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Ekins M, Erpenbeck D, Wrheide G, Hooper JNA. Deep Water Polymastiidae (Porifera, Polymastiida) from the South West Pacific. Zootaxa 2023; 5369:57-88. [PMID: 38220726 DOI: 10.11646/zootaxa.5369.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Indexed: 01/16/2024]
Abstract
This study reports on some deep water sponges in the family Polymastiidae collected during the 2017 Abyss Cruise off the East Coast of Australia and the 2003 NORFANZ Expedition to the Lord Howe and Norfolk Ridges in the Tasman Sea, Southwest Pacific Ocean. Species of Radiella, Spinularia, Ridleia, Tentorium and Polymastia were collected from abyssal and bathyal depths. From these collections, seven new species were discovered: Radiella nidula sp. nov., Radiella pumix sp. nov., Radiella sclera sp. nov., Spinularia flagellata sp. nov., Tentorium labium sp. nov., Ridleia echidna sp. nov. and Polymastia norfanzii sp. nov. In addition, two species previously known are redescribed based on the new collections: viz. Polymastia zitteli and Polymastia invaginata.
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Affiliation(s)
- Merrick Ekins
- Queensland Museum; PO Box 3300; South Brisbane 4101; Brisbane; Queensland; Australia; School of Biological Sciences; University of Queensland; St Lucia; Queensland; 4072 Australia; Griffith Institute for Drug Discovery; Griffith University; Brisbane 4111; Queensland; Australia.
| | - Dirk Erpenbeck
- GeoBio-Center; Ludwig-Maximilians-Universitt Mnchen; Richard-Wagner-Strae 10; 80333 Munich; Germany; Dept. of Earth and Environmental Sciences Ludwig-Maximilians-Universitt Mnchen; Richard-Wagner-Strae 10; 80333 Munich; Germany SNSB Bayerische Staatssammlung fr Palontologie und Geologie; Richard-Wagner-Str. 10; 80333 Mnchen; Germany.
| | - Gert Wrheide
- GeoBio-Center; Ludwig-Maximilians-Universitt Mnchen; Richard-Wagner-Strae 10; 80333 Munich; Germany; Dept. of Earth and Environmental Sciences Ludwig-Maximilians-Universitt Mnchen; Richard-Wagner-Strae 10; 80333 Munich; Germany; SNSB Bayerische Staatssammlung fr Palontologie und Geologie; Richard-Wagner-Str. 10; 80333 Mnchen; Germany.
| | - John N A Hooper
- Queensland Museum; PO Box 3300; South Brisbane 4101; Brisbane; Queensland; Australia; Griffith Institute for Drug Discovery; Griffith University; Brisbane 4111; Queensland; Australia.
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2
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Abstract
BACKGROUND Nipple inversion, which is defined as a nipple located on a plane deeper than the areola, presents both functional and cosmetic problems. Surgical repair of severe cases involves suture or flap techniques. In the present study, an alternative repair technique using two cross dermal areolar flaps to correct challenging inverted nipples is presented. Releasing the inverted nipple is performed by severing the underlying tight fibrous tissue bands and canaliculi. METHODS This is a retrospective case series. Fifteen patients who had been operated between January 2010 and January 2016 were included in the study. Seven of these had bilateral inverted nipples. Patient age at operation ranged from 26 to 47 years (mean age, 32.5 years). All nipples were congenital, with no previous operations. The follow-up period ranged between 8 and 16 months (mean of 13 months). RESULTS There were no complications associated with surgery, including infection, hematoma, permanent sensory disturbance, or nipple necrosis. Unilateral recurrence occurred in one patient on the 26th postoperative day. This patient was reoperated on successfully using the same method. Adequate projection was achieved in all patients. All patients were satisfied with their results. CONCLUSIONS The authors conclude that their procedure is a reliable, simple, safe, and effective method for correction of inverted nipples. The alignment of the scar with the junction of the nipple and the areola leads to a more aesthetic appearance with no apparent scarring. This technique can be applied to any type of inverted nipple as a primary surgical procedure. 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 .
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Affiliation(s)
- Bilge Kagan Aysal
- Department of Plastic, Reconstructive and Aesthetic Surgery, Mugla Sitki Kocman University, Kotekli Mahallesi Marmaris yolu no:48, Mentese, Mugla, Turkey.
| | - Celalettin Sever
- Private Practice; Plastic, Reconstructive and Aesthetic Surgery, Acibadem Mahallesi Beyazgul sokak No:1 Kat:5, Uskudar, Istanbul, Turkey
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Butler KM, Bahrambeigi V, Merrihew A, Friez MJ, Cathey SS. Scalp-Ear-Nipple syndrome: first report of a Potassium channel tetramerization domain-containing 1 in-frame insertion and review of the literature. Clin Dysmorphol 2021; 30:167-172. [PMID: 34456244 DOI: 10.1097/mcd.0000000000000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Pathogenic missense variants in the potassium channel tetramerization domain-containing 1 (KCTD1) gene are associated with autosomal dominant Scalp-Ear-Nipple syndrome (SENS), a type of ectodermal dysplasia characterized by aplasia cutis congenita of the scalp, hairless posterior scalp nodules, absent or rudimentary nipples, breast aplasia and external ear anomalies. We report a child with clinical features of an ectodermal dysplasia, including sparse hair, dysmorphic facial features, absent nipples, 2-3 toe syndactyly, mild atopic dermatitis and small cupped ears with overfolded helices. We also review the published cases of SENS with molecularly confirmed KCTD1 variants. METHODS AND RESULTS Using whole-exome sequencing, we identified a novel, de novo in-frame insertion in the broad-complex, tramtrack and bric-a-brac (BTB) domain of the KCTD1 gene. By comparing to the previously reported patients, we found that our patient's clinical features and molecular variant are consistent with a diagnosis of SENS. CONCLUSIONS This is only the 13th KCTD1 variant described and the first report of an in-frame insertion causing clinical features, expanding the mutational spectrum of KCTD1 and SENS.
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Affiliation(s)
| | - Vahid Bahrambeigi
- Graduate School of Biomedical Sciences, The University of Texas, MD Anderson Cancer Center UTHealth, Houston, Texas, USA
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Marinho-Soares C, Pulido-Valente M. Axillary Mass after Delivery. N Engl J Med 2021; 385:450. [PMID: 34320290 DOI: 10.1056/nejmicm2033023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Johansson HKL, Christiansen S, Draskau MK, Svingen T, Boberg J. Classical toxicity endpoints in female rats are insensitive to the human endocrine disruptors diethylstilbestrol and ketoconazole. Reprod Toxicol 2021; 101:9-17. [PMID: 33571642 DOI: 10.1016/j.reprotox.2021.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/21/2020] [Accepted: 01/11/2021] [Indexed: 11/21/2022]
Abstract
Developmental exposure to endocrine disrupting chemicals can have negative consequences for reproductive health in both men and women. Our knowledge about how chemicals can cause adverse health outcomes in females is, however, poorer than our knowledge in males. This is possibly due to lack of sensitive endpoints to evaluate endocrine disruption potential in toxicity studies. To address this shortcoming we carried out rat studies with two well-known human endocrine disruptors, diethylstilbestrol (DES) and ketoconazole (KTZ), and evaluated the sensitivity of a series of endocrine related endpoints. Sprague-Dawley rats were exposed orally from gestational day 7 until postnatal day 22. In a range-finding study, disruption of pregnancy-related endpoints was seen from 0.014 mg/kg bw/day for DES and 14 mg/kg bw/day for KTZ, so doses were adjusted to 0.003; 0.006; and 0.0012 mg/kg bw/day DES and 3; 6; or 12 mg/kg bw/day KTZ in the main study. We observed endocrine disrupting effects on sensitive endpoints in male offspring: both DES and KTZ shortened anogenital distance and increased nipple retention. In female offspring, 0.0012 mg/kg bw/day DES caused slightly longer anogenital distance. We did not see effects on puberty onset when comparing average day of vaginal opening; however, we saw a subtle delay after exposure to both chemicals using a time-curve analysis. No effects on estrous cycle were registered. Our study shows a need for more sensitive test methods to protect the reproductive health of girls and women from harmful chemicals.
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Affiliation(s)
- Hanna K L Johansson
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, DK-2800, Denmark
| | - Sofie Christiansen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, DK-2800, Denmark
| | - Monica Kam Draskau
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, DK-2800, Denmark
| | - Terje Svingen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, DK-2800, Denmark
| | - Julie Boberg
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, DK-2800, Denmark.
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Abstract
The reconstruction of the nipple–areola complex is the last step in the breast reconstruction process. Several techniques have been described over the years. The aim of this review is to provide clarity on the currently available reconstructive options.
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Affiliation(s)
- Andrea Sisti
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA
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Mitchell KB, Johnson HM. Breast Pathology That Contributes to Dysfunction of Human Lactation: a Spotlight on Nipple Blebs. J Mammary Gland Biol Neoplasia 2020; 25:79-83. [PMID: 32495215 DOI: 10.1007/s10911-020-09450-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2020] [Indexed: 01/19/2023] Open
Abstract
Nipple blebs are blister-like fibrinous lesions that form on the surface of the nipple during lactation, and can result in orifice obstruction and mastitis. They likely result from superficial extension of underlying ductal plugging, and can present concurrently with hyperlactation and mammary dysbiosis. Despite their prevalence, few formal reports on nipple blebs exist. In this perspective, we review the experience of a breastfeeding medicine practice that receives referrals for patients with nipple blebs, and provide preliminary insight into etiology, management, and outcomes of these lesions.
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Affiliation(s)
- Katrina B Mitchell
- Surgical Oncology, Ridley-Tree Cancer Center, Sansum Clinic, 540 W. Pueblo Street, Santa Barbara, CA, 93105, USA.
| | - Helen M Johnson
- Department of Surgery, Brody School of Medicine, East Carolina University, 600 Moye Boulevard, Greenville, NC, 27834, USA
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Mathur B, Loh CYY. Sensation-Sparing Correction of Inverted Nipples Using the 'Drawbridge' Flap Approach. Aesthetic Plast Surg 2019; 43:348-353. [PMID: 30361983 DOI: 10.1007/s00266-018-1260-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION An inverted nipple can cause significant functional and psychologic disturbance to women. The holy grail of any surgical technique to correct this is to restore adequate nipple projection and at the same time, try to preserve lactation and nipple sensation. We describe our experience using an inferior dermal nipple-areolar interposition flap to correct the inverted nipple alongside with selective release of the lactiferous ducts of the nipple. MATERIALS AND METHODS We have employed this technique successfully in 97 cases of inverted nipples in 60 patients with follow-up periods of up to 2 years. Twenty-three of them had unilateral inversion, and 37 of them had bilateral nipple inversion. RESULTS The appearance of the nipple was good to excellent. Seventy to 80% of the initial postoperative nipple projection at the end of 1 year was maintained. Postoperative complications included stitch abscess in one patient (n = 1) and an epidermal cyst in another (n = 1). Nipple sensation was preserved in 100% of cases. There was no recurrence of inversion in any of the nipples. DISCUSSION By identifying the root cause of inverted nipples in each individual case, and selectively targeting them, we minimize surgical morbidity with a simple technique that avoids any form of traction or compression of the nipple and minimizes the risk of altered nipple sensation. 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 .
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Affiliation(s)
- Bhagwat Mathur
- St. Andrew's Centre for Plastic Surgery and Burns, Chelmsford, UK.
- St Andrew's Centre for Plastic and Reconstructive Surgery, Broomfield Hospital, Court Road, Chelmsford, Essex, CM1 7ET, UK.
| | - Charles Yuen Yung Loh
- St. Andrew's Centre for Plastic Surgery and Burns, Chelmsford, UK.
- St Andrew's Centre for Plastic and Reconstructive Surgery, Broomfield Hospital, Court Road, Chelmsford, Essex, CM1 7ET, UK.
- Center for Vascularized Composite Allotransplantation, Department of Plastic Surgery, Chang Gung Memorial Hospital, 5 Fu-hsing Street, Gueishan, Taoyuan, 333, Taiwan, ROC.
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Dessena L, Dast S, Perez S, Mercut R, Herlin C, Sinna R. Inverted Nipple Treatment and Poliglecaprone Spacer. Aesthetic Plast Surg 2018; 42:958-963. [PMID: 29717339 DOI: 10.1007/s00266-018-1139-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Nipple inversion is defined as a non-projectile nipple. It is a frequent pathologic condition, in which the whole nipple, or a portion of its, is buried inward towards the lactiferous duct and lies below the plane of the areola. Numerous strategies have been described to correct nipple inversion. All the procedures have the purpose to give a good shape to the nipple, preserving its function and sensitivity, when it is possible. To avoid recurrences and to obtain good aesthetic results, we present a modified percutaneous technique. METHOD We performed a retrospective study between 2011 and 2016 and included all the cases of inverted nipples treated in our department. Our modified percutaneous technique consists of a minimal incision supported by a percutaneous suture as a temporary spacer to fill the defect caused by releasing the fibro-ductal bands. RESULTS A total of 41 cases of inverted nipples were corrected in 32 patients. After 1 year of follow-up, no recurrence was observed and all nipples maintained complete eversion. There was only one case of partial unilateral necrosis in a patient who underwent tumorectomy and radiotherapy. All patients were satisfied with the aesthetic outcomes. CONCLUSION This is a simple, safe and cheap technique that should be considered as a reliable method for long-term correction of nipple inversion. 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 .
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Affiliation(s)
- Lidia Dessena
- Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France
| | - Sandy Dast
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France.
- Department of Plastic, Reconstructive and Aesthetic Surgery, Amiens University Hospital, Hopital Sud, 80054, Amiens Cedex 01, France.
| | - Simon Perez
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France
| | - Razvan Mercut
- Department of Plastic and Reconstructive Surgery, UMF Craiova, Craiova, Romania
| | - Christian Herlin
- Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France
| | - Raphael Sinna
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France
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10
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Abstract
We present a rare case of a 13-year old girl with a bilateral polythelia. We would like to draw attention to this particular mammary malformation.
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Liang W, Zhao Z, Liu S, Gu T. Cross Vertical Mattress Suturing with Basilar Tightening During the Correction of Inverted Nipple in 30 Cases. Aesthetic Plast Surg 2017; 41:782-787. [PMID: 28424925 DOI: 10.1007/s00266-017-0856-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/04/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the efficacy of cross vertical mattress suturing with basilar tightening during the correction of inverted nipple. METHODS Thirty patients with inverted nipples underwent cross vertical mattress suturing with basilar tightening. The postoperative results were recorded. RESULTS All the patients were followed up for 6 months to 2 years. The results of 28 cases were satisfactory, and there was no recurrence. Two patients relapsed, and a mild depression was formed. They were satisfied with the results after the second correction. CONCLUSION The method of cross vertical mattress suturing with basilar tightening has been applied to treat inverted nipple, with minimal trauma, which provides a reliable guarantee for a long-term effect. It is worthy to be widely used in clinical practice. 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 .
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Affiliation(s)
- Weizhong Liang
- Department of Plastic Surgery, China Meitan General Hospital, Xibahe nan Road No. 1-4, Chaoyang District, Beijing, 100028, China
| | - Zuojun Zhao
- Department of Plastic Surgery, China Meitan General Hospital, Xibahe nan Road No. 1-4, Chaoyang District, Beijing, 100028, China
| | - Shu Liu
- Department of Plastic Surgery, China Meitan General Hospital, Xibahe nan Road No. 1-4, Chaoyang District, Beijing, 100028, China
| | - Tingmin Gu
- Department of Plastic Surgery, China Meitan General Hospital, Xibahe nan Road No. 1-4, Chaoyang District, Beijing, 100028, China.
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Humeňanská A, Havrlentová L, Jackanin S, Žiak D, Mazur M. [Polymastia in unusual localization during pregnancy]. Rozhl Chir 2017; 96:179-182. [PMID: 28537415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Polymastia is a fairly well-described and not entirely uncommon developmental anomaly in embryogenesis of the breast. It occurs in the milk line, most often in the axila but may also be present outside of this area. Clinical manifestation of polymastia is due to sex hormones, especially during puberty, pregnancy and lactation. Supernumerary/ aberrant breasts can undergo the same pathological changes, such as benign and malignant, as normally positioned breasts. In our case report we present a case of a pregnant patient with axillary polymasty bilaterally with benign tumors by ultrasound, further in anal and labia majora area.Key words: polymastia aberrant breast - gravidity gigantomastia.
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13
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Saltvig I, Sjøstrand H, Oldenburg MH, Matzen SH. [Inverted nipples]. Ugeskr Laeger 2016; 178:V04160273. [PMID: 27745579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Inverted nipples is an anatomical variation which can be uni- or bilateral, congenital or acquired. The degree of inversion can vary from slight to severe. Treatment can be surgical or non-surgical and should depend on the degree of functional problems. Non-surgical treatment can be beneficial, does not risk affecting sensibility, spares the lactiferous ducts, and therefore does not risk any interference with breast-feeding. Surgical options should only be considered when non-surgical treatment is insufficient.
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Zhou X, Zhu M, Sun B, Li C, Zhang B, Chen K. [EFFECTIVENESS OF ROTATION-EMBEDDING TECHNOLOGY FOR TREATMENT OF MODERATE TO SEVERE INVERTED NIPPLES]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2016; 30:389-391. [PMID: 27281891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the effectiveness of rotation-embedding technology for treatment of moderate to severe inverted nipples. METHODS Between March 2012 and March 2014, 24 patients (39 nipples) with moderate to severe inverted nipples were treated using rotation-embedding technology. The age ranged from 28 to 42 years (mean, 32 years). The bilateral nipples involved in 15 cases, unilateral nipple in 9 cases, including 30 moderate inverted nipples, 9 severe inverted nipples. The first time operation was performed in the other patients except 1 patient who had received corrective operation of bilateral nipples. RESULTS The operation was successfully performed in all patients; primary healing of incision was obtained; no swollen, bleeding, dehiscence, or blood flow obstacle occurred. All patients were followed up 5-24 months (mean, 12 months). The shapes of nipples were satisfactory; bilateral nipples were symmetrical basically; no nipple inversion recurred, and the nipple skins had good sensation. CONCLUSION Using rotation-embedding technology can correct moderate to severe inverted nipples effectively.
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Abstract
BACKGROUND Nipple inversion in females can be congenital or acquired. Women who desire treatment for this condition often report difficulty with breastfeeding and interference with their sexuality. However, data are limited on the demographics of patients who undergo surgery to repair inverted nipples and the associated recurrence rates and complications. OBJECTIVES The authors assessed outcomes of a 7-year experience with an integrated approach to the correction of nipple inversion that minimizes ductal disruption. METHODS A retrospective chart review was performed for 103 consecutive patients who underwent correction of nipple inversion. (The correction technique was initially reported in 2004 and entailed an integrated approach.) Complication rates, breastfeeding status, and patient demographics were documented. RESULTS Among the 103 patients, 191 nipple corrections were performed. Nine patients had undergone previous nipple-correction surgery. Recurrence was experienced by 12.6% of patients, 3 of whom had bilateral recurrence. Other complications were partial nipple necrosis (1.05%), breast cellulitis (1.57%), and delayed healing (0.5%). The overall complication rate was 15.74%. Fifty-seven percent of the patients had a B-cup breast size, and 59% were 21 to 30 years of age. CONCLUSIONS Results of the authors' 7-year experience demonstrate the safety and effectiveness of their technique to correct inverted nipples. LEVEL OF EVIDENCE 4: Therapeutic.
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Affiliation(s)
- Daniel J Gould
- Dr Gould is a Resident in the Division of Plastic and Reconstructive Surgery, and Dr Nadeau is an Aesthetic Surgery Fellow, University of Southern California (USC), Los Angeles. Dr Macias is a plastic surgeon in private practice in Marina del Rey, California. Dr Stevens is a Clinical Professor in the Department of Surgery and the Director of the Aesthetics Division of the Division of Plastic and Reconstructive Surgery, USC, and the Director of the Marina del Rey-USC Aesthetic Surgery Fellowship, Los Angeles, California
| | - Meghan H Nadeau
- Dr Gould is a Resident in the Division of Plastic and Reconstructive Surgery, and Dr Nadeau is an Aesthetic Surgery Fellow, University of Southern California (USC), Los Angeles. Dr Macias is a plastic surgeon in private practice in Marina del Rey, California. Dr Stevens is a Clinical Professor in the Department of Surgery and the Director of the Aesthetics Division of the Division of Plastic and Reconstructive Surgery, USC, and the Director of the Marina del Rey-USC Aesthetic Surgery Fellowship, Los Angeles, California
| | - Luis H Macias
- Dr Gould is a Resident in the Division of Plastic and Reconstructive Surgery, and Dr Nadeau is an Aesthetic Surgery Fellow, University of Southern California (USC), Los Angeles. Dr Macias is a plastic surgeon in private practice in Marina del Rey, California. Dr Stevens is a Clinical Professor in the Department of Surgery and the Director of the Aesthetics Division of the Division of Plastic and Reconstructive Surgery, USC, and the Director of the Marina del Rey-USC Aesthetic Surgery Fellowship, Los Angeles, California
| | - W Grant Stevens
- Dr Gould is a Resident in the Division of Plastic and Reconstructive Surgery, and Dr Nadeau is an Aesthetic Surgery Fellow, University of Southern California (USC), Los Angeles. Dr Macias is a plastic surgeon in private practice in Marina del Rey, California. Dr Stevens is a Clinical Professor in the Department of Surgery and the Director of the Aesthetics Division of the Division of Plastic and Reconstructive Surgery, USC, and the Director of the Marina del Rey-USC Aesthetic Surgery Fellowship, Los Angeles, California
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16
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Wang H, Duan J, Xin F, Cao X. [Clinicopathological analyses of accessory breast cancer: a report of 22 cases]. Zhonghua Yi Xue Za Zhi 2015; 95:260-263. [PMID: 25877240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore the clinicopathological characteristics, diagnosis, multi-disciplinary therapy and prognosis of accessory breast cancer. METHODS The clinical data were retrospectively analyzed for 22 patients with accessory breast cancer from December 2000 and September 2013. RESULTS Three patients underwent breast-conserving local wide excision of tumor plus axillary lymph node dissection while the remainder had Auchincloss or Halsted mastectomy. The most common histological type was infiltrating ductal carcinoma (n = 16, 72%) and one of them was associated with mucous adenocarcinoma. There were carcinoma simplex (n = 1), papillary adenocarcinoma (n = 1) and adenocarcinoma (n = 4). The most common pathological stages (according to AJCC Staging of Breast Cancer, 2002, 6th edition) were II (n = 15, 68%),I(n = 3), III (n = 4) and IV (n = 0). The median follow-up period was 3 (1-14) years. And the follow-up rate was 100%.Until October 2014, 2 patients died from metastasis and the remainder survived. CONCLUSIONS Accessory breast cancer is rare and has a worse prognosis.Now the clinical diagnostic criteria to it remains controversial and the diagnosis is often late. A definite diagnosis is made on the basis of clinical characteristics, postoperative pathology and imaging examinations. And surgery remains a major option.
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Affiliation(s)
- Haotian Wang
- Center of Breast Cancer, Cancer Institute & Hospital, Tianjin Medical University, Tianjin 300060, China
| | - Jingjing Duan
- Center of Breast Cancer, Cancer Institute & Hospital, Tianjin Medical University, Tianjin 300060, China
| | - Fei Xin
- Center of Breast Cancer, Cancer Institute & Hospital, Tianjin Medical University, Tianjin 300060, China
| | - Xuchen Cao
- Center of Breast Cancer, Cancer Institute & Hospital, Tianjin Medical University, Tianjin 300060, China.
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Abstract
Ectopic breast carcinoma in the axillary region is rare with an incidence ranging from 0.3-6%. We report a case of infiltrating duct carcinoma in an adult female arising in aberrant breast tissue in the axilla diagnosed on fine needle aspiration cytology. There was history of recent increase in size of the lump which was otherwise present for the past 5 years. This case highlights the role fine needle aspiration cytology can play in the early diagnosis of malignant transformation of lumps.
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18
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Zhang P, Li W, Deng Y. [Continuous traction treatment for correction of inverted nipple with self-made adjustable tractor]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28:1389-1391. [PMID: 25639057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore the effectiveness of self-made adjustable tractor for correction of inverted nipple. METHODS Between March 2005 and March 2011, 37 female patients with inverted nipples (69 nipples) underwent continuous traction with self-made adjustable tractor for 2 to 4 months. The age ranged from 18 to 46 years (mean, 23 years). Of 37 cases, 5 had unilateral inverted nipple, and 32 had bilateral inverted nipples, including 8 cases (15 nipples) of mild inversion, 16 cases (30 nipples) of moderate inversion, and 13 cases (24 nipples) of severe inversion. The 2 cases (4 nipples) recurred after traditional surgical method, and 1 case (2 nipples) had infection because of severe inversion before traction. RESULTS No infection or hemodynamic disorder occurred during traction. All cases were followed up 6-12 months (mean, 8.2 months). Wound healed after traction in 1 patient (2 nipples) with infection because of severe inversion; 2 recurrent cases (2 nipples) were cured after re-traction; wire dislocation occurred in 1 case (1 nipple), and was cured after changing traction position. The shape, sensation, and erectile function were normal after treatment with no scar. CONCLUSION Continuous traction with self-made adjustable tractor is a good method for all the types of inverted nipple. It is a simple, safe, effective, and minimally invasive method without scar.
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Affiliation(s)
- Ramnik V Patel
- Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Paediatric Urology, Great Ormond Street Children Hospital NHS Trust, London, UK
| | - Dhaval Govani
- University of Birmingham Medical School, Birmingham, UK
| | - Rasila Patel
- Department of Alternative Medicine, PGICHR, Rajkot, Gujarat, India
| | - Bhaumik Bhayani
- Department of Plastic Surgery, PGICHR, Rajkot, Gujarat, India
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20
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Jansen T. [Accessory breast nipple]. MMW Fortschr Med 2014; 156:5. [PMID: 24912249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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21
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Lourenço C, Brandão M. [Axillary polymastia: a postpartum diagnosis]. ACTA MEDICA PORT 2014; 27:274. [PMID: 24813500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 09/28/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Cátia Lourenço
- Serviço de Ginecologia-Obstetrícia. Centro Hospitalar de Vila Nova de Gaia/Espinho. Gaia. Portugal..
| | - Margarida Brandão
- Serviço de Ginecologia-Obstetrícia. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal
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Galli-Tsinopoulou A, Stergidou D. Polythelia: simple atavistic remnant or a suspicious clinical sign for investigation? Pediatr Endocrinol Rev 2014; 11:290-297. [PMID: 24716395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Supernumerary nipples (or polythelia) usually appear along the embryonic milk lines or in other sites including the back, thigh, vulva, neck etc. The frequency of polythelia ranges from 0.2% to 5.6%. Despite the plethora of published cases concerning its association with other congenital malformations or syndromes with different patterns of inheritance, polythelia still remains a controversial and theoretical issue. Although most reports describe a link between supernumerary nipples and kidney/urinary tract anomalies, a potential relationship with other congenital anomalies or malignancies has also been speculated. Additionally, polythelia has been associated with genodermatoses, thus being related with an increased malignant potential, as well as with an increased risk for solid tumors such as renal adenocarcinoma, testicular cancer, prostate cancer, and urinary bladder carcinoma. The fact that the Scaramanga (ska) mutant mice presented with ectopic breast tissue imply that misregulation of the neuregulin-3 signaling pathway may be critical in the occurrence of polythelia. This is an attempt to review existing literature in order to (a) draw reliable conclusions whether polythelia is a manifestation of simple atavism or may be associated with concomitant severe conditions needing further investigation and/or management, (b) elucidate its aetiology and (c) establish appropriate clinical and laboratory approach.
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23
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Jain S, Jain A, Singh AK, Goswami D, Upadhyay AN, Negi N. Newer innovations in treatment of retracted nipple: authors' reply. Indian J Pediatr 2014; 81:227. [PMID: 23881477 DOI: 10.1007/s12098-013-1056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Suchitra Jain
- Department of Gynaecology, VCSGGMS&RI, Govt. Medical, College, Srinagar Garhwal, Uttarakhand, India
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24
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Arun Babu T, Patra PK. Newer innovations in treatment of retracted nipple: correspondence. Indian J Pediatr 2014; 81:226. [PMID: 23881476 DOI: 10.1007/s12098-013-1043-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 04/05/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Thirunavukkarasu Arun Babu
- Department of Pediatrics, Indira Gandhi Medical College and Research Institute (IGMC&RI), A Government of Puducherry Institution, Puducherry, 605 009, India,
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25
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Wang K, Luan J, Ma J. An uncommon case of ectopic breast and its reconstruction. Chin Med J (Engl) 2014; 127:3674-3675. [PMID: 25316249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- Keming Wang
- 17th Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College, Beijing 100144, China
| | - Jie Luan
- 8th Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College, Beijing 100144, China
| | - Jiguang Ma
- 17th Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College, Beijing 100144, China.
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Fonseca GM, Cantín M. Familial polythelia associated with dental anomalies: a case report. Colomb Med (Cali) 2014; 45:45-7. [PMID: 24970959 PMCID: PMC4045223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 01/18/2014] [Accepted: 01/23/2014] [Indexed: 11/21/2022] Open
Abstract
Polythelia has been defined as the presence of supernumerary nipples without accessory glandular tissue. Usually, these growths follow imaginary mammary lines running from the armpits to the groin. Although the presence of dental anomalies may occasion only a simple cosmetic problem with specific clinical considerations, the association with familial polythelia has been scarcely reported. This paper reports on a case of polythelia that is associated with dental anomalies in an Argentine family and discusses suggestions for a thorough dental history and medical consultation to prevent possible pathological conditions or potential malignant transformation of mammary tissues.
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Affiliation(s)
- Gabriel M Fonseca
- Pathology Department, Faculty of Dentistry, Universidad Nacional de Córdoba, Argentina. ; Pathology Department, Faculty of Dentistry, Universidad Nacional de Córdoba, Argentina
| | - Mario Cantín
- Doctoral Program in Morphological Sciences, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile ; Research Center for Biomedical Sciences, Universidad Autónoma de Chile, Temuco, Chile
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Francone E, Nathan MJ, Murelli F, Bruno MS, Traverso E, Friedman D. Ectopic breast cancer: case report and review of the literature. Aesthetic Plast Surg 2013; 37:746-9. [PMID: 23620009 DOI: 10.1007/s00266-013-0125-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 03/25/2013] [Indexed: 02/06/2023]
Abstract
UNLABELLED Ectopic breast tissue comes in two forms: supernumerary and aberrant. Despite morphologic differences, ectopic breast tissue presents characteristics analogous to orthotopic breast tissue in terms of function and, most importantly, pathologic degeneration. Data in the literature concerning its precise incidence, the probability of malignant degeneration, and its standardized management are scarce and controversial. This study selected more than 100 years of literature, and this report discusses a case of ectopic breast cancer treatment, suggesting novel therapeutic advice that could bring considerable clinical advantages, improve cosmetic results, and reduce the psychological impact on patients. 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 .
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Affiliation(s)
- Elisa Francone
- Department of Surgery, Breast Unit, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 8, 16132, Genoa, Italy.
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Abstract
OBJECTIVES To compare the efficacy, merits and demerits of various methods for the treatment of retracted nipple, i.e., two new innovative methods (rubber band method and sucking by the husband) with the in-use syringe method. METHODS A prospective study on 213 women having retracted nipple, 71 in each of the three groups was carried out. Group A included patients in which syringe method was used; Group B comprised of woman in which rubber band method was used and Group C included patients with vigorous sucking by the husband. RESULTS Highest success rates were seen in Group C (vigorous sucking by the husband), being 52, 88 and 94 % on days 3, 7 and 14 respectively. Success rates in Group B (rubber band method) were lower, being 43, 66 and 74 % respectively and lowest in Group A (syringe method), i.e., 33, 47 and 64 %, respectively on corresponding days. Problem of difficulty in applying technique were common in Group B (38 %), less common in Group A (22 %) and nil in Group C. The incidence of local pain had the same trend i.e., 48 and 30 % in Group B and A, respectively, and nil in Group C. Disliking taste of milk in mouth and problem of privacy were highest in Group C i.e., 28 % and 100 % respectively. CONCLUSIONS Although syringe method is well established, sucking by husband is definitely superior and a boon for difficult cases too. Rubber band method is a bit inferior due to complicated technique, local pain and no lactation stimulation.
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Affiliation(s)
- Suchitra Jain
- Department of Gynaecology, VCSGGMS&RI, Govt. Medical College, Srinagar Garhwal, Uttarakhand 246 174, India
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29
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Pagkalos VA, Ghali S, Hedén P. Nipple elevation using loupes magnification and a double-layer purse-string suture. Aesthetic Plast Surg 2013; 37:354-8. [PMID: 23404450 DOI: 10.1007/s00266-013-0086-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/24/2013] [Indexed: 11/27/2022]
Abstract
UNLABELLED Nipple elevation is a procedure that enhances the projection of the nipples. The aim is to achieve an aesthetically satisfying appearance that is stable over time and at the same time to maintain the sensory and lactating functions of the nipples. The surgical technique described in this report is based on release of the retracting lactiferous ducts and fibrous bands under loupes magnification and use of two layers of sutures to secure the acquired height of the nipple. The result is a satisfying projection accompanied by preservation of the sensory and lactating functions. 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 .
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30
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Grimshaw EC, Cohen PR. Supernumerary nipple and seminoma: case report and review of polythelia and genitourinary cancers. Dermatol Online J 2013; 19:4. [PMID: 23374946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
The presence of supernumerary nipples, known as polythelia, is the most common presentation of accessory breast tissue. It is usually considered to be a benign congenital anomaly. However, polythelia may warrant attention for more than mere cosmetic concern because supernumerary nipples have been shown to be associated with an increased risk of genitourinary malignancies. We describe a 53-year-old man with an accessory nipple on the left chest who presented with stage IIA testicular seminoma at the age of 47. Published reports of patients with polythelia and genitourinary malignancies, as well as other neoplasms, are reviewed. Because patients with accessory nipples have a predisposition to develop visceral cancers, polythelia should be considered as a genodermatosis with malignant potential.
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31
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Levinienė G, Tamulevičienė E, Kudzytė J, Petrauskienė A, Zaborskis A, Aželienė I, Labanauskas L. Factors associated with breastfeeding duration. Medicina (Kaunas) 2013; 49:415-421. [PMID: 24589578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The assessment of the factors associated with breastfeeding duration helps in creation of a national policy according to the World Health Organization strategy and recommendations. The objective of the study was to identify the factors associated with breastfeeding duration. MATERIAL AND METHODS These analyses are based on a sample of mothers with babies attending one family health center in Kaunas, Lithuania. Completed questionnaires were obtained from 195 mothers (response rate, 97.5%). One year later, the same respondents, who had 1-year-old children, answered questions of the second questionnaire. RESULTS Half (53.8%) of the surveyed women breastfed for 3-5 months, 29.7% for 6 months and more, and 16.5% of the respondents breastfed for less than 3 months. The oldest (31-40 years) women breastfed their babies significantly longer than the youngest (<20 years) mothers. The mothers with a higher education breastfed their babies significantly longer than the less educated mothers. The married women breastfed longer than single or living with a partner. The mothers who did not give extra fluids and pacifiers breastfed significantly longer than the women who gave them. The majority of the mothers who had sore nipples, milk stasis, and mastitis breastfed for only up to 3 months. CONCLUSIONS Mothers at risk of short breastfeeding duration should be targeted as a group for breastfeeding promotion early in the pregnancy. The education of healthcare professionals who provide prenatal and postnatal care allows them to choose women who need additional breastfeeding support.
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Affiliation(s)
- Giedra Levinienė
- Department of Children Diseases, Medical Academy, Lithuanian University of Health Sciences, Baltijos 120, 47116 Kaunas, Lithuania.
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32
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Cruz NI, Korchin L. Breast asymmetry pattern in women with idiopathic scoliosis. Bol Asoc Med P R 2013; 105:9-12. [PMID: 24282913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Breast asymmetry is frequent in women with idiopathic scoliosis. To understand the pattern of breast asymmetry in these women a clinical study was performed in which 54 female patients with idiopathic scoliosis were evaluated. The information recorded for each patient included: age, weight, height, scoliosis type, Cobb angle, breast measurements, and presence of rib cage asymmetry. Breast volume was calculated using anatomic measurements (anthropomorphic method). The mean age of the group was 25 +/- 7 years. A right convex thoracic curve occurred in 85%, with a mean Cobb angle of 32 +/- 15 degrees. Our study indicated that women with idiopathic scoliosis consistently presented breast asymmetry that followed a predictable pattern. The breast on the side of the convex thoracic scoliosis curve is always smaller in volume (mean difference 59 +/- 39 mi). The affected side also presents a smaller areola, a higher position of the nipple (mean difference 2.2 +/- 1.3 cm) and a higher position of the inframammary fold (mean difference 2.1 +/- 1.4 cm) when compared to the opposite breast. Though the asymmetry is predictable, the degree to which the patient presents these changes does not correlate with the severity of the scoliosis (Cobb angle). We believe that the severity of the asymmetry is a result of the difference between the hypoplastic breast and the normal breasts. In women with very large opposite breasts the asymmetry appears to be worse.
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Affiliation(s)
- Norma I Cruz
- Division of Plastic Surgery, Department of Surgery, UPR School of Medicine, Puerto Rico Health Science Center, San Juan, Puerto Rico.
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Ming J, Meng G, Yuan Q, Zhong L, Tang P, Zhang K, Chen Q, Fan L, Jiang J. Clinical characteristics and surgical modality of plasma cell mastitis: analysis of 91 cases. Am Surg 2013; 79:54-60. [PMID: 23317612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The objective of this study was to investigate the clinical characteristics and surgical modality of plasma cell mastitis (PCM). A total of 93 breasts of 91 female patients with PCM from June 2003 to June 2010 (unilateral in 89 patients and bilateral in two patients) were investigated in this study. All breasts were divided into two groups: the direct excision group (DE group) received focused excision and nipple retraction correction; and the incision drainage group (ID group) received these procedures only in the event of failing at least two incision drainages. Clinical characteristics, extent of excision, and prognosis were compared between two groups. There were 53 breasts in the DE group and 40 breasts in the ID group. No significant differences were noted in the number of retracted nipples and abscesses in the first visit or extent of disease between two groups (P > 0.05). However, during surgery, 3.85 ± 0.97 abscesses per breast were detectable in the ID group, which was significantly higher than 1.21 ± 0.06 abscesses per breast in the DE group. The ID group had significantly higher inflammation and excised extent compared with the DE group (P < 0.05). Hospitalization time was 179.60 ± 14.8 days in the ID group, which was significantly higher than 22.49 ± 1.93 days in the DE group (P < 0.05). Bacterial culture was negative for pus of 39 nonrupturing abscesses. Congenital nipple retraction may be the primary cause of PCM. Early and complete focused excision and nipple retraction correction are effective treatment methods.
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Affiliation(s)
- Jia Ming
- Breast Disease Center, Southwest Hospital affiliated with The Third Military Medical University, Chongqing, China
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Köse R, Ozgoönül A, Bingöl I. Intraareolar polythelia: a rare anomaly. J PAK MED ASSOC 2012; 62:499-500. [PMID: 22755319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Polythelia, the presence of supernumerary nipples or nipple-areola complexes, is the most common anomaly of the pediatric breast. Although polythelia is common, intraareolar polythelia (nipple dichotomy) is an extremely rare congenital malformation. Surgical treatment is performed as a prophylaxis against breast cancer which has a higher prevalence in polythelia or polymastia. We describe a case of a young woman with polythelia in the right breast. The patient was a 25-year-old young woman who had two nipples by birth on the areola of the right breast. An abdominal ultrasound examination showed no urorenal malformations. Surgery was performed with elliptical excision under local anesthesia. A management of such cases with polythelia or polymastia was discussed in the view of recent literature.
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Affiliation(s)
- Rüstü Köse
- Department of Plastic and Reconstructive Surgery, Harran University, School of Medicine, Sanliurfa, Turkey
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35
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Somma F, Calzoni C, Arleo S, Chiummariello S. [Polythelia and supernumerary breast. Personal experience and review of the literature]. Ann Ital Chir 2012; 83:109-112. [PMID: 22462329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM Our study focuses on the approach, management and treatment of patients with polythelia and supernumerary breast and the target is the search for a treatment algorithm for these diseases. MATERIAL OF STUDY We considered at 18 patients treated from 2006 to 2011 for breast congenital anomalies in excess. 14 surgical procedures were performed, 8 for supernumerary nipple excision (1 case associated with Poland Syndrome) and 6 for accessory breast ablation. All patients were aged between 15 and 34 years and belonged to both sexes. RESULTS The breast tissue it was detected fibrocystic mastopathy in 5 cases of polimastia. In the remaining cases the nipples and mammary tissues were normal. After a median follow-up from one to five years, we obtained in all cases not only an excellent aesthetic result but also a psychological. DISCUSSION The supernumerary breast tissue is not just a cosmetic problem, it is also subject to the same pathological lesions that are observed in a normal breast. In view of the potential malignant transformation of anomalous breast incidentally, early and accurate diagnosis is required as well as its monitoring over time. CONCLUSIONS. We therefore believe that surgical approach is always necessary in cases of polimastia, while considering options in the treatment of polythelia, where it becomes crucial if aesthetic and/or psychologically problems in the patient coexist.
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Affiliation(s)
- Francesco Somma
- Cattedra di Chirurgia Plastica e ricostruttiva, Università degli Studi di Perugia.
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36
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Kiyohara T, Takahashi H, Kumakiri M. Supernumerary breast tissue with Toker cells clinically and dermoscopically mimicking atrophic dermatofibroma: the efficacy of estrogen receptor immunoreactivity. J Dermatol 2011; 39:873-5. [PMID: 22168245 DOI: 10.1111/j.1346-8138.2011.01443.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shiau JP, Chin CC, Lin MH, Hsiao CW. Correction of severely inverted nipple with telescope method. Aesthetic Plast Surg 2011; 35:1137-42. [PMID: 21556984 DOI: 10.1007/s00266-011-9739-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 04/11/2011] [Indexed: 11/27/2022]
Abstract
For female patients, an inverted nipple can result in functional problems, such as difficulty breast feeding, and emotional difficulties because of self-consciousness about the condition. Numerous surgical techniques for inverted nipple correction have been proposed, but none of the methods provides a reliable outcome. Most methods involve releasing retractile ducts and fibrous bands and adding bulk at the base of nipple; however, these techniques can cause injury to normal lactiferous ducts and sensory dysfunction. Herein we describe a "telescope method," performed under local anesthesia, which consists of making a circumferential incision, pulling out the nipple, and tightening the nipple base. With this technique, most lactiferous ducts and parallel sensory nerves that travel through the nipple base are not injured, and the procedure is associated with a less visible scar and nipple deformity than other methods. We report on 23 nipples of 17 patients that were successfully treated with this method. There was no recurrence of nipple inversion or sensory disturbance in the follow-up period. This technique is a simple, safe, and reliable method for the correction of severely inverted nipples.
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Affiliation(s)
- Jiun-Pyng Shiau
- Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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38
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Osswald SS, Osswald MB, Elston DM. Ectopic breasts: familial functional axillary breasts and breast cancer arising in an axillary breast. Cutis 2011; 87:300-304. [PMID: 21838088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Supernumerary breasts and nipples are not uncommon and have familial and syndrome associations. Although usually of only cosmetic concern, hormonal changes and inflammatory or neoplastic conditions that affect primary breast tissue also may occur in areas of ectopic breast tissue. We describe cases of familial functional axillary breasts and primary carcinoma of the breast arising in ectopic axillary breast tissue.
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Körber A, Dissemond J. [3 breast nipples - polythelia. Why the kidneys should be checked in this case]. MMW Fortschr Med 2011; 153:6. [PMID: 21966861 DOI: 10.1007/bf03368076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Andreas Körber
- Universitätsklinikum Essen, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Hufelandstrasse 55, D-45122 Essen
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40
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Wu G, He X, An Y, Hu C, Yang Z, Guo L, Teng L. [Effect of continuous elastic outside distraction on change of collagen content in female minipig's nipples and their supporting tissues]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2010; 24:1510-1514. [PMID: 21261104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To observe the effect of continuous elastic outside distraction on the change of collagen content in female minipig's nipples and their supporting tissues, and to investigate the mechanism of continuous elastic outside distraction correcting inverted nipples. METHODS Three 3-month-old female minipigs (weighing 18.5-22.0 kg), which had 12 nipples, were employed. Four nipples of each minipig were not treated as control group (n = 12), and the other nipples were continuously distracted with inverted nipple correction instruments as experimental group (n = 24). The nipple specimens were harvested at 2, 4, 8, and 12 weeks after distraction and HE staining was performed to observe the change of their tissue structure. And saturated picric acid sirius red staining was used to observe the distribution and content of collagen types I and III, image analysis software for quantitative analysis. RESULTS The control group had normal structure of epidermis at all time points. In experimental group, the epidermis thickened; basal cells, fibroblasts, and capillary significantly proliferated along with the times; and the content and the density of collagen types I and III increased gradually. There were significant differences in collagen type I at 4, 8, and 12 weeks, and in collagen type III at 2, 4, 8, and 12 weeks between 2 groups (P < 0.01). There were significant differences in the ratio of collagen type I to III at 2 and 4 weeks between 2 groups (P < 0.05). CONCLUSION Continuous elastic outside distraction can increase the quantity of collagen types I and III in the tissue, the thickness of the dermis, and the height of the nipple, which may be one of key mechanisms of correction the inverted nipple by continuous elastic outside distraction.
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Affiliation(s)
- Guoping Wu
- Department of Plastic and Burns Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou Sichuan 646000, PR China.
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Castaño-León AM, Eguren C, Daudén E. [Bilateral familial polythelia without associated malformations]. Actas Dermosifiliogr 2010; 101:453-454. [PMID: 20525491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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Abstract
Although hyperandrogenism is an important condition and is considered the possible pathogenesis behind polycystic ovary syndrome (PCOS), data supporting this is still scarce. We sought to determine whether or not prenatal androgen exposure leads to PCOS and the possible cellular mechanisms involved. To induce prenatal androgen exposure, pregnant rats were treated with daily subcutaneous injections of free testosterone (T) or dihydrotestosterone (DHT) from embryonic days 16 to 19, and their female offspring were studied as adults. The mRNA expression of the progesterone receptor (PR) in the preoptic area (POA) hypothalamus was higher in the experimental groups than in the control group after ovariectomy and stimulation with estradiol benzoate. The levels of T, P, leutinizing hormone (LH), and estradiol were higher in the experimental groups than in the control groups. The frequency and magnitude of LH secretion was increased in experimental rats as compared with the control group. The anogenital distance of the experimental groups was prolonged and the nipple number was lower than that of the control group. Almost all experimental rats had prolonged or irregular estrous cycles. The experimental groups had fewer corpus luteum and preovulatory follicles and more preantral follicles and antral follicles than the controls. Our findings are consistent with the hypothesis that excess androgen during the prenatal period may cause PCOS. Additionally, we show that hyperandrogenic interference in the release of preovulatory LH surges is mediated by the suppressive effects of androgens on PR expression in POA-hypothalamic tissue.
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Affiliation(s)
- Xiao-Yan Wu
- Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, China
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Kim TS, Jung KK, Kim SS, Kang IH, Baek JH, Nam HS, Hong SK, Lee BM, Hong JT, Oh KW, Kim HS, Han SY, Kang TS. Effects of in utero exposure to DI(n-Butyl) phthalate on development of male reproductive tracts in Sprague-Dawley rats. J Toxicol Environ Health A 2010; 73:1544-1559. [PMID: 20954080 DOI: 10.1080/15287394.2010.511579] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of this study was to determine the effects of di(n-butyl) phthalate (DBP) administration on male reproductive organ development in F1 Sprague-Dawley rats following in utero exposure. During gestation days (GD) 10-19, pregnant rats were administered daily, orally, DBP at 250, 500, or 700 mg/kg or flutamide (1, 12.5, or 25 mg/kg/d) as a positive control. The male offspring were sacrificed at 31 d of age. DBP and flutamide dose-dependently significantly increased the incidence of hypospadias and cryptorchidism in F1 male offspring. The weights of testes and accessory sex organs (epididymides, seminal vesicles, ventral prostate, levator ani plus bulbocavernosus muscles (LABC), and Cowper's glands) were significantly reduced in DBP-treated animals. Furthermore, cauda agenesis of epididymides and ventral prostate atrophy were observed in high-dose 700-mg/kg DBP males. Anogenital distance (AGD) and levels of dihydrotestosterone (DHT) and testosterone were significantly decreased in the DBP (700 mg/kg/d)-treated groups. In particular, the expression of androgen receptor (AR) and 5α-reductase type 2 in the proximal penis was markedly depressed following administration of DBP (700 mg/kg/d) or flutamide (25 mg/kg/d). The expression of sonic hedgehog (Shh) in the urethral epithelium of the proximal penis was significantly less in the DBP (700 mg/kg/d)- or flutamide (25 mg/kg/d)-treated groups. In addition, DBP dose-dependently significantly increased the expression of estrogen receptor (ER α) in the undescended testis. Data demonstrated that in utero exposure to DBP produced several abnormal responses in male reproductive organs, and these effects may be due to disruption of the stage-specific expression of genes related to androgen-dependent organs development.
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Affiliation(s)
- Tae Sung Kim
- Health Effects Analysis Team, National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration, Seoul, South Korea
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Karacaoglu E. Correction of recurrent grade III inverted nipple with antenna dermoadipose flap: case report. Aesthetic Plast Surg 2009; 33:843-8. [PMID: 19296150 DOI: 10.1007/s00266-009-9322-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 02/09/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Numerous techniques have been reported for the correction of the inverted nipple. It was also reported that no single technique was appropriate for correcting all types of nipple deformities because different grades of inverted nipple have different levels of fibrosis, soft tissue bulk, and lactiferous ductus structure. In this article a novel technique for the repair of recurrent grade III inverted nipple is described in detail. METHODS In this technique, dermoadipose flaps were generated within the area of de-epithelialization of mastopexy.The flap is called "antenna flap" because of its designing. RESULTS No major vital complications such as necrosis of the major flap or nipple were seen. There was no recurrence of nipple inversion after 15 months. The shape and projection of the patient's nipple was deemed satisfactory. CONCLUSION This technique yielded a satisfactory result without recurrence of inversion. It should be considered for use on any patient contemplating correction of inverted nipple and mastopexy. It should be emphasized that this technique also permits the performance of mastopexy in conjunction with the correction of inverted nipple.
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Affiliation(s)
- Ercan Karacaoglu
- Department of Plastic and Reconstructive Surgery, Yeditepe University School of Medicine, Istanbul, Turkey.
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Peeters G, Decloedt J, Nagels H, Cambier B. Treatment of the severe or recurrent inverted nipple by interposition of a resorbable polydioxanone sheet. J Plast Reconstr Aesthet Surg 2009; 63:e175-6. [PMID: 19595657 DOI: 10.1016/j.bjps.2009.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Accepted: 06/08/2009] [Indexed: 11/30/2022]
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Abstract
Severely inverted nipples are invaginated deeply and present many aesthetic, functional, and psychological problems. Many methods have been proposed for correction of this deformity. The authors describe a new simple method using two broad triangular areolar dermofibrous flaps. This method affords sufficient tissue to fill the dead space. Furthermore, it furnishes bulk to drive up the nipple, and because the cross lay of the flap and the epidermis make the areola circular and small, it provides sufficient areolar tissue for reconstruction of the defective nipple. The manipulation of postoperative "donut" traction is simple and useful. This method was used to correct 14 nipples of 9 patients successfully without any postoperative problems and with minimal scars and no recurrence of inversion. It is an ideal surgical procedure for the severely inverted nipple.
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Affiliation(s)
- H L Wu
- Department of Plastic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Zhejiang Province, 310003, Hangzhou, P. R. China
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Benmously-Mlika R, Deghais S, Bchetnia M, Charfeddine C, Mokni M, Kassar S, Haouet S, Boubaker S, Mokhtar I, Abdelhak S, Dhahri ABO. Supernumerary nipples in association with Hailey-Hailey disease in a Tunisian family. Dermatol Online J 2008; 14:15. [PMID: 18713596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Supernumerary nipples (SNs) or polythelia are developmental abnormalities of breast tissue. They are located along the embryonic mammary lines. Polythelia usually occurs as a sporadic abnormality, although familial aggregation has been occasionally reported. Hailey-Hailey disease is a rare autosomal genodermatosis characterized by disturbed keratinocyte adhesion. These cutaneous disorders have been described in correlation with many other abnormalities. We report here the association of Hailey-Hailey disease and supernumerary nipples in a Northern Tunisian family. To our knowledge, this is the first report of such a clinical association.
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Liu Q, Cen Y, Li J. [Correction of inverted nipples by double stitching of U-shape]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2008; 22:593-596. [PMID: 18630444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To introduce a way to correct mildly and moderately inverted nipple. METHODS From May 2004 to January 2007, 16 patients (aged 18-38 years) with original bilateral inverted nipple were corrected with the double stitching of U-shape. Sixteen cases included 11 mildly inverted nipples and 5 moderately inverted nipples. Six of them received massage and vacuum aspiration, and the results were not satisfactory. After the pulling out inverted nipples, four microincisions about 0.1 cm on the border of areola and the basilar part of nipple were designed in each horizontal and perpendicular directions, then double stitching was performed to increase the supporting and sustaining tissue under the nipple and close the way nipple invert. RESULTS Most cases exhibited excellent aesthetic projection and incision healed by first intention. Followup examinations were performed at 6 months to 2 years and revealed no evidence of recurring inversion, nipple tilting or lactation disturbance. No surgical complications such as infection, nipple and areola of breast necrosis, permanent numbness. The scars in the local site were limited and not conspicuous. CONCLUSION Double stitching of U-shape is easy and simple with few complications. It is an ideal method to correct mild and moderate inverted nipple.
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Affiliation(s)
- Quan Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China
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Patel Y. Inverted nipples: correction using a simple disposable syringe. East Afr Med J 2008; 85:51-52. [PMID: 18543528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Hass U, Scholze M, Christiansen S, Dalgaard M, Vinggaard AM, Axelstad M, Metzdorff SB, Kortenkamp A. Combined exposure to anti-androgens exacerbates disruption of sexual differentiation in the rat. Environ Health Perspect 2007; 115 Suppl 1:122-8. [PMID: 18174960 PMCID: PMC2174404 DOI: 10.1289/ehp.9360] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 12/04/2006] [Indexed: 05/19/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether the joint effects of three androgen receptor antagonists (vinclozolin, flutamide, procymidone) on male sexual differentiation after in utero and postnatal exposures can be predicted based on dose-response data of the individual chemicals. METHODS Test chemicals and mixtures were administered by gavage to time-mated nulliparous, young adult Wistar rats from gestational day 7 to the day before expected birth, and from postnatal days 1-16. Changes in anogenital distance (AGD) and nipple retention (NR) in male offspring rats were chosen as end points for extensive dose-response studies. Vinclozolin, flutamide, and procymidone were combined at a mixture ratio proportional to their individual potencies for causing retention of six nipples in male offspring. RESULTS With AGD as the end point, the joint effects of the three anti-androgens were essentially dose additive. The observed responses for NR were slightly higher than those expected on the basis of dose addition. A combination of doses of each chemical, which on its own did not produce statistically significant AGD alterations, induced half-maximal mixture effects. At individual doses associated with only modest effects on NR, the mixture induced NR approaching female values in the males. CONCLUSIONS Effects of a mixture of similarly acting anti-androgens can be predicted fairly accurately on the basis of the potency of the individual mixture components by using the dose addition concept. Exposure to anti-androgens, which individually appears to exert only small effects, may induce marked responses in concert with, possibly unrecognized, similarly acting chemicals.
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Affiliation(s)
- Ulla Hass
- Danish Institute for Food and Veterinary Research, Department of Toxicology and Risk Assessment, Soborg, Denmark.
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