm of the subcutaneous tissue of 30 total mastectomy specimens were studied with a step-serial sectioning technique. The incidence and mode of involvement of the skin and subcutaneous tissue were recorded in detail. This was correlated with other clinical and pathologic parameters. RESULTS: The incidence of skin involvement outside the nipple-areola complex was 20% (6 of 30). This was significantly related to the clinical T stage, site of the tumor, skin tethering, pathologic tumor size, and perineural infiltration. When the effects of both skin and subcutaneous tissue involvement were considered, the incidence of skin-flap involvement outside the nipple-areola complex was 23% (7 of 30). The significant parameters related to skin-flap involvement were skin tethering (75% vs. 15%; P <.05), pathologic tumor size (P <.03), and perineural infiltration (63% vs. 9%; P <.01). CONCLUSIONS: It would be oncologically safe to perform SSM in T1 and T2 tumors, because the chance of skin involvement is small. It is safe to preserve the skin overlying the tumor if there is no skin tethering.