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1.
Ann Plast Surg ; 83(4): 459-463, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31524743

RESUMO

BACKGROUND: Autologous fat transfer has been widely used in breast augment surgery. The breast fat graft is different form facial, it needs megavolume grafts. However, most Asian women are thin, who often encounter the fat resource insufficiency during breast augmentation. In fact, some processing methods do contribute to great loss of potential fat that could have been grafted. How to choose a best processing method to achieve optimal transfer in patients with insufficient fat resources is fairly important. METHODS: Lipoaspirate was obtained from 10 healthy female patients who underwent liposuction from abdomen. According to the processing methods, 10-mL initial fat grafts divided into 4 groups: decantation (group A), centrifugation (group B), cotton pad (group C), and cell-assisted lipotransfer (CAL) (group D). Lipoaspirate from each group was compared in the vitro and vivo experiments. The content and function of stromal vascular fraction (SVF) were compared as well as lipoaspirate survival after grafting in nude mice. RESULTS: The SVFs were counted in decantation group 4.32 ± 0.75 × 10/mL, centrifuge group 3.48 ± 0.78 × 10/mL, cotton pad group 1.64 ± 0.84 × 10/mL, CAL group 4.08 ± 0.73 × 10/mL. The decantation group was higher than the cotton pad group (P < 0.05). All the groups' SVFs had capability of multilineage differentiation. The fat graft weight in decantation group: 0.3908 ± 0.023 g, centrifuge group 0.3073 ± 0.015 g, cotton pad group 0.1726 ± 0.019 g, and CAL group 0.2396 ± 0.021 g. The weight of the fat graft in the decantation group was greater than that of the centrifugation group, cotton pad group and CAL group (P < 0.05). There was no significant difference in cell integrity, necrotic cysts and fibrosis between the groups. The vascularization degree in the cotton pad group was lower than that in the decantation group (P < 0.05). CONCLUSIONS: Decantation processing can achieve optimal transplantation in patients who have insufficient fat resources.

3.
Chin Med J (Engl) ; 132(18): 2223-2228, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31490259

RESUMO

BACKGROUND: Autologous fat grafting has gained popularity in breast augmentation. Various methods can be used to estimate the volume retention rate. This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate. METHODS: Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from inception of the database up to February 2019. Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. The characteristics of the included studies were summarized, and the reported volume retention rate from the studies was compared. A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria. RESULTS: A total of 618 articles were identified, of which 12 studies, with a total of 1337 cases, were eligible. The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same, as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different. CONCLUSIONS: Currently, the tools available for estimating the volume retention rate come with limitations. In order to objectively evaluate the percentage of graft retention, a standard protocol that applies to the different methods should be established in the future.

4.
Aesthetic Plast Surg ; 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31562543

RESUMO

BACKGROUND: Nodules or calcifications have been a common complication after breast augmentation with fat grafting, especially in cases with partial bolus fat grafting. There are some clinical preventive measures, but mechanisms related to this complication have not been elucidated yet. Inorganic phosphate (PI), being a product of fat metabolism, is a well-known stimulus of other kinds of pathological calcification such as vascular calcification. We aimed to determine whether PI had a similar effect on formation of nodules after fat grafting. METHODS: Nodules or calcification after fat grafting models using nude mice were created by bolus fat injection. Levels of PI of necrotic liquid located in the central zone and mineralization deposition of graft were examined 1 week, 2 weeks, 1 month, 2 months and 7 months after bolus fat injection. External high phosphate solution was injected 3 times a week to the fat grafts for 2 months, and mineral deposition was examined. In addition, adipose-derived stem cells (ADSCs) were treated with high phosphate osteogenic differentiation medium in various concentrations and times. ADSCs were also treated with osteogenic differentiation in addition to tetramisole which could reduce the level of PI. Mineral depositions of the cells were examined. The central necrotic liquid was extracted from patients who found palpable nodules after breast augmentation with fat grafting. The level of PI of this necrotic liquid and normal lipoaspirates from patients who received normal liposuction for body contouring was compared. RESULTS: The in vivo study indicated that the local PI concentration of the necrotic zone increased significantly 2 months after large volume bolus fat injection. Calcification was not formed after 2 months, but was formed after 7 months, indicating that the effect of PI on calcification was time-dependent. In addition, with the effect of external injection of high phosphate solution into the fat graft, calcification was formed after 2 months, indicating the effect of PI on calcification was dose-dependent. The in vitro study also indicated PI could induce calcification of ADSC in a time- and dose-dependent manner. The study in humans indicated that the level of PI in the necrotic zone of nodules after fat grafting was higher than that in normal lipoaspirates. CONCLUSIONS: This study indicated that the level of PI in the central necrotic zone was elevated after bolus fat injection, which could provide an environment to induce calcification of surrounding tissue. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

5.
BMC Plant Biol ; 19(1): 371, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438856

RESUMO

BACKGROUND: Propamocarb (PM) is one of the main pesticides used for controlling cucumber downy mildew. However, due to its volatility and internal absorption, PM can easily form pesticide residues on cucumber fruits that seriously endanger human health and pollute the environment. The breeding of new cucumber varieties with a low abundance of PM residues via genetic methods constitutes an effective strategy for reducing pesticide residues and improving cucumber safety and quality. To help elucidate the molecular mechanism resulting in a low PM residue abundance in cucumber, we used the cucumber cultivar 'D0351' (which has the lowest PM residue content) as the test material and identified genes related to low PM residue abundance through high-throughput tag-sequencing (Tag-Seq). RESULTS: CsMAPEG was constitutively expressed and showed both varietal and organizational differences. This gene was strongly expressed in 'D0351'. The expression levels of CsMAPEG in different cucumber tissues under PM stress were as follows: fruit>leaf>stem>root. CsMAPEG can respond to salicylic acid (SA), gibberellin (GA) and Corynespora cassiicola Wei (Cor) stress and thus plays an important regulatory role in plant responses to abiotic and biological stresses. The PM residue abundance in the fruits of CsMAPEG-overexpressing plants was lower than those found in antisense CsMAPEG plants and wild-type plants at all tested time points. The results revealed that CsMAPEG played a positive role in reducing the PM residue abundance. A CsMAPEG sense construct increased the contents of SOD, POD and GST in cucumber fruits, enhanced the degradation and metabolism of PM in cucumber, and thus effectively reduced the pesticide residue abundance in cucumber fruits. CONCLUSIONS: The expression patterns of CsMAPEG in cucumber cultivars with high and low pesticide residue abundances and a transgenic verification analysis showed that CsMAPEG can actively respond to PM stress and effectively reduce the PM residue abundance in cucumber fruits. The results of this study will help researchers further elucidate the mechanism responsible for a low PM residue abundance in cucumber and lay a foundation for the breeding of new agricultural cucumber varieties with low pesticide residue abundances.


Assuntos
Carbamatos/farmacologia , Cucumis sativus/genética , Fungicidas Industriais/farmacologia , Genes de Plantas , Resíduos de Praguicidas , Clonagem Molecular , Cucumis sativus/efeitos dos fármacos , Cucumis sativus/enzimologia , Cucumis sativus/fisiologia , Perfilação da Expressão Gênica , Vetores Genéticos , Filogenia , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Transformação Genética
9.
Aesthetic Plast Surg ; 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31240336

RESUMO

BACKGROUND: The goal of breast plastic surgery is to improve the shape of the breasts. The shape of the breast is determined by several parameters and proportions; however, the proportions that have the greatest impact on breast aesthetics have not been investigated. The purpose of this study is to determine which breast proportions are crucial to aesthetics and should be given priority when surgery is designed. METHODS: Breasts were divided into a high-satisfaction group and a low-satisfaction group according to an aesthetic evaluation that consisted of self-evaluations and evaluations by plastic surgeons. Three-dimensional scanning and measurement of the breasts were performed. The differences in breast parameters and proportions between the two groups were analyzed, and the ROC curve of each proportion was applied to determine which index had a significant influence on satisfaction and could predict satisfaction well. RESULTS: A total of 179 unilateral breasts were evaluated and measured; of these, 68 breasts were classified as high satisfaction, and 111 were classified as low satisfaction. There were no significant differences in breast width between the two groups. In the high-satisfaction group, the absolute value and the value divided by the breast width of breast projection and the lower pole length were significantly greater than those of the low-satisfaction group. The areas under the ROC for breast projection and lower pole length, as aesthetic predictive indexes, were greater than 0.7. CONCLUSIONS: Breast width emerged as the benchmark of breast aesthetic assessment. Breast projection and the lower pole length had a great impact on unilateral breast aesthetics and should be given priority when improving the breast shape, and appropriate ratio of low pole length and breast projection to breast radius might bring a more satisfying outcome. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

11.
Eye (Lond) ; 33(10): 1626-1634, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31073163

RESUMO

PURPOSE: To evaluate the effect of vitrectomy with inverted internal limiting membrane (ILM) flap for the treatment of macular hole retinal detachment (MHRD) in high myopia compared with that of ILM peeling. METHODS: PubMed, EMBASE, Web of Science, MEDLINE, Ovid, Wan Fang and CNKI were systematically reviewed. The primary outcome parameters were the MH closure rate, retinal reattachment rate and postoperative BCVA. Secondary outcome parameters, included intraoperative or postoperative complications. RESULTS: Seven retrospective comparative studies including 228 eyes were selected. No significant difference was detected in either postoperative BCVA (MD -0.07; 95% CI: -0.17 to 0.03; p = 0.16) or the improvement in postoperative BCVA (MD -0.17; 95% CI: -0.50 to 0.16; p = 0.32) between the ILM flap group and ILM peeling group. The retinal reattachment rate using inverted ILM flap was not significantly different from that using ILM peeling (odds ratio (OR) 2.24; 95% CI: 0.75-6.73; p = 0.15). The MH closure rate was higher with inverted ILM flap than with ILM peeling (OR 11.86; 95% CI: 5.65 to 24.92; p < 0.00001). There was no significant difference in intraoperative or postoperative complications, including concomitant cataract rate (OR 1.22; 95% CI: 0.42-3.58; p = 0.71). CONCLUSION: The inverted ILM flap technique could contribute to a higher MH closure rate than ILM peeling, but visual improvement was similar. Both surgical methods could obtain a high-retinal reattachment rate with fewer intraoperative and postoperative complications.

12.
Aesthetic Plast Surg ; 43(4): 890-898, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31139912

RESUMO

BACKGROUND: Subpectoral and prepectoral planes have commonly been used in implant-based breast augmentation. The effect of implant plane on complication rate was still unclear. This meta-analysis demonstrated current evidence with regard to comparison of complication rates between subpectoral and prepectoral breast augmentation. METHODS: Pubmed, EMBASE and Cochrane library were searched to December 2018. The results of selected studies were meta-analyzed to obtain a pooled odds ratio of the effect of subpectoral versus prepectoral breast augmentation on rates of complications. RESULTS: There were significantly lower rates of capsular contracture and hematoma but higher rates of implant displacement and animation deformity in the subpectoral group compared with the prepectoral group. There was no significant difference with regard to rates of reoperation, seroma, rippling, infection and implant rupture between these two groups. CONCLUSIONS: Subpectoral and subglandular breast augmentations both have their merits and demerits with regard to complications. The pros and cons of each procedure should be fully explained to patients and selection of implant plane should be considered more comprehensively. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

13.
Ann Plast Surg ; 2019 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-31021839

RESUMO

BACKGROUND: Autologous fat transfer has been widely used in breast augment surgery. The breast fat graft is different form facial, it needs megavolume grafts. However, most Asian women are thin, who often encounter the fat resource insufficiency during breast augmentation. In fact, some processing methods do contribute to great loss of potential fat that could have been grafted. How to choose a best processing method to achieve optimal transfer in patients with insufficient fat resources is fairly important. METHODS: Lipoaspirate was obtained from 10 healthy female patients who underwent liposuction from abdomen. According to the processing methods, 10-mL initial fat grafts divided into 4 groups: decantation (group A), centrifugation (group B), cotton pad (group C), and cell-assisted lipotransfer (CAL) (group D). Lipoaspirate from each group was compared in the vitro and vivo experiments. The content and function of stromal vascular fraction (SVF) were compared as well as lipoaspirate survival after grafting in nude mice. RESULTS: The SVFs were counted in decantation group 4.32 ± 0.75 × 10/mL, centrifuge group 3.48 ± 0.78 × 10/mL, cotton pad group 1.64 ± 0.84 × 10/mL, CAL group 4.08 ± 0.73 × 10/mL. The decantation group was higher than the cotton pad group (P < 0.05). All the groups' SVFs had capability of multilineage differentiation. The fat graft weight in decantation group: 0.3908 ± 0.023 g, centrifuge group 0.3073 ± 0.015 g, cotton pad group 0.1726 ± 0.019 g, and CAL group 0.2396 ± 0.021 g. The weight of the fat graft in the decantation group was greater than that of the centrifugation group, cotton pad group and CAL group (P < 0.05). There was no significant difference in cell integrity, necrotic cysts and fibrosis between the groups. The vascularization degree in the cotton pad group was lower than that in the decantation group (P < 0.05). CONCLUSIONS: Decantation processing can achieve optimal transplantation in patients who have insufficient fat resources.

15.
Aesthetic Plast Surg ; 43(5): 1186-1194, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30877446

RESUMO

BACKGROUND: Breast hypoplasia or amastia with pectoralis major muscle defect in female Poland syndrome patients always necessitates surgical intervention. This study aims to introduce an efficient endoscopic technique to perform breast reconstruction in Poland syndrome patients with a latissimus dorsi myo flap and an implant using a single transverse axillary incision (ELDM + IMPLANT) and to evaluate its safety and effectiveness. METHODS: A prospective study was designed to recruit Poland syndrome candidates for ELDM + IMPLANT breast reconstruction. Only one transaxillary incision was made to harvest the LDM flap and create the anterior chest wall pocket. The LDM flap was transposed to the front to reconstruct the breast with a silicone implant. Patient demographics, LDM area, implant size, contralateral symmetry surgery, operative time and post-operative complications were collected. The BREAST-Q reconstruction module was used to evaluate patient quality of life. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire was used to evaluate patient upper extremity disabilities. RESULTS: Sixteen eligible patients were recruited and received ELDM + IMPLANT-BR. Mean endoscopic time for LDM flap harvesting was 61.6 min. All of the 16 patients recovered uneventfully without any significant complications. The post-operative scores of satisfaction with breast and psychosocial well-being were significantly higher than the pre-operative ones. The score of DASH was 7.1 pre-operatively and 8.3 post-operatively with no significant difference either. The score of satisfaction with outcome was 80.0. CONCLUSIONS: Our proposed ELDM + IMPLANT technique provides a safe and efficient way to reconstruct breasts in Poland syndrome patients with a high satisfaction rate, optimized aesthetic outcome and minimized donor site morbidity. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

16.
Aesthetic Plast Surg ; 43(2): 328-335, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30607574

RESUMO

BACKGROUND: A prospective cohort study was developed to compare the surgical scars in the axilla and the inframammary fold at short-, medium- and long-term time periods after surgery. METHODS: Patients who underwent primary breast augmentation with implants in our department were divided into two groups based on the incision location they chose and were followed up for scar assessment at 1 month, 6 months and 12 months post-surgery from June 2012 to March 2016. Each scar was evaluated by the Vancouver Scar Scale (VSS) and patient satisfaction score. The data were analyzed with Wilcoxon rank-sum tests, Cochran-Armitage trend tests and Fisher's exact probability tests based on the data type. RESULTS: One hundred and sixty-three patients were completely investigated three times. Ninety-four patients underwent breast augmentation surgeries with implants through axillary approaches and 69 patients through IMF approaches. At 1 month after surgery, the median total VSS score was 6 in the axillary incision group and 4 in the IMF group, with statistically significant differences (P < 0.05). Larger proportions of high scores in terms of vascularity and height were found in the axillary incision group (P < 0.05). At 6 months after surgery, the median total VSS score was 4 in the axillary incision group and 3 in the IMF group, with statistical significance (P < 0.05). The axillary group still had a larger proportion of high scores in terms of vascularity and height than that of the IMF group (P < 0.05). At 12 months after surgery, the median total VSS score was 2 in both groups. The median patient satisfaction score was 9 in both groups. No significant differences were noted in the total VSS and patient satisfaction scores between the two groups. However, the axillary group had a larger proportion of high scores in terms of vascularity and low scores in terms of pliability. CONCLUSIONS: The total VSS score for the axillary incision group was significantly higher than that for the IMF incision group one and 6 months after surgery, mainly on the subscales of vascularity and height. At 12 months after surgery, the total VSS scores were not different between the two groups, and patients with both kinds of incisions were highly satisfied with scar appearance. The research confirmed that the scars at two locations can achieve comparable appearance in the long term after surgery. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

17.
Aesthetic Plast Surg ; 43(2): 514-520, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30552469

RESUMO

BACKGROUND: PGGFRα+ preadipocytes are the major subpopulations that can regenerate into adipocytes. Two different types of macrophages exist in the fat tissue: the classically activated macrophage (M1) and the alternatively activated macrophage (M2). In this study, we investigated whether M1/M2 macrophages play distinct roles in adipogenic differentiation of PDGFRα+ preadipocytes. METHODS: Mouse preadipocytes and macrophages were isolated from C57BL/6 male mice of 6-8 weeks. The culture supernate of M1 and M2 macrophages was collected and co-cultured with the PDGFRα+ preadipocytes. After 3 days, Oil Red O staining was used to evaluate to adipogenic differentiation of PDGFRα+ preadipocytes and the expression of adipogenic-related transcription factors (C/EBP-α, PPARγ) were also tested. RESULTS: The results showed that when cultured in vitro, M1 macrophages could significantly suppress the adipogenesis of PDGFRα+ preadipocytes as well as the C/EBP-α and PPARγ expression, but M2 macrophages did not have significant influence on the adipogenesis of PDGFRα+ preadipocytes nor on C/EBP-α and PPARγ expression compared with the control group. CONCLUSIONS: M1 macrophages significantly suppress PDGFRα+ preadipocyte adipogenesis which provides a possible way to improve adipogenesis and fat retention after fat-free grafting by mitigating acute inflammation and manipulating M1 macrophage levels. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

18.
Aesthetic Plast Surg ; 43(1): 243-252, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30552471

RESUMO

BACKGROUND: Pathologic calcification has frequently occurred after breast augmentation with fat grafting as well as other conditions such as breast cancer, trauma, myocardial infarction, arteriosclerosis and even after reduction mammoplasty. Inorganic phosphate, correlated with fat metabolism, is an important factor that induces pathologic calcification such as vascular calcification. METHODS: A literature search was conducted using PubMed with the keywords: calcification, inorganic phosphate, fat. Studies related to the process of pathologic calcification, correlation between inorganic phosphate and pathologic calcification, between inorganic phosphate and fat metabolism in pathologic calcification were collected. RESULTS: Various mechanisms were referred to in pathologic calcification among which inorganic phosphate played an important role. Inorganic phosphate could be liberated, under the effect of various enzymes, in the process of fat metabolism. The authors hypothesized that a large-scale necrotizing zone, which could occur in fat grafting with large amounts per cannula, might provide a high-phosphate environment which might contribute to differentiation of surrounding cells such as stem cells or regenerated vessel cells into osteoblast-like cells that induce pathologic calcification. CONCLUSION: Inorganic phosphate, which was correlated with fat metabolism, played a significant role in pathologic calcification. We firstly hypothesize that calcification after fat grafting may be related to locally increasing concentrations of phosphate in a necrotizing zone. Further research should be conducted to verify this hypothesis. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

20.
Int J Ophthalmol ; 11(11): 1848-1855, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30450318

RESUMO

AIM: To evaluate the efficacy and safety of vitrectomy with internal limiting membrane (ILM) peeling for diabetic macular edema (DME). METHODS: The PubMed, Embase, Web of Science, Cochrane, SionMed, ClinicalTrials.gov, CNKI databases and Wanfang databases, published until Oct. 2017, were searched to identify studies comparing the clinical outcomes following vitrectomy with and without ILM peeling, for treating DME. Pooled results were expressed as odds ratios (ORs) with corresponding 95% confidence intervals (CI) for vitrectomy with and without ILM peeling with regard to best corrected visual acuity (BCVA), central macular thickness (CMT), and complication incidents. RESULTS: A total of 14 studies involving 857 eyes were included of which three studies were Chinese and the rests were English literatures. Meta-analysis indicated that compared with vitrectomy alone, vitrectomy with ILM peeling could improve BCVA more obviously (OR=1.66, 95%CI: 1.12-2.46, P=0.01) and had higher rate of CMT reduction (OR=3.89, 95%CI: 1.37-11.11, P=0.01). There were significant statistical differences between the two surgical methods for both BCVA and CMT (P<0.05). For the incidence of intraoperative and postoperative complications, the incidence of epiretinal membrane (ERM) was slightly lower in the ILM peeling group than the group without ILM peeling (OR=0.38, 95%CI: 0.07-2.00, P=0.25), although insignificant statistically. Other incidences of overall complications, iatrogenic peripheral retinal break and increased intraocular pressure indicated no significant difference between two groups (OR=1.19, 95%CI: 0.82-1.73, P=0.36; OR=1.21, 95%CI: 0.66-2.21, P=0.53; OR=1.34, 95%CI: 0.75-2.40, P=0.32). CONCLUSION: Vitrectomy is effective for DME and the effect can be improved by additional ILM peeling, especially for anatomical efficacy, without increasing the incidence of intraoperative and postoperative complications. However, it is imperative to gain more evaluation in the future due to the paucity of prospective randomized study.

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