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Tissue expander breast

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https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#1
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28716116/catching-and-monitoring-clinical-innovation-through-performance-indicators-the-case-of-the-breast-conserving-surgery-indicator
#2
Anna Maria Murante, Silvio Candelori, Paola Rucci, Sabina Nuti, Manuela Roncella, Matteo Ghilli, Andrea Mercatelli, Maria Pia Fantini
BACKGROUND: The evolution in the surgical and diagnostic procedures, the attention to women's preferences, the case mix, and differences in professional practices may lead to a variability in the quality of breast cancer clinical pathway. To catch and manage this variability it is important to use valid measures. The aim of this paper is to examine the concurrent validity of the breast-conserving surgery (BCS) indicator and to provide evidence to guide the quality improvement process...
July 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28714966/nanoscale-imaging-of-clinical-specimens-using-pathology-optimized-expansion-microscopy
#3
Yongxin Zhao, Octavian Bucur, Humayun Irshad, Fei Chen, Astrid Weins, Andreea L Stancu, Eun-Young Oh, Marcello DiStasio, Vanda Torous, Benjamin Glass, Isaac E Stillman, Stuart J Schnitt, Andrew H Beck, Edward S Boyden
Expansion microscopy (ExM), a method for improving the resolution of light microscopy by physically expanding a specimen, has not been applied to clinical tissue samples. Here we report a clinically optimized form of ExM that supports nanoscale imaging of human tissue specimens that have been fixed with formalin, embedded in paraffin, stained with hematoxylin and eosin, and/or fresh frozen. The method, which we call expansion pathology (ExPath), converts clinical samples into an ExM-compatible state, then applies an ExM protocol with protein anchoring and mechanical homogenization steps optimized for clinical samples...
July 17, 2017: Nature Biotechnology
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#4
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28679691/metastatic-triple-negative-breast-cancer-patient-with-tp53-tumor-mutation-experienced-11-months-progression-free-survival-on-bortezomib-monotherapy-without-adverse-events-after-ending-standard-treatments-with-grade-3-adverse-events
#5
Tobias Meißner, Adam Mark, Casey Williams, Wolfgang E Berdel, Stephanie Wiebe, Andrea Kerkhoff, Eva Wardelmann, Timo Gaiser, Carsten Müller-Tidow, Philip Rosenstiel, Norbert Arnold, Brian Leyland-Jones, Andre Franke, Martin Stanulla, Michael Forster
A triple-negative breast cancer patient had no hereditary BRCA1, BRCA2, or TP53 risk variants. After exhaustion of standard treatments, she underwent experimental treatments and whole-exome sequencing of tumor, blood, and a metastasis. Well-tolerated experimental bortezomib monotherapy was administered for a progression-free period of 11 mo. After progression, treatments were changed and the exome data were evaluated, expanded with RNA and exome sequencing of a late-stage metastasis. In the final stage, eribulin alone and in combination with anthracyclines were administered...
July 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28671886/effect-of-drain-placement-on-infection-seroma-and-return-to-operating-room-in-expander-based-breast-reconstruction
#6
Caleb J Ollech, Lisa M Block, Ahmed M Afifi, Samuel O Poore
INTRODUCTION: There is significant variability in the location and management of drains in breast reconstruction, with most surgeons attempting to shorten the duration of drains while preventing complications possibly related to early removal. The aim of this work was to compare our experiences with placement of 1 versus 2 drains in tissue expander breast reconstruction. METHODS: This is a retrospective cohort study comparing 2 groups of patients after breast tissue expander placement in a complete submuscular pocket and without the use of acellular dermal matrix...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28671885/effects-of-the-metallic-port-in-tissue-expanders-on-dose-distribution-in-postmastectomy-radiotherapy-a-tridimensional-experimental-model-of-dosimetry-in-breast-reconstruction
#7
Marcelo Felix da Silva, Harley Francisco de Oliveira, Leandro Frederich Borges, Helio Humberto Angotti Carrara, Jayme Adriano Farina
The purpose of this research was to develop an experimental model of dosimetry using a breast phantom and evaluate the effects of the metallic port in tissue expanders on dose distribution in postmastectomy radiotherapy. Dose distribution was assessed using an experimental acrylic dosimetry simulator in the absence and presence of a metallic disc (MD), which is similar to that used in tissue expanders containing a magnetic port, by collecting coronal and sagittal radiochromic films. Dosimetry film analysis did not show any changes in dose distribution, except for a MD shadow in the sagittal film where the dose distribution rate was on average 14% lower than in other areas...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28656281/microrna-503-inhibits-the-proliferation-and-invasion-of-breast-cancer-cells-via-targeting-insulin-like-growth-factor-1-receptor
#8
Jingwang Yan, Yonghuan Xu, Haipeng Wang, Taiping Du, Hao Chen
MicroRNAs (miRs), a class of non-coding RNAs that are 18‑25 nucleotides in length, serve as key regulators in the development and progression of human cancers. Previously, miR‑503 has been implicated in breast cancer. However, the underlying mechanism of miR‑503 in regulating the proliferation and invasion of breast cancer cells remains largely unknown. In the present study, reverse transcription‑quantitative polymerase chain reaction analysis indicated that the expression of miR‑503 was significantly reduced in breast cancer tissues compared with their matched adjacent normal tissues...
August 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28641917/complications-in-tissue-expansion-a-logistic-regression-analysis-for-risk-factors
#9
Christian Smolle, Alexandru Tuca, Paul Wurzer, Stephanie M Spendel, Abigail A Forbes, Stephan Spendel, Michael Schintler, Emir Haxhija, Katja Schwenzer-Zimmerer, Herwig Friedl, Lars-Peter Kamolz, Daryousch Parvizi
BACKGROUND: Tissue expansion is frequently used in reconstructive surgery. Although the surgical procedure is typically considered simple, reported complication rates of tissue expansions exceed 40%. There is little evidence concerning risk factors for complications in tissue expansion in body regions other than breast. The aim was to determine risk factors for complications in non-breast tissue expansion. METHODS: 34 patients treated with subcutaneous tissue expanders between 2005 and 2014 were analyzed...
June 19, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28634940/3d-primary-culture-model-to-study-human-mammary-development
#10
Daniel H Miller, Ethan S Sokol, Piyush B Gupta
We present a protocol for expanding human mammary tissues from primary patient-derived cells in three-dimensional (3D) cultures. The primary epithelial cells are seeded into 3D hydrogels with defined components, which include both proteins and carbohydrates present in mammary tissue. Over a span of 10-14 days, the seeded cells form mammary tissues with complex ductal-lobular topologies and include luminal and basal cells in the correct orientation, together with cells that stain positively for stem cell markers...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28611768/innate-immunity-and-breast-milk
#11
REVIEW
Nicole Theresa Cacho, Robert M Lawrence
Human milk is a dynamic source of nutrients and bioactive factors; unique in providing for the human infant's optimal growth and development. The growing infant's immune system has a number of developmental immune deficiencies placing the infant at increased risk of infection. This review focuses on how human milk directly contributes to the infant's innate immunity. Remarkable new findings clarify the multifunctional nature of human milk bioactive components. New research techniques have expanded our understanding of the potential for human milk's effect on the infant that will never be possible with milk formulas...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28607860/spy-elite-s-ability-to-predict-nipple-necrosis-in-nipple-sparing-mastectomy-and-immediate-tissue-expander-reconstruction
#12
Mark L Venturi, Ali N Mesbahi, Libby R Copeland-Halperin, Victoria Y Suh, Louisa Yemc
BACKGROUND: Nipple-sparing techniques have improved the aesthetics of reconstruction following mastectomy, but nipple necrosis complicates up to 37% of procedures, distressing patients, delaying adjuvant therapy, and compromising outcomes. No method reliably detects nipple necrosis better than clinical assessment of tissue perfusion. We prospectively assessed the accuracy of intraoperative indocyanine green laser angiography to predict nipple necrosis. METHODS: Twenty consecutive women undergoing immediate tissue expander breast reconstruction following 32 nipple-sparing mastectomies underwent indocyanine green fluorescence imaging to assess nipple perfusion immediately before and after intraoperative tissue expansion...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28607855/seri-surgical-scaffold-in-2-stage-breast-reconstruction-2-year-data-from-a-prospective-multicenter-trial
#13
Nolan Karp, Mihye Choi, David A Kulber, Susan Downey, Gloria Duda, Gabriel M Kind, Mark L Jewell, Diane K Murphy, Max R Lehfeldt, Neil Fine
BACKGROUND: Soft-tissue support devices are used during breast reconstruction. This study investigated long-term clinical data following SERI Surgical Scaffold (SERI) implantation, a bioresorbable, silk-derived scaffold for soft-tissue support. METHODS: This was a prospective, multicenter study in 103 subjects who received SERI during stage 1 of 2-stage breast reconstruction with subpectoral tissue expander placement (Natrelle Style 133V; Allergan plc, Dublin, Ireland) followed by subpectoral breast implant placement...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28602267/post-reconstruction-dermatitis-of-the-breast
#14
A C Rosen, C Goh, M E Lacouture, B J Mehrara, P G Cordeiro, P L Myskowski
BACKGROUND: Approximately one-third of women diagnosed with breast cancer undergo mastectomy with subsequent implant-based or autogenous tissue-based reconstruction. Potential complications include infection, capsular contracture, and leak or rupture of implants with necessity for explantation. Skin rashes are infrequently described complications of patients who undergo mastectomy with or without reconstruction. METHODS: A retrospective analysis of breast cancer patients referred to the Dermatology Service for diagnosis and management of a rash post-mastectomy and expander or implant placement or transverse rectus abdominis myocutaneous (TRAM) flap reconstruction was performed...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28599842/composite-breast-reconstruction-implant-based-breast-reconstruction-with%C3%A2-adjunctive-lipofilling
#15
C E Sommeling, K Van Landuyt, H Depypere, R Van den Broecke, S Monstrey, P N Blondeel, W A Morrison, F B Stillaert
INTRODUCTION: Options for breast reconstructions enclose autologous tissue transfers or implants. Fat grafting is gaining more interest in this specific field of breast surgery. This study concentrates on the technique and aesthetic results of breast reconstruction with fat grafts combined with implants, in women who have undergone total mastectomy. METHODS: Breast reconstructions (n = 23) was performed using a protocol of intratissular expansion with serial deflation-lipofilling...
May 22, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28591940/cost-analysis-of-postmastectomy-reconstruction-a-comparison-of-two-staged-implant-reconstruction-using-tissue-expander-and-acellular-dermal-matrix-with-abdominal-based-perforator-free-flaps
#16
Bao Ngoc N Tran, Ayotunde Fadayomi, Samuel J Lin, Dhruv Singhal, Bernard T Lee
BACKGROUND AND OBJECTIVES: Two staged tissue expander-implant with acellular dermal matrix (TE/I + ADM) and deep inferior epigastric perforator (DIEP) flap are the most common implant and autologous methods of reconstruction in the U.S. Implant-based techniques are disproportionally more popular, partially due to its presumed cost effectiveness. We performed a comprehensive cost analysis to compare TE/I + ADM and DIEP flap. METHODS: A comparative cost analysis of TE/I + ADM and DIEP flap was performed...
June 7, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28574950/prepectoral-breast-reconstruction-a-safe-alternative-to-submuscular-prosthetic-reconstruction-following-nipple-sparing-mastectomy
#17
Hani Sbitany, Merisa Piper, Rachel Lentz
BACKGROUND: Nipple sparing mastectomy (NSM) with immediate prosthetic reconstruction is routinely performed due to excellent aesthetic results, and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, due to pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major, by placing the prosthesis completely above the muscle with complete acellular dermal matrix (ADM) coverage...
May 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28567608/individual-difference-in-pectoralis-major-muscle-thickness-and-its-effect-on-single-stage-breast-reconstruction-using-a-tissue-expander
#18
Naohiro Ishii, Jiro Ando, Michiko Harao, Masaru Takemae, Kazuo Kishi
BACKGROUND: In breast reconstruction using a tissue expander (TE), sufficient coverage of the TE with the pectoralis major (PM) muscle, particularly with a musculofascial flap, is highly important for avoiding postoperative complications. In patients in whom the PM is thin, intraoperative trauma often occurs, leading to troublesome repair. The present study aimed to investigate the usefulness of preoperative measurement of PM thickness in planning of breast reconstruction using a TE. METHODS: In this case-control study, we identified 68 patients (70 breasts) with mammary carcinoma treated with simple mastectomy and TE insertion from April 2014 to December 2016...
May 31, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28554356/radioactive-seed-localization-program-for-patients-with-nonpalpable-breast-lesions
#19
Judy Burroughs, Jennifer L Fencl, Matthew C Wakefield
Without early diagnosis and treatment, many lives are lost to breast cancer. Increased breast cancer awareness has facilitated research to guide health care providers toward improving patient outcomes. Research in diagnostic and treatment modalities has expanded to focus on improving the quality of life for patients with breast cancer who are living longer than expected. Providers can offer patients with nonpalpable breast lesions new screening techniques and improved treatment options, including radioactive seed localization lumpectomy...
June 2017: AORN Journal
https://www.readbyqxmd.com/read/28550025/30-years-of-the-mineralocorticoid-receptor-mineralocorticoid-receptor-null-mice-informing-cell-type-specific-roles
#20
REVIEW
Timothy J Cole, Morag J Young
The mineralocorticoid receptor (MR) mediates the actions of two important adrenal corticosteroid hormones, aldosterone and cortisol. The cell signalling roles of the MR in vivo have expanded enormously since the cloning of human MR gene 30 years ago and the first MR gene knockout in mice nearly 20 years ago. Complete ablation of the MR revealed important roles postnatally for regulation of kidney epithelial functions, with MR-null mice dying 1-2 weeks postnatally from renal salt wasting and hyperkalaemia, with elevated plasma renin and aldosterone...
July 2017: Journal of Endocrinology
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