Breast volume measurement in young Chinese women and clinical applications

The authors carried out research on breast volume and body surface anatomy of 125 women. As a result, an average breast volume for Chinese women was obtained (325.36 +/- 12.66 ml), and a table with several linear equations for calculating breast volume was derived. The authors applied these results to their clinical work and succeeded in making mammaplasty more precise in 178 patients.

The relationship between hemoglobin levels and diabetic retinopathy

This study evaluates the relationship between hemoglobin levels and diabetic retinopathy. Hemoglobin values measured in 1991 and 1992 were collected from 1691 subjects attending a diabetic clinic in Oulu, Finland, and the mean values for the two years were used in the analyses. A classification of retinopathy, based on non-mydriatic photographs taken in 1991 and 1992, was used as the outcome variable. Multiple logistic regression analyses, controlled for serum creatinine levels, proteinuria, and other prognostic factors associated with diabetes, showed that the odds ratio of having any retinopathy was 2.0 (95% confidence interval 1.2-3.3) among subjects with a hemoglobin level of less than 12 g/dl, as compared with those having a hemoglobin level > or = 12 g/dl. Among the retinopathic subjects with low hemoglobin levels, the relative odds of having a severe retinopathy rather than a mild one was 5.3 (2.3-12.6). We conclude that subjects with normocytic anemia tended to have an increased risk of retinopathy, especially of the severe form.

Risk for diabetes and persistent impaired glucose tolerance among middle-aged Finns

Among 183 middle-aged Finnish subjects with impaired glucose tolerance (IGT) defined according to the 1985 World Health Organization (WHO) criteria) who were retested on average 2.1 years after the first examination, diabetes developed in 14 (7.7%), persistent IGT in 54 (29.5%), and IGT was transient in 115 (62.8%). The odds ratio for diabetes was 4.4 (95% Confidence Interval (CI): 1.3-15.3) among subjects with a body mass index (BMI) of 30 kg/m2 or more, compared with those with a BMI of less than 30 kg/m2. The increase in BMI during the follow-up period was also an independent risk predictor for diabetes. The odds ratios of having persistent rather than transient IGT were 3.0 (95% CI: 1.2-7.8) and 4.3 (95% CI: 1.5-12.6), among subjects with fasting insulin levels of 8.1-12.9 mU/1 and 13.0 mU/1 or more, respectively, compared with subjects with a fasting insulin level of no more than 8.0 mU/1. the degree of glucose intolerance and the diagnosis of hypertension at the initial examination were predictive of persistent IGT. It is evident from the present data that fasting hyperinsulinaemia forms an essential basis of persistence of IGT and diabetes, and that obesity plays a precipitating role for the deterioration from IGT to diabetes. Efforts to prevented diabetes should be focused on ways to reduce insulin resistance and obesity.

Haemoglobin A(1c) measurement for diabetes among subjects with a previous history of impaired glucose tolerance

Haemoglobin A(1c) (HbA(1c)) measurement for diagnosis of diabetes and impaired glucose tolerance (IGT) was assessed during a prospective study of subjects with IGT; 183 of the 207 IGT persons underwent the second oral glucose tolerance tests (OGTT) 2.1 years, on the average, after the first tests. HbA(1c) was administered to every participant before the second OGTTs. The results of HbA(1c) were compared with those of the second OGTTs. The sensitivity of HbA(1c) test was 71% for diabetes and 41% for IGT, when the specificity was 93% at a cutoff point of 4.81%. The conclusion is that the HbA(1c) test is moderately sensitive for diabetes but insensitive for IGT, when it is specific. However, it may be useful for selecting and reducing the total number of subjects referred to 2-h OGTTs in a follow-up study of subjects with IGT, if the rate of progression to diabetes is not high.

[Mentoplasty for common congenital mandibular deformities]

Since 1987, the authors have performed mentoplasty for congenital mandibular deformities in 46 patients with the assistance of X-ray pantomoscanning. Mandibular deformities include: 1) Bilateral hyperplasia of mandibular angles and massetter hypertrophy; 2) Retrognathia or micrognathia; 3) Asymmetric mandibular deformity. In this paper, following problems are discussed: 1) The advantages of an extraoral approach in mentoplasty; 2) The importance of the X-ray pantomoscanning; 3) The specific feature of asymmetric chin; 4) The improvement of the silicon implant used in mentoplasty; 5) Evaluation of the composite operative result.

Random capillary whole blood glucose test as a screening test for diabetes mellitus in a middle-aged population

This study was aimed at assessing the adequacy of a random capillary whole blood glucose (RCBG) test as a screening test for diabetes mellitus in a middle-aged (55-year-old) Finnish population. Both the screening test (RCBG) and a standard 2-h oral glucose tolerance test (OGTT) were performed on all the participants according to the WHO criteria. The prevalence based on the 2-h OGTTs was 8.5% (11.7% for men and 6.0% for women). The sensitivity, specificity and predictive values of the screening test for diabetes and the receiver operator characteristic (ROC) curves were studied. The likelihood ratios for diabetes within the test categories were also calculated. When a cut-off point of 6.2 mmol l-1 was used, which proved to be the most appropriate in the present study, the specificity was 92% and the sensitivity 63% (79% for men and 40% for women). The men had much higher sensitivities than the women at all cut-off points, but the specificities were comparable. The present study indicated that the RCBG test could be used as a screening test in a subpopulation with a high prevalence of diabetes and severe hyperglycaemia, but it would be quite insensitive in a subpopulation with a considerable overlap of RCBG values between the diabetic group and the non-diabetic one. It would be inappropriate to use the RCBG test as a routine screening test for diabetes in a general population, particularly among subjects with a known low prevalence of diabetes.

Rheumatic pains of previously undiagnosed diabetic subjects

To identify the early diabetic musculoskeletal symptoms of previously undiagnosed diabetic subjects, a case-control study was carried out. The cases and controls were recruited from a population aged 55 years. Questions concerning the symptoms were asked before the 2-h oral glucose tolerance tests (OGTT). The results show that pain in the right hand was the most prominent symptom among the diabetic women. Pains in the left hand and the shoulders in the diabetic women and pains in the right knee and the right hip joint in the diabetic men tended to be more prevalent than the corresponding symptoms in the controls. The highest prevalence of most musculoskeletal pains occurred in the highest tertile of 2-h OGTT values among women. The conclusion is that the hand pain is closely associated with the development of diabetes and may give clues to an early diagnosis of diabetes in a middle-aged population.

[Double-circle-incision for reduction mammaplasty]

The authors have used the double-circle incision for reduction mammoplasty on 55 breasts in 28 patients. The main features of the technique are: 1. Complicated and rigid preoperative markings are substituted by a simple and flexible double-circle incision; 2. Proper dissection between the skin and glandular tissue instead of non-dissection; 3. A conic stump of residual glandular tissue is formed instead of a cylindrical stump; 4. Glandular remodelling is substituted by skin "brassiere" retailoring; 5. The nipple-areola site is determined at the end instead of being the first step of the operation. The clinical results revealed that this new method is suitable for medium or large hypertrophy, especially for young women with good, thick and elastic skin, but it is not suitable for macromastia or severe breast ptosis.

Breast volume measurement in 125 young Chinese women

The authors carried out research on breast volume and body surface anatomy of 125 unmarried young women. As a result, an average breast volume for young Chinese women was obtained (325.36 +/- 12.66 ml), and a table together with several linear equations for calculating breast volume were derived. These will provide plastic surgeons with useful tools for designing mammaplasty procedures.

[Breast volume measurement in 125 Chinese young women]

The author carried out measurement of breast volume and the body surface anatomy in 125 unmarried young women. Through the measurement and analysis, the author came to the following conclusions: 1. The characteristics of body build of Chinese young women are: a. The mean height: 159.00 cm-160.00 cm; The mean weight: 50.40 kg-60.00 kg; The standard weight: height minus 110. b. The mean chest circumference difference, 2.0 cm. c. The mean distance from nipple to the supra-sternal notch is 19.05 cm, that of between nipples 20.0 cm, forming a equilateral triangle. d. The average breast volume, 310-330 ml; The standard breast volume, 250-350 ml; if the body weight is over the standard, the breast volume increases by 20 ml every 1.0 kg in body weight. e. The standard breast forward projection: 3.0 cm-4.0 cm. 2. Variables of the breast volume are: a. The breast volume is positively correlated with weight, chest circumference, waist circumference and buttock circumference, but negatively with height. b. The breast volume is closely related to difference between the chest circumference across the nipple and that across the horizontal line just under the armpits. The correlative equation can be approximately represented as V = 250 + 50 x D + 20 x OW (D = difference OW = overweight). c. The nipple position is not dependent on the height, but varies with the breast volume, that is, the nipple position lowers 1.0 cm with every increase of 300 ml in the breast volume. 3. The breast volume calculating table is derived from the radius and forward projection of breasts.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical experience and surgical anatomy of 32 free anterolateral thigh flap transplantations

The anterolateral thigh flap, first described by Song, is one of the septocutaneous flaps in the thigh. Since November 1985 we have transferred 32 anterolateral thigh flaps successfully without any loss. Six of these flaps were performed in Australia. The vascular pedicles are divided into three types: fasciocutaneous perforator (37.5%-12/32), vertical musculocutaneous perforator (56.2%-18/32) and horizontal musculocutaneous perforator (6.6%-2/32). This paper presents the surgical anatomy of the flap and clinical experience.

Experience using microvascular anastomotic rings for the transplantation of 20 free flaps

A new microvascular anastomosis technique was employed with success in 1985-1986 with the result of 18 free-flap survivals and 2 failures. The rate of success in microvascular anastomoses was 90.5 percent (38 of 42). The advantages of this technique are its simplicity, convenience, and safety, and it may shorten the duration of the operation. Our experience in using vascular anastomotic rings is presented.