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Inferior Pedicle Breast Reduction for the Management of Gestational Gigantomastia: Literature Review and a Case Presentation

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Modern Plastic Surgery 2017年第4期7卷 39-49页

作者： P. Agbenorku W.B. Rockwell M. Obeng j. Akpaloo O. Owusu-Danso P.E. Hoyte-Williams B. Farhat E. Turkson E. Tano Z. Schumacher P.K.S. Fiifi-Yankson Division of Plastic & Reconstructive Surgery Department of Surgery School of Medical Sciences Komfo Anokye Teaching Hospital Kwame Nkrumah University of Science & Technology Kumasi Ghana Plastic Surgery Division University of Utah Health Sciences Center Salt Lake City UT USA Section of Plastic Surgery St. Elizabeth Boardman Health Center University of Pittsburgh School of Medicine Boardman OH USA

Background: The actual cause of Gestational gigantomastia (Gg) remains a dilemma. Its treatment has ideally been surgical, employing most commonly the different pedicle techniques in the last decade. Aim: This paper reviews the literature on the management of Gg using the inferior pedicle technique (IPT) and supports it with a successful case presentation using the IPT. Method: Using the PubMed search engine and Google scholar, literature search was done for Gg treated with the inferior pedicle reduction method. Published literature from other sources was also included. Data obtained was cleaned and analysed. The inferior pedicle breast reduction technique was employed without any modification in the normal procedure for the case presented. Results: Thirty-one literature addressing Gg and IPT were identified. Most surgeons use this technique with very good outcomes. Our patient confirmed reduced breast mould, firm and adolescent looking breast with no back, shoulder, neck and rib pains. She also experienced with time increased nipple areolar sensation, ability to undertake all tasks with ease and a new sense of confidence. Conclusion: The inferior pedicle breast reduction technique can be the standard treatment for gestational gigantomastia with the length from suprasternal notch to the nipple ≤ 50 cm that present without any anatomical complications.

关键词： Gestational Gigantomastia Hormones Surgical Inferior Pedicle Medical Treatment

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斯里兰卡港口工程明年开始

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集装箱化 1998年第12期9卷 9-9页

作者： M．j．C

Work on the Colombo and Galle port projects will begin next year, Sri Lanka' s deputy finance minister GL Peiris told Parliament recently while presenting the government' s 1999 budget.'The container handling capacity of Colombo' s Queen elizabeth Quay will be increased to 1 m TEU a year, from 250000 TEU for the present, at a cost of $ 350 m breakwater.

关键词：斯里兰卡港口工程港口建设建设时间

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脂肪移植的研究：第二部分注射设备对脂肪物质属性的影响

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中国美容整形外科杂志 2014年第10期25卷 I0013-I0018页

作者： David Atashroo jordan Raphel Michael T. Chung Kevin j. Paik Andreina Parisi-Amon Adrian McArdle Kshemendra Senarath-Yapa elizabeth R. Zielins Ruth Tevlin Chris Duldulao Graham G. Walmsley Michael S. Hu Arash Momeni Brian Domecus joe R. Rimsa Lauren Greenberg Geoffrey C. Gurtner Michael T. Longaker Derrick C. Wan 魏峰高景恒张晨斯坦福大学医学院Hagey儿科再造医学实验室整形再造外科中心外科部干细胞生物学与再生医学中心美国加利福尼亚州斯坦福斯坦福大学材料科学、工程学及生物工程学部门洛帕克 TauTona研究组门洛帕克帕洛阿尔托外科中心帕洛阿尔托《中国美容整形外科杂志》编辑部大连大学附属新华医院整形外科

目的尽管脂肪移植可以治疗多种软组织缺陷，但其结果仍有一定的不确定性。本研究中，我们将对使用一种自动、低剪切力装置或改良Coleman技术注射脂肪的物理性质进行对比。方法从9例患者处提取脂肪抽吸物，经过处理后采取改良Coleman技... 详细信息

目的尽管脂肪移植可以治疗多种软组织缺陷，但其结果仍有一定的不确定性。本研究中，我们将对使用一种自动、低剪切力装置或改良Coleman技术注射脂肪的物理性质进行对比。方法从9例患者处提取脂肪抽吸物，经过处理后采取改良Coleman技术或一种自动、低剪切力装置进行脂肪注射。通过一种2mm口径套管注入脂肪，并与微处理的脂肪进行对比。当组织开始失去其固态性质时，利用血流速度计测量其存储模量及剪切速率。同时，对脂肪组织的黏性进行测量，并通过载玻片实验定性评估每个治疗组的总产量。结果利用自动、低剪切力装置注射的脂肪，其物理性质与微处理的脂肪最接近。该自动装置组的脂肪存储模量（G’）比改良Coleman技术组高，而强度极限更延后。同样，测得该自动装置组的脂肪黏性与微处理组相当，比改良Coleman技术组的高。结论与改良Coleman技术相比，利用连于2mm插管的自动、低剪切力装置处理的脂肪抽吸物可以更好地保留脂肪组织完整的物理性质。本研究通过流变数据证实，该自动装置比改良Coleman技术对脂肪组织的损伤更小，其应用可能会增加移植脂肪的完整性。

关键词：脂肪移植注射脂肪软组织缺陷脂肪抽吸物物理性质低剪切力物质设备

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Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol

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World journal of Meta-Analysis 2019年第6期7卷 290-296页

作者： Kareeann SF Khow Michelle WK Kee Pazhvoor N Shibu Solomon CY Yu Mellick j Chehade Renuka Visvanathan Aged and Extended Care Services the Queen Elizabeth HospitalWoodville SouthSA 5011Australia Centre of Research Excellence Frailty Trans-disciplinary Research to Achieve Healthy AgeingUniversity of AdelaideAdelaideSA 5005Australia Discipline of Orthopaedics and Trauma Faculty of Medical and Health SciencesUniversity of AdelaideAdelaideSA 5005Australia

BACKGROUND Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes. AIM To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes. METHODS Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery;Exposure: Perioperative anaemia;Comparison: No anaemia before or after hip fracture surgery;Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate. CONCLUSION This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.

关键词： Anaemia Haemoglobin Hip fracture Length of stay Mortality Outcomes Perioperative Readmission

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全身性高血压和青光眼:共同的发病机制及并发现象

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世界核心医学期刊文摘（眼科学分册） 2005年第11期1卷 23-23页

作者： Langman M.j.S. Lancashire R.j. Cheng K.K. Stewart P.M. 曹绪胜 Department of Medicine Queen Elizabeth Hospital Birmingham B15 2TH United Kingdom Prof.

Aims: To determine whether systemic hypertension and glaucoma might coexist mo re often than expected, with possible implications for treatment. Methods: Case -control study using general practitioner database of patients with glaucoma ma tched with controls for age and sex. Results: Hypertension was significantly mor e common in the 27 080 patients with glaucoma (odds ratio 1.29, 95%confidence i ntervals 1.23 to 1.36, p< 0.001) than in controls. Treatment by oral βblockade appeared to protect from risk (odds ratio 0.77, 95%CI 0.73 to 0.83, p < 0.0001) , but oral calcium channel antagonists or angiotensin converting enzyme (ACE) in hibitors did not (odds ratios 1.34, 1.24 to 1.44 and 1.16 1.09-1.24, respective ly, p < 0.0001 in each case). Oral corticosteroid treatment was associated with enhanced risk (odds ratio 1.78, 1.61 to 1.96). Conclusion: Common pathogenetic m echanisms in ciliary and renal tubular epithelia may explain coincidence of glau coma and systemic hypertension. The choice of cardiovascular treatment, could su bstantially influence glaucoma incidence, with βblockade protecting and ACE inh ibitors or calcium channel blockers not affecting underlying risk.

关键词：发病机制性别匹配 β受体阻滞剂心血管治疗病例对照研究执业医师病理遗传学糖皮质激素

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The Role of Synthetic Biology in Atmospheric Greenhouse Gas Reduction: Prospects and Challenges

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BioDesign Research 2020年第1期2020卷 1-8页

作者： Charles DeLisi Aristides Patrinos Michael MacCracken Dan Drell George Annas Adam Arkin George Church Robert Cook-Deegan Henry jacoby Mary Lidstrom jerry Melillo Ron Milo Keith Paustian john Reilly Richard j.Roberts Daniel Segrè Susan Solomon Dominic Woolf Stan D.Wullschleger Xiaohan Yang Department of Biomedical Engineering and Program in Bioinformatics College of EngineeringBoston UniversityBoston MA 02215USA The NOVIM Group Kohn HallUC Santa BarbaraCA 93106USA Climate Institute WashingtonDCUSA Department of Energy WashingtonDCUSA Center for Health Law Ethics&Human Rights at the Boston University School of Public HealthSchool of MedicineBoston UniversityUSA Department of Bioengineering University of CaliforniaBerkeley CAUSA Department of Genetics Harvard Medical SchoolCambridge MAUSA School for the Future of Innovation in Society Arizona State UniversityBarrett&O’Connor Washington Center1800 I StreetNWWashingtonDC 20006USA Sloan School of Management MITCambridge MAUSA Department of Chemical Engineering University of WashingtonSeattle WashingtonUSA The Ecosystems Center of the Marine Biological Laboratory in Woods Hole MAUSA Department of Plant and Environmental Sciences Weizmann Institute of ScienceRehovotIsrael Department of Soil and Crop Sciences Colorado State UniversityFort Collins CO 80523USA MIT joint Program on the Science and Policy of Global Change MITCambridge MAUSA New England Biolabs Beverly MAUSA Department of Biology and Program in Bioinformatics Boston UniversityBoston MA 02215USA Department of Earth Atmospheric and Planetary SciencesMITCambridge MAUSA Soil and Crop Sciences Section School of Integrated Plant SciencesCornell UniversityIthaca NYUSA Environmental Sciences Division Oak Ridge National LaboratoryOak Ridge TNUSA Biosciences Division Oak Ridge National LaboratoryOak RidgeTNUSA

The long atmospheric residence time of CO2 creates an urgent need to add atmospheric carbon drawdown to CO2 regulatory *** and systems biology(SSB),which enables manipulation of cellular phenotypes,offers a powerful approach to amplifying and adding new possibilities to current land management practices aimed at reducing atmospheric *** participants(in attendance:Christina Agapakis,George Annas,Adam Arkin,George Church,Robert Cook-Deegan,Charles DeLisi,Dan Drell,Sheldon Glashow,Steve Hamburg,Henry jacoby,Henry Kelly,Mark Kon,Todd Kuiken,Mary Lidstrom,Mike MacCracken,june Medford,jerry Melillo,Ron Milo,Pilar Ossorio,Ari Patrinos,Keith Paustian,Kristala jones Prather,Kent Redford,David Resnik,john Reilly,Richard ***,Daniel Segre,Susan Solomon,elizabeth Strychalski,Chris Voigt,Dominic Woolf,Stan Wullschleger,and Xiaohan Yang)identified a range of possibilities by which SSB might help reduce greenhouse gas concentrations and which might also contribute to environmental sustainability and *** include,among other possibilities,engineering plants to convert CO2 produced by respiration into a stable carbonate,designing plants with an increased root-to-shoot ratio,and creating plants with the ability to self-fertilize.A number of serious ecological and societal challenges must,however,be confronted and resolved before any such application can be fully assessed,realized,and deployed.

关键词： Synthetic Roberts enable

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直击2型糖尿病至缓解

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英国医学杂志中文版 2018年第9期21卷 488-492页

作者：胡永莲(译) 武晓泓(校) 南京医科大学第一附属医院内分泌科

2型糖尿病，通常被认为进展性、不可治愈，目前影响着英国5％-10％的人口，大约320万。糖尿病在出现并发症之前，大多数患者完全是通过初级保健进行管理，构成全科医疗活动的主要组成部分。英国国家健康体系（NHS）总开支中大约有10％... 详细信息

2型糖尿病，通常被认为进展性、不可治愈，目前影响着英国5％-10％的人口，大约320万。糖尿病在出现并发症之前，大多数患者完全是通过初级保健进行管理，构成全科医疗活动的主要组成部分。英国国家健康体系（NHS）总开支中大约有10％用于治疗糖尿病。国际数据显示，糖尿病患者的医疗费用是年龄和性别相同的非糖尿病患者平均水平的2到3倍。

关键词：糖尿病缓解方法治疗方法预防措施

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持续正压通气治疗中枢性睡眠呼吸暂停伴心力衰竭

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世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 8-8页

作者： Bradley T.D Logan A.G. Kimoff R.j. 任付先 Department of Medicine Toronto General Hospital University Health Network 200 Elizabeth St. Toronto Ont. M5G 2C4 Canada

BACKGROUND: The Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure trial tested the hypothesis that continuous positive airway pressure(CPAP) would improve the survival rate without heart transplantation of patients who have central sleep apnea and heart failure. METHODS: After medical therapy was optimized, 258 patients who had heart failure(mean age [± SD], 63± 10 years; ejection fraction, 24.5± 7.7 percent) and central sleep apnea(number of episodes of apnea and hypopnea per hour of sleep, 40± 16) were randomly assigned to receive CPAP(128 patients) or no CPAP(130 patients) and were followed for a mean of two years. During follow- up, sleep studies were conducted and measurements of the ejection fraction, exercise capacity, quality of life, and neurohormones were obtained. RESULTS: Three months after undergoing randomization, the CPAP group, as compared with the control group, had greater reductions in the frequency of episodes of apnea and hypopnea(- 21± 16 vs.- 2± 18 per hour, Pjection fraction(2.2± 5.4 percent vs. 0.4± 5.3 percent, P=0.02), and the distance walked in six minutes(20.0± 55 vs.- 0.8± 64.8 m, P=0.016). There were no differences between the control group and the CPAP group in the number of hospitalizations, quality of life, or atrial natriuretic peptide levels. An early divergence in survival rates without heart transplantation favored the control group, but after 18 months the divergence favored the CPAP group, yet the overall event rates(death and heart transplantation) did not differ(32 vs. 32 events, respectively; P=0.54). CONCLUSIONS: Although CPAP attenuated central sleep apnea, improved nocturnal oxygenation, increased the ejection fraction, lowered norepinephrine levels, and increased the d

关键词：中枢性睡眠呼吸暂停持续正压通气治疗心力衰竭患者平均年龄 CPAP 射血分数随访期间神经内分泌心脏移植发作次数

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冠状动脉搭桥术后抑郁的性别差异

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世界核心医学期刊文摘(心脏病学分册) 2006年第4期 37-37页

作者： Mitchell R.H.B. Robertson E. Harvey P.j. 柴大军 Toronto General Hospital EN-7-233 200 elizabeth St Toronto Ont. M5G 2C4 Canada

Background: Previous research suggests that after coronary artery bypass graft(CABG)surgery, women fare worse than men. This study investigates sex differences in depression during recovery from CABG surgery. Methods: We followed 137 patients(72 men, 65 women)undergoing elective isolated first CABG surgery between july 2003 and April 2004. Patients were interviewed ≤28 days before surgery and between 6 and 12 weeks after surgery. Patients completed a structured diagnostic interview for major depressive disorder(MDD)and the Beck Depression Inventory(BDI). Clinical data were retrieved from patient charts. Results: Prevalence of MDD before surgery was 28.2%, but decreased to 16.4%after surgery(P=.038). Women had significantly more depressive symptoms than men pre-CABG, with a mean BDI of 12.5(95%CI 10.6-14.4)for women versus 8.0(95%CI 6.3-9.8)for men(P=.0001), but not post-CABG. There was a significant sex-by-time interaction with depre ssive symptoms in women improving almost 6-fold more than in men, with BDI chan ge scores of 4.1(95%CI 2.0-6.1)for women versus 0.7(95%CI-1.0-2.5)for men(P =.008). The interaction remained significant after adjusting the model for the p redetermined baseline characteristics education, social support, and operative r isk. Conclusions: Women had more depressive symptoms than men pre-CABG, but imp roved to a level comparable to men post-CABG. Women benefited from CABG as much or more than men in terms of their mental health. Preoperative depressive sympt oms should not preclude women from CABG surgery.

关键词：抑郁症状术前男性女性 CABG 性别差异差异(心理学)

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马拉维布兰太尔慢性溃疡的病因学和发病率

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世界核心医学期刊文摘（皮肤病学分册） 2006年第11期2卷 60-60页

作者： Zeegelaar j.E. Stronk A.C. Steketee W.H. 朱国兴 Department of Dermatology Academic Medical Centre P.O. Box 22660 1100 DD Amsterdam NetherlandsDr.

Background: Little information is available on the incidence and etiology of chronic ulcers in the tropics. Therefore, the incidence and etiology of chronic skin ulcers were assessed in out-patients at the Department of Dermatology and in in-patients at the Departments of Dermatology, Surgery, Medicine, and Pediatrics, Queen elizabeth Central Hospital (QECH), Blantyre, Malawi. Method: In a 10-week study period, 44 patients (31 males, 70%) with chronic skin ulcers were diagnosed from 6292 patients seen by the departments involved. Results: The mean age of patients with ulcers was 38 years (range, 9 months to 82 years). The most frequent cause of ulcers was bacterial infection (n = 22), followed by malignancy (n = 11) and trauma (n = 7). Conclusion: In contrast with developed countries, venous and diabetic ulcers were uncommon. In addition to bacterial infections, a surprisingly large number of malignancies were found in this study. We speculate that human immunodeficiency virus (HIV) infection, which is seen with a high prevalence at QECH, is a contributing factor. Because of the large number of malignancies, we recommend early histopathologic investigation of chronic ulcers in this part of Africa.

关键词：布兰太尔慢性溃疡病因学慢性皮肤溃疡糖尿病性溃疡细菌感染中心医院静脉性促进因素病理学

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