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Sample records for breast seed implant

  1. Permanent Breast Seed Implant Dosimetry Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Brian M., E-mail: Brian.Keller@sunnybrook.ca [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Ravi, Ananth [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Sankreacha, Raxa [Carlo Fidani Regional Cancer Center, Mississauga, ON (Canada); Pignol, Jean-Philippe [Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada)

    2012-05-01

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose-volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V{sub 90}, V{sub 100}, V{sub 150}, and V{sub 200} were as follows: 98.8% {+-} 1.2% (range, 94.5-100%); 97.3% {+-} 2.1% (range, 90.3-99.9%), 68.8% {+-} 14.3% (range, 32.7-91.5%); and 27.8% {+-} 8.6% (range, 15.1-62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V{sub 100} changed from 85.6% to 88.4% (p = 0.004) and the mean V{sub 200} changed from 36.2% to 48.3% (p < 0.001). Skin toxicity was associated with maximum skin dose (p = 0.014). Conclusions: Preplanning dosimetry should aim for a V{sub 90} of approximately 100%, a V{sub 100} between 95% and 100%, and a V{sub 200} between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 Multiplication-Sign 1-cm{sup 2} surface area, should be limited to 90% of the

  2. Permanent Breast Seed Implant Dosimetry Quality Assurance

    International Nuclear Information System (INIS)

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose–volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V90, V100, V150, and V200 were as follows: 98.8% ± 1.2% (range, 94.5–100%); 97.3% ± 2.1% (range, 90.3–99.9%), 68.8% ± 14.3% (range, 32.7–91.5%); and 27.8% ± 8.6% (range, 15.1–62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V100 changed from 85.6% to 88.4% (p = 0.004) and the mean V200 changed from 36.2% to 48.3% (p 90 of approximately 100%, a V100 between 95% and 100%, and a V200 between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 × 1-cm2 surface area, should be limited to 90% of the prescription dose to minimize delayed skin toxicity.

  3. Online gamma-camera imaging of 103Pd seeds (OGIPS) for permanent breast seed implantation

    Science.gov (United States)

    Ravi, Ananth; Caldwell, Curtis B.; Keller, Brian M.; Reznik, Alla; Pignol, Jean-Philippe

    2007-09-01

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq 103Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  4. Online gamma-camera imaging of {sup 103}Pd seeds (OGIPS) for permanent breast seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Ravi, Ananth [Department of Medical Biophysics, University of Toronto (Canada); Caldwell, Curtis B [Department of Medical Biophysics, University of Toronto (Canada); Keller, Brian M [Medical Physics, Sunnybrook Health Sciences Centre (Canada); Reznik, Alla [Department of Medical Biophysics, University of Toronto (Canada); Pignol, Jean-Philippe [Department of Medical Biophysics, University of Toronto (Canada)

    2007-09-21

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq {sup 103}Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  5. Optimization of permanent breast seed implant dosimetry incorporating tissue heterogeneity

    Science.gov (United States)

    Mashouf, Shahram

    Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG43 formalism, which generates the dose in homogeneous water medium. Recently, AAPM task group no. 186 (TG186) emphasized the importance of accounting for heterogeneities. In this work we introduce an analytical dose calculation algorithm in heterogeneous media using CT images. The advantages over other methods are computational efficiency and the ease of integration into clinical use. An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of the source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. The dose distributions obtained through applying ICF to TG43 protocol agreed very well with those of Monte Carlo simulations and experiments in all phantoms. In all cases, the mean relative error was reduced by at least a factor of two when ICF correction factor was applied to the TG43 protocol. In conclusion we have developed a new analytical dose calculation method, which enables personalized dose calculations in heterogeneous media using CT images. The methodology offers several advantages including the use of standard TG43 formalism, fast calculation time and extraction of the ICF parameters directly from Hounsfield Units. The methodology was implemented into our clinical treatment planning system where a cohort of 140 patients were processed to study the clinical benefits of a heterogeneity corrected dose.

  6. Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast 103Pd seed implant

    Science.gov (United States)

    Afsharpour, Hossein; Pignol, Jean-Philippe; Keller, Brian; Carrier, Jean-François; Reniers, Brigitte; Verhaegen, Frank; Beaulieu, Luc

    2010-08-01

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast 103Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D90 reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D10 increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

  7. Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast {sup 103}Pd seed implant

    Energy Technology Data Exchange (ETDEWEB)

    Afsharpour, Hossein; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de recherche en cancerologie de l' Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, QC G1R 2J6 (Canada); Pignol, Jean-Philippe; Keller, Brian [Department of Radiation Oncology, Sunnybrook and Women' s Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Carrier, Jean-Francois [Departement de Radiologie, Radio-Oncologie et Medecine Nucleaire, Hopital Notre-Dame de CHUM, 1560 Sherbrooke E, Montreal, QC H2L 4M1 (Canada); Reniers, Brigitte; Verhaegen, Frank, E-mail: beaulieu@phy.ulaval.c [Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht (Netherlands)

    2010-08-21

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast {sup 103}Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D{sub 90} reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D{sub 10} increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

  8. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant

    Energy Technology Data Exchange (ETDEWEB)

    Furstoss, C.; Reniers, B.; Bertrand, M. J.; Poon, E.; Carrier, J.-F.; Keller, B. M.; Pignol, J. P.; Beaulieu, L.; Verhaegen, F. [Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Departement de Radio-Oncologie et Centre de Recherche du CHUM, Hopital Notre-Dame, 1560 rue Sherbrooke Est, Montreal, Quebec H2L 4M1 (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, CHUQ Pavillon L' Hotel-Dieu de Quebec, 11 Cote du Palais, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec G1K 7P4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands)

    2009-05-15

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of {sup 125}I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast {sup 125}I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V{sub 85}, V{sub 100}, and V{sub 200} for this kind of treatment in the target. D{sub 90} and D{sub 50} were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT

  9. First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer

    International Nuclear Information System (INIS)

    Purpose: A new technique of adjuvant partial breast irradiation using 103Pd permanent breast seed implants (PBSI) is presented. The procedure is performed in a single 1-hour session under local anesthesia. Methods and Materials: Patients referred to a single institution for adjuvant radiotherapy after lumpectomy for an infiltrating ductal carcinoma ≤3 cm in diameter, surgical margin ≥2 mm, no extensive in situ carcinoma, no lymphovascular invasion, and minimal or negative lymph node involvement were offered a PBSI. Results: Between May and December 2004, 31 eligible patients underwent CT scan and ultrasound simulations assessing PBSI feasibility. Fifteen were excluded because of feasibility issues, and 16 received PBSI. A minimal peripheral dose of 90 Gy was prescribed to the planning target volume corresponding to the clinical target volume identified on the CT scan plus a margin of 1 cm. The procedure was well tolerated; 56% of the patients reported no pain during the procedure, and 46% of the patients developed National Cancer Institute Common Toxicity Criteria Grade 1 acute reaction. None experienced toxicity Grade 2 or 3. Conclusions: Permanent breast seed implantation seems feasible and well tolerated on these preliminary clinical data and represents an ultimate step in the reduction of treatment fraction for partial breast irradiation

  10. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery ... wait 1 to 3 months before the permanent breast implant is placed during the second stage. In the ... from your chest and replaces it with a breast implant. This surgery takes 1 to 2 hours. Before ...

  11. Photon counting readout pixel array in 0.18-μm CMOS technology for on-line gamma-ray imaging of 103palladium seeds for permanent breast seed implant (PBSI) brachytherapy

    Science.gov (United States)

    Goldan, A. H.; Karim, K. S.; Reznik, A.; Caldwell, C. B.; Rowlands, J. A.

    2008-03-01

    Permanent breast seed implant (PBSI) brachytherapy technique was recently introduced as an alternative to high dose rate (HDR) brachytherapy and involves the permanent implantation of radioactive 103Palladium seeds into the surgical cavity of the breast for cancer treatment. To enable accurate seed implantation, this research introduces a gamma camera based on a hybrid amorphous selenium detector and CMOS readout pixel architecture for real-time imaging of 103Palladium seeds during the PBSI procedure. A prototype chip was designed and fabricated in 0.18-μm n-well CMOS process. We present the experimental results obtained from this integrated photon counting readout pixel.

  12. BREAST IMPLANT SURFACE DEVELOPMENT

    OpenAIRE

    Valencia Lazenco, Anai Alicia

    2015-01-01

    Bilateral breast augmentation is one of the most common cosmetic surgical procedures carried out on women in the western world. Breast augmentation involves increasing the volume of a woman‘s breasts through surgery by placing a silicone implant in the subglandular or subpectoral cavity. Although a capsule forms inevitably around breast implants as a natural part of healing, it can cause significant morbidity if the capsule becomes firm and contracted, a condition known as breast capsular con...

  13. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...

  14. Breast fibromatosis associated with breast implants.

    Science.gov (United States)

    Seo, Yoon Nae; Park, Young Mi; Yoon, Hye Kyoung; Lee, Sun Joo; Choo, Hye Jung; Ryu, Ji Hwa

    2015-09-01

    Fibromatosis refers to an extra-abdominal desmoid tumor or aggressive fibromatosis. Breast fibromatosis can develop in association with the capsule around a breast implant, although reports of cases of fibromatosis associated with breast implants are rare. As the demand for breast augmentation has increased, it is important to understand the diseases associated with breast implants. In the present report, we describe a case of breast fibromatosis that developed adjacent to a breast implant and demonstrated a relatively well-defined border even though it invaded the surrounding structures. We also explore the specific imaging features for diagnosing breast fibromatosis in association with implants by reviewing previous literature.

  15. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...

  16. SU-E-J-215: Towards MR-Only Image Guided Identification of Calcifications and Brachytherapy Seeds: Application to Prostate and Breast LDR Implant Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Elzibak, A; Fatemi-Ardekani, A; Soliman, A; Mashouf, S; Safigholi, H; Ravi, A; Morton, G; Song, WY [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Han, D [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: To identify and analyze the appearance of calcifications and brachytherapy seeds on magnitude and phase MRI images and to investigate whether they can be distinguished from each other on corrected phase images for application to prostate and breast low dose rate (LDR) implant dosimetry. Methods: An agar-based gel phantom containing two LDR brachytherapy seeds (Advantage Pd-103, IsoAid, 0.8mm diameter, 4.5mm length) and two spherical calcifications (large: 7mm diameter and small: 4mm diameter) was constructed and imaged on a 3T Philips MR scanner using a 16-channel head coil and a susceptibility weighted imaging (SWI) sequence (2mm slices, 320mm FOV, TR/ TE= 26.5/5.3ms, 15 degree flip angle). The phase images were unwrapped and corrected using a 32×32, 2D Hanning high pass filter to remove background phase noise. Appearance of the seeds and calcifications was assessed visually and quantitatively using Osirix (http://www.osirix-viewer.com/). Results: As expected, calcifications and brachytherapy seeds appeared dark (hypointense) relative to the surrounding gel on the magnitude MRI images. The diameter of each seed without the surrounding artifact was measured to be 0.1 cm on the magnitude image, while diameters of 0.79 and 0.37 cm were measured for the larger and smaller calcifications, respectively. On the corrected phase images, the brachytherapy seeds and the calcifications appeared bright (hyperintense). The diameter of the seeds was larger on the phase images (0.17 cm) likely due to the dipole effect. Conclusion: MRI has the best soft tissue contrast for accurate organ delineation leading to most accurate implant dosimetry. This work demonstrated that phase images can potentially be useful in identifying brachytherapy seeds and calcifications in the prostate and breast due to their bright appearance, which helps in their visualization and quantification for accurate dosimetry using MR-only. Future work includes optimizing phase filters to best identify

  17. The ruptured PIP breast implant

    International Nuclear Information System (INIS)

    Public concern erupted about the safety of Poly Implant Prothèse (PIP) breast implants when it was revealed in 2011 that they contained an inferior, unlicensed industrial-grade silicone associated with a high rate of rupture. There followed national guidance for UK clinicians, which led to a considerable increase in referrals of asymptomatic women for breast implant assessment. In this review we discuss possible approaches to screening the PIP cohort and the salient characteristics of a ruptured implant

  18. The Evolution of Breast Implants.

    Science.gov (United States)

    Gabriel, Allen; Maxwell, G Patrick

    2015-10-01

    Breast augmentation remains one of the most common procedures performed in the United States. However, shape, feel, safety, and longevity of the implants remain important areas of research. The data provided by manufacturers show the safety and efficacy of these medical devices. Clinicians should strive to provide ongoing data and sound science to continue to improve clinical outcomes in the future. This article explores the evolution of breast implants with special emphasis on the advancement of silicone implants.

  19. Evaluation of breast silicone implants.

    Science.gov (United States)

    Brenner, R James

    2013-08-01

    While clinical evaluation of breast implants and their complications can identify capsule contracture and rupture of saline implants, the identification of silicone implant failure is best accomplished by silicone specific protocols for MRI with orthogonal acquisition. Such imaging can also help resolve other clinical problems. Following a brief overview of the history and development of commercial use of silicone implants and alternatives, this article outlines the approach toward optimal imaging and expected results.

  20. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten;

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether...... untreated ruptures are associated with changes over time in magnetic resonance imaging findings, serologic markers, or self-reported breast symptoms. A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic...... breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations...

  1. Silicone breast implants and platinum.

    Science.gov (United States)

    Wixtrom, Roger N

    2007-12-01

    Platinum, in a specific form, is used as a catalyst in the cross-linking reactions of the silicone gel and elastomer in breast implants. After manufacture, it remains in the devices at low-parts-per-million levels. Potential concerns have been raised as to whether this platinum might diffuse from silicone breast implants into the body and result in adverse health effects. The weight of evidence indicates that the platinum present is in its most biocompatible (zero valence) form, and the very minute levels (<0.1 percent) that might diffuse from the implants do not represent a significant health risk to patients. PMID:18090821

  2. An Uncommon Presentation of Breast Implant Rupture.

    Science.gov (United States)

    Koh, Eugene; Watson, David I; Dean, Nicola R

    2016-05-01

    Late periprosthetic seroma has lately been concerning for breast implant-associated anaplastic large cell lymphoma. The authors present an uncommon presentation of breast implant rupture with a seroma and skin rash forming 2 years after insertion of the implant. PMID:27579243

  3. [Management of breast cancer in a woman with breast implants].

    Science.gov (United States)

    Remacle, S; Lifrange, E; Nizet, J-L

    2015-01-01

    The incidence of breast cancer, currently one woman on eight, also concerns patients who underwent augmentation surgery. Breast implants have already been the subject of numerous publications concerning the risk of inducing breast cancer or of delaying its diagnosis; however, no significant causal relationship has been established. The purpose of this article is to assess the diagnostic and therapeutic consequences when breast cancer is identified in a patient with breast implants.

  4. [Evaluation of asymetric implants in breast cancer].

    Science.gov (United States)

    Fitoussi, A; Couturaud, B; Laki, F; Alran, S; Salmon, R J

    2005-10-01

    Since more than twenty years, methods of breast reconstruction using implants have continued to evolve in order to improve their aesthetic results. Shapes and materials of these implants have also evolved to obtain contours similar to that of the natural opposite breast. Therefore it can be considered that the use of asymmetric implants is the last step in implant technology before using made to measure implants. Asymmetric implants allow obtaining different contours in harmony to the different breast shapes according to the side, left or right, of the reconstructed breast which maximise the naturalness of the result. Such implants have an axis directed towards the exterior and lower part of the chest wall, are wider than high with a thinner part on their inner edge and a concave rear side moulding the curves of the chest wall. In our own experience, we placed more than 500 asymmetric implants. When analysing retrospectively the medical records of 156 patients, no distinctive features were observed when compared to symmetric classic implants in easiness in the surgical procedure or in complications except a slightly higher rate of seroma formation. When compared to usual implants the main benefits of asymmetric implants are: to offer a wider breadth, to slope down gently on their upper and inner sides according to their concave rear side, and therefore to better match subtle curves of a normal breast. Moreover such contours allow a distribution of the volume which fit better to the usual natural breast configuration of patients who underwent surgery for breast carcinoma. At last, such implants are easy to place and a very low rate of secondary rotation has been observed. In summary, for all these reasons, asymmetric implants, can be considered to be the class one in the choice of implants for breast reconstruction after breast surgery. PMID:16198040

  5. Cutaneous Silicone Granuloma Mimicking Breast Cancer after Ruptured Breast Implant

    Directory of Open Access Journals (Sweden)

    Waseem Asim Ghulam El-Charnoubi

    2011-01-01

    Full Text Available Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.

  6. Immunopathologic effects of silicone breast implants.

    OpenAIRE

    S.S. Teuber; Yoshida, S H; Gershwin, M E

    1995-01-01

    Silicone-gel breast implants have been associated with a myriad of autoimmune and connective tissue disorders by anecdotal reports and small observational series. To date, no prospective epidemiologic studies have been done to substantiate these observations, but an increasing body of literature is being developed and older studies are being recognized that point to immunotoxic or inflammatory effects of these breast implant components. The development of disease due to implants would depend ...

  7. Is a radiolucent breast implant needed

    International Nuclear Information System (INIS)

    Over 1 million American women have undergone augmentation mammoplasty. The silicone implants used create numerous technical difficulties during mammography. An American College of Radiology mammography phantom was used to assess the effect prototype implants have on resolution of microcalcifications and masses. Implants filled with silicone gel and/or saline had equal radiodensity and obscured all phantom artifacts. Implants filled with peanut oil and sunflower oil had equal radiolucency and allowed visualization of microcalcifications and several masses. The implant filled with gelatin was of intermediate radiodensity. A more radiolucent breast implant is possible, and further research is needed to define the best filter material and test its biocompatibility

  8. Magnetic resonance imaging of breast implants.

    Science.gov (United States)

    Shah, Mala; Tanna, Neil; Margolies, Laurie

    2014-12-01

    Silicone breast implants have significantly evolved since their introduction half a century ago, yet implant rupture remains a common and expected complication, especially in patients with earlier-generation implants. Magnetic resonance imaging is the primary modality for assessing the integrity of silicone implants and has excellent sensitivity and specificity, and the Food and Drug Administration currently recommends periodic magnetic resonance imaging screening for silent silicone breast implant rupture. Familiarity with the types of silicone implants and potential complications is essential for the radiologist. Signs of intracapsular rupture include the noose, droplet, subcapsular line, and linguine signs. Signs of extracapsular rupture include herniation of silicone with a capsular defect and extruded silicone material. Specific sequences including water and silicone suppression are essential for distinguishing rupture from other pathologies and artifacts. Magnetic resonance imaging provides valuable information about the integrity of silicone implants and associated complications.

  9. Dyspnea Associated with Silicone Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Katherine Rider

    2015-08-01

    Full Text Available We present a case of a 48-year-old woman with a significant history of atopy. She presented with a 1-month history of dyspnea on exertion. Pulmonary function testing was normal, with no obstruction or reversibility post-bronchodilation. Bilateral breast implant rupture was detected on further investigation for a left upper lobe nodule, and the patient underwent bilateral implant removal. There was an improvement in her respiratory symptoms. Systemic symptoms, labeled as “Autoimmune/Inflammatory Syndrome Induced by Adjuvants,” are known to be associated with breast implants, with 14% of women in a cohort developing autoimmune disease secondary to their implants. An improvement in symptoms has been demonstrated following breast implant removal.

  10. Reconstructive breast implantation after mastectomy for breast cancer

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R;

    2005-01-01

    BACKGROUND: Clinical reports have raised concern about local complications following breast implantation used in reconstructive or cosmetic surgery, but there is a shortage of epidemiological studies in this area. OBJECTIVE: To assess in a prospective epidemiological manner the occurrence of short......-term local complications in a nationwide implantation registry. DESIGN, SETTING, AND PARTICIPANTS: The Danish Registry for Plastic Surgery of the Breast prospectively collects preoperative, perioperative, and postoperative information on Danish women undergoing breast augmentation. Through the registry, we...... collected data on short-term local complications among 574 women who underwent postmastectomy reconstruction with breast implants from June 1, 1999, through July 24, 2003. MAIN OUTCOME MEASURES: Complication incidence rates. RESULTS: Thirty-one percent of the women who underwent initial implantation...

  11. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten;

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had......%, and a specificity of 97%. Correspondingly, the predictive value of a positive MRI examination was 99% and the predictive value of a negative MRI examination was 79%. CONCLUSIONS: We conclude that MRI is highly accurate for identification of silicone breast implant rupture, with a high sensitivity and specificity...

  12. Imaging of common breast implants and implant-related complications: A pictorial essay.

    Science.gov (United States)

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  13. Imaging of common breast implants and implant-related complications: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Amisha T Shah

    2016-01-01

    Full Text Available The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  14. Delayed breast reconstruction with implants after invasive breast cancer does not impair prognosis

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Düring, Maria; Henriksen, Trine Foged;

    2008-01-01

    We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women......We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women...

  15. Silicone Gel-Filled Breast Implants: Updated Safety Information

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Silicone Gel-Filled Breast Implants: Updated Safety Information Share ... Español When the Food and Drug Administration allowed silicone gel-filled breast implants back on the market ...

  16. Silicone breast implants and connective tissue disease

    DEFF Research Database (Denmark)

    Lipworth, Loren; Holmich, Lisbet R; McLaughlin, Joseph K

    2011-01-01

    The association of silicone breast implants with connective tissue diseases (CTDs), including systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and fibromyalgia, as well as a hypothesized new "atypical" disease, which does not meet established diagnostic criteria for any known...... CTD, has been extensively studied. We have reviewed the epidemiologic literature regarding an association between cosmetic breast implants and CTDs, with particular emphasis on results drawn from the most recent investigations, many of which are large cohort studies with long-term follow-up, as well...... as on those studies that address some of the misinformation and historically widespread claims regarding an association between breast implants and CTDs. These claims have been unequivocally refuted by the remarkably consistent evidence from published studies, as well as numerous independent meta...

  17. Immunopathologic effects of silicone breast implants.

    Science.gov (United States)

    Teuber, S S; Yoshida, S H; Gershwin, M E

    1995-01-01

    Silicone-gel breast implants have been associated with a myriad of autoimmune and connective tissue disorders by anecdotal reports and small observational series. To date, no prospective epidemiologic studies have been done to substantiate these observations, but an increasing body of literature is being developed and older studies are being recognized that point to immunotoxic or inflammatory effects of these breast implant components. The development of disease due to implants would depend on the interaction of genetic host factors so that only a few patients would potentially be at risk. Based on the example of other chemically mediated disorders, such as scleroderma in association with silica exposure, latency periods of more than 30 years before disease develops may be possible. Herein we review studies on silicone and immunity. PMID:7785255

  18. Breast implants under siege: an historical commentary.

    Science.gov (United States)

    Fisher, J C; Brody, G S

    1992-01-01

    Despite 3 decades of rapidly expanding application of polydimethylsiloxane as a relatively safe implantable biomaterial, the American public is being told by a vocal minority that its use in the breast implant may be dangerous. Most of the furor has been generated by consumer advocates with support of a handful of scientists who have expressed opinions, not well supported by facts, about the risks of these devices. These anxieties have been fueled in the public's mind by a media more interested in sensationalism than disciplined reporting. The controversy has complicated the regulatory process and has become politicized in the halls of State Legislatures and Congress. Remarkably, this controversy has not involved the many other biomedical applications of silicone. How has this controversy gathered momentum? What role has the government played and how have the professional, scientific, corporate, and patient communities responded to public concern? This discussion places the breast implant battle into an historical perspective. PMID:10171114

  19. Interference of breast implants with echocardiographic image acquisition and interpretation

    Directory of Open Access Journals (Sweden)

    Movahed Mohammad-Reza

    2007-02-01

    Full Text Available Abstract Echocardiography is one of the most important diagnostic testing in cardiology. The presence of a breast implant overlying heart can cause significant impairment of the echocardiographic acoustic window. Breast implants are increasing in popularity in the USA and the Federal Drug and Food Administration (FDA just approved silicone implants again. In this review, the impact of silicone breast implant on the echocardiographic image acquisition and interpretation is discussed.

  20. High-grade Angiosarcoma Associated with Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Nicolas R. Smoll, MBBS

    2013-04-01

    Full Text Available Summary: Since the serendipitous discovery that implanted polymers cause sarcomas in rats, much research has been conducted to prove or disprove a link between silicone breast implants and/or polymer-based materials and breast cancer. In light of an initial report that 35% of rats implanted with a variety of polymers developed fibrosarcomas, we report a case of primary angiosarcoma found in a patient presenting with bilateral rupture of gel-filled breast implants.

  1. Silicone Breast Implant and Automatic Implantable Cardioverter Defibrillator: Can They Coexist? A Case Report

    Science.gov (United States)

    Arik, Zaretski

    2016-01-01

    Summary: We present a case of a silicone breast implant rupture after insertion of an automatic implantable cardioverter defibrillator (AICD). A 51-year-old woman presented to our plastic surgery clinic to exchange her silicone breast implants. The patient underwent cosmetic mastopexy and breast augmentation in 2008. Because of recurrent myocardial infarctions and chronic heart failure, she underwent an insertion of an AICD in 2014 in which the left breast implant was hit. In this report, we discuss the first case of an AICD insertion, disrupting a breast implant. This case report illustrates the rare but real possibility of breast implant rupture after even minor surgical manipulation of the breast area. PMID:27622117

  2. Capsular Contracture In Silicone Breast Implants: Insights From Rat Models.

    Science.gov (United States)

    Vieira, Vilberto J; D'Acampora, Armando; Neves, Fernanda S; Mendes, Paulo R; Vasconcellos, Zulmar A DE; Neves, Rodrigo D'Eça; Figueiredo, Claudia P

    2016-09-01

    Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is a frequent complication in breast augmentation and reconstructive surgery, that requires invasive intervention. The inflammatory response to implanted mammary prostheses appears to be directly associated to capsular contracture. This review discusses the evidences from rat models studies, on the role of inflammation and fibrosis in capsular contraction and its relation to silicone breast implants surface.

  3. Lightweight breast implants: a novel solution for breast augmentation and reconstruction mammaplasty.

    Science.gov (United States)

    Govrin-Yehudain, Jacky; Dvir, Haim; Preise, Dina; Govrin-Yehudain, Orel; Govreen-Segal, Dael

    2015-11-01

    Breast augmentation and reconstruction mammaplasty have been in practice for decades and are highly prevalent surgeries performed worldwide. While overall patient satisfaction is high, common long-term effects include breast tissue atrophy, accelerated ptosis and inframammary fold breakdown. Increasing evidence attributes these events to the durative loading and compressive forces introduced by the breast implants. Mechanical challenges exceeding the elastic capacity of the breast tissue components, eventually lead to irreversible tissue stretching, directly proportional to the introduced mass. Thus, it is suggested that, contrary to long-standing dogmas, implant weight, rather than its volume, stands at the basis of future tissue compromise and deformation. A novel lightweight implant has been developed to address the drawbacks of traditional breast implants, which demonstrate equivalence between their size and weight. The B-Lite(®) breast implant (G&G Biotechnology Ltd., Haifa, Israel) design allows for a reduction in implant weight of up to 30%, while maintaining the size, form, and function of traditional breast implants. The CE-marked device can be effectively implanted using standard of care procedures and has been established safe for human use. Implantation of the B-Lite(®) breast implant is projected to significantly reduce the inherent strains imposed by standard implants, thereby conserving tissue stability and integrity over time. In summary, this novel, lightweight breast implant promises to reduce breast tissue compromise and deformation and subsequent reoperation, further improving patient safety and satisfaction.

  4. Effect of N+ implantation on rice IR36 seeds germination

    International Nuclear Information System (INIS)

    Effects of N+ implantation on germination of IR36(4N) seeds were studied. As a result of N+ implantation, (0-2 x 1016 cm-2), simulative effect on seed germination was observed in low dose. Germination rate, seedling amylase activity of treated samples are higher than that of CK, but seed survival rate and amylase activity of seedlings significantly decreased. Membrane permeability was increased when the dosage was increased to 4 x 1016 cm-2 and higher. The optimum N+ implantation dose for IR36(4N) breading is about 6.0 x 1016-8.0 x 1016 cm-2. (authors)

  5. Sci—Fri PM: Topics — 02: Evaluation of Dosimetric Variations in Partial Breast Seed Implant (PBSI) due to Patient Arm Position (Up vs. Down)

    Energy Technology Data Exchange (ETDEWEB)

    Watt, E [Department of Physics and Astronomy, University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Long, K [Tom Baker Cancer Centre, Calgary, AB (Canada); Husain, S [Tom Baker Cancer Centre, Calgary, AB (Canada); Department of Oncology, University of Calgary, Calgary, AB (Canada); Meyer, T [Department of Physics and Astronomy, University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Department of Oncology, University of Calgary, Calgary, AB (Canada)

    2014-08-15

    The planning for PBSI is done with the patient's ipsilateral arm raised, however, anatomical changes and variations are unavoidable as the patient resumes her daily activities, potentially resulting in significant deviations in implant geometry from the treatment plan. This study aims to quantify the impact of the ipsilateral arm position on the geometry and dosimetry of the implant at eight weeks, evaluated on post-plans using the MIM Symphony™ software (MIM Software, Cleveland, OH). The average dose metrics for the three patients treated at the TBCC thus far using rigid fusion and contour transfer for the arms up position were 76% for the CTV V100, 61% for the PTV V100, and 37% for the PTV V200; and for the arms down position 81% for the CTV V100, 64% for the PTV V100, and 42% for the PTV V200. Qualitative analysis of the post-implant CT for one of the three patients showed poor agreement between the seroma contour transferred from the pre-implant CT and the seroma visible on the post-implant CT. To obtain a clinically accurate plan for that patient, contour modifications were used, yielding improved dose metric averages for the arms-up position for all three patients of 87% for the CTV V100, 68% for the PTV V100, and 39% for the PTV V200. Overall, the data available shows that dosimetric parameters increase with the patient's arm down, both in terms of coverage and in terms of the hot spot, and accrual of more patients may confirm this in a larger population.

  6. Magnetic resonance imaging of trilucent TM breast implants

    International Nuclear Information System (INIS)

    AIM: To demonstrate the magnetic resonance imaging (MRI) appearances of intact and ruptured Trilucent TM implants with imaging and surgical correlation. The appearances of the implant transponder artefact are also described MATERIALS AND METHODS: A retrospective review of the MRI findings in 34 patients with bilateral subpectoral Trilucent TM breast implants (Lipomatrix, Inc./Collagen Aesthetics International Inc., Neuchatel, Switzerland) was performed. Patients under implant surveillance and those with suspected implant rupture formed the study group. Imaging findings were correlated with surgical appearances. RESULTS: Surgical correlation was available in 53% of patients. Fifty per cent (18/36) of implants were intact at surgery, 50% (18/36) of implants were ruptured. Of the 18 ruptured implants, 17 were intracapsular ruptures and one an extracapsular rupture. The sensitivity of MRI for detection of intracapsular rupture in Trilucent TM breast implants was 82% specificity 76%, positive predictive value 78%, negative predictive value 81% and accuracy 79% in this study group. No case of implant rupture was obscured by the transponder artefact. Four implants were found to have 'pseudocapsules' at surgery (5·9%), the implants were intact with fluid present between the implant and capsule. Only one pseudocapsule was demonstrated on MRI. CONCLUSION: Magnetic resonance imaging is currently the most accurate technique for diagnosis of implant rupture in Trilucent TM breast implants. Transponder artefact does not appear to interfere with the assessment of implant rupture. Elson, E. M. et al. (2002)

  7. Investigations of silicone breast implants with the NMR-MOUSE.

    Science.gov (United States)

    Krüger, Mirko; Schwarz, Annett; Blümich, Bernhard

    2007-02-01

    Silicone breast implants are used for breast augmentation and breast reconstruction. The issues of concern associated with such implants are: (a) the quality control of each implant before implantation, and (b) the detection of implant bleeding after implantation. We have studied the use of the Nuclear Magnetic Resonance-MObile Universal Surface Explorer (NMR-MOUSE) for the nondestructive testing of (a) the quality of implant shells, and (b) changes in implant gel due to leakage of body fluid into the implant. Depth profiles measured nondestructively through implant shells at different positions of each implant by the Profile NMR-MOUSE assured good reproducibility of the quality and thickness of different shell layers. The leakage of implants upon rupture was mimicked by observing changes in the transverse NMR relaxation time of the implant gel upon ingress of physiological saline solution and safflower oil through the rupture. Results demonstrate that nondestructive testing with unilateral NMR is a potential method for use in the quality control of implants and for the screening of implants for rupture after implantation. PMID:17275616

  8. Automated treatment planning engine for prostate seed implant brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To develop a computer-intelligent planning engine for automated treatment planning and optimization of ultrasound- and template-guided prostate seed implants. Methods and Materials: The genetic algorithm was modified to reflect the 2D nature of the implantation template. A multi-objective decision scheme was used to rank competing solutions, taking into account dose uniformity and conformity to the planning target volume (PTV), dose-sparing of the urethra and the rectum, and the sensitivity of the resulting dosimetry to seed misplacement. Optimized treatment plans were evaluated using selected dosimetric quantifiers, dose-volume histogram (DVH), and sensitivity analysis based on simulated seed placement errors. These dosimetric planning components were integrated into the Prostate Implant Planning Engine for Radiotherapy (PIPER). Results: PIPER has been used to produce a variety of plans for prostate seed implants. In general, maximization of the minimum peripheral dose (mPD) for given implanted total source strength tended to produce peripherally weighted seed patterns. Minimization of the urethral dose further reduced the loading in the central region of the PTV. Isodose conformity to the PTV was achieved when the set of objectives did not reflect seed positioning uncertainties; the corresponding optimal plan generally required fewer seeds and higher source strength per seed compared to the manual planning experience. When seed placement uncertainties were introduced into the set of treatment planning objectives, the optimal plan tended to reach a compromise between the preplanned outcome and the likelihood of retaining the preferred outcome after implantation. The reduction in the volatility of such seed configurations optimized under uncertainty was verified by sensitivity studies. Conclusion: An automated treatment planning engine incorporating real-time sensitivity analysis was found to be a useful tool in dosimetric planning for prostate

  9. The Effect of Breast Implants on Mammogram Outcomes.

    Science.gov (United States)

    Kam, Kelli; Lee, Esther; Pairawan, Seyed; Anderson, Kendra; Cora, Cherie; Bae, Won; Senthil, Maheswari; Solomon, Naveenraj; Lum, Sharon

    2015-10-01

    Breast cancer detection in women with implants has been questioned. We sought to evaluate the impact of breast implants on mammographic outcomes. A retrospective review of women undergoing mammography between March 1 and October 30, 2013 was performed. Demographic characteristics and mammogram results were compared between women with and without breast implants. Overall, 4.8 per cent of 1863 women identified during the study period had breast implants. Median age was 59 years (26-93). Women with implants were younger (53.9 vs 59.2 years, P breast tissue (72.1% vs 56.4%, P = 0.004) than those without. There were no statistically significant differences with regards to Breast Imaging Recording and Data System 0 score (13.3% with implants vs 21.4% without), call back exam (18.9% with vs 24.1% without), time to resolution of abnormal imaging (58.6 days with vs 43.3 without), or cancer detection rate (0% with implants vs 1.0% without). Because implants did not significantly affect mammogram results, women with implants should be reassured that mammography remains useful in detecting cancer. However, future research is required to determine whether lower call back rates and longer time to resolution of imaging findings contribute to delays in diagnosis in patients with implants.

  10. [Evaluation of asymmetric implants in breast augmentation surgery].

    Science.gov (United States)

    Fitoussi, A D; Couturaud, B

    2005-10-01

    Since more than 30 years, the quality of breast implants has continued to evolve in order to improve the aesthetic results of prosthetic augmentation. Shapes and materials of these implants have also evolved to obtain stronger and more reliable prostheses almost similar to the natural breast. Therefore it can be considered that the use of asymmetric implants is the last step in implant technology before using made to measure implants. Asymmetric implants allow obtaining different contours in harmony to the different breast shapes capable to reproduce faithfully, in all dimensions, the anatomy of the female breast, including the differences between each side which maximise the naturalness of the result. Such implants have an axis directed towards the exterior and lower part of the chest wall, are wider than high with a thinner part on their inner edge and a concave rear side moulding the curves of the chest wall. In our own experience, we placed between 2002 and 2004, asymmetric implants in 100 patients. Such implants were easy to place and no secondary rotation was observed. The control of secondary displacements even in case of prosthesis change seems to be linked to their concave rear side, roughness and asymmetry. When analysing retrospectively the medical records, no distinctive features were observed when compared to symmetric classic implants in easiness in the surgical procedure or in complications except a slightly higher rate of seroma formation. However asymmetric implants are less appropriate in case of major breast ptosis, patients being unsatisfied by the "too natural" breast shape. Moreover a high risk of secondary rotation seems to be real in such cases. In summary, for all these reasons, asymmetric implants, are gradually considered to be a first-rank choice for implants in breast augmentation cosmetic surgery. PMID:16198044

  11. Implantation of iodine-125 seed for head and neck carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the technological feasibility, efficacy and morbidity of 125I-seed implantation for head and neck cancer. Methods: Forty patients with head and neck cancer were treated with 125I-seed intersitial brachytherapy guided by uhrasound or CT. Among them thirty-six patients were performed under local anesthesia and four were under general anesthesia. Thirty-six patients were treated with 125I-seed implantation under ultrasound guidance and four cases under CT guidance. Seed needles were implanted in parallel with each other, 1-1.5 cm apart. Mick applicator was used to each needle to implant seed. The radioactive activity ranged 0.40-0.70 mCi, and the matched peripheral doses were 90-145 Gy. The mean number of 125I-seed was 3-84. Five cases received external beam irradiation one week after seed implantation, and the total doses were 45-50 Gy(200 cGy/f). All the cases were examined by X-ray or CT after implantation for quality evaluation and by routine chest X ray within twenty-four to forty-eight hours after seed implantation. Results: These patients were followed-up for 3-33 months. In 10 tongue carcinoma patients, complete response was shown in 3 cases, partial response in three cases, no change in three cases and progressive disease in one case. The local control rate was 60%, the median survival time was 11 monthes, and the one-year and two year survival rates were 87.50% and 35%, respectively. In 14 patients with recurrent cancer of head and neck the local control rate was 76.47% ,the one-year and two-year survival rates were 66.08% and 24%, respectively, and the median survival time was 9 months. In 16 patients with metastatic cancer of head and neck the local control rate was 95.23%, the one-year and two-year survival rates were 54.55% and 32.73%, and the median survival time was 9 months. One seed migrated to the maxilla and loss of seeds happened in two cases, but there was no clinically related mobidity. Conclusion: 125I-seed

  12. Psychological characteristics of Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Lipworth, Loren; Kjøller, Kim; Hölmich, Lisbet R;

    2009-01-01

    An excess of suicide among women with cosmetic breast implants compared with controls has consistently been reported in epidemiologic studies. We have evaluated psychological characteristics among 423 Danish women with cosmetic breast implants, compared with 414 controls. Odds ratios (OR) with 95......% confidence intervals (CI) for self-reported psychological symptoms were calculated using multiple logistic regression. Substantial excesses of all studied symptoms before implant surgery were reported among women with breast implants compared with women with other cosmetic surgery, whereas ORs for virtually......, the corresponding ORs for these 3 psychological symptoms after surgery were 0.9 (95% CI = 0.6-1.4), 1.0 (95% CI = 0.7-1.5), and 1.0 (95% CI = 0.6-1.5), respectively. In conclusion, women with cosmetic breast implants reported preoperative psychological symptoms indicative of depressive disorders substantially more...

  13. Mortality and suicide among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Jacobsen, Poul Harboe; Hölmich, Lisbet R; McLaughlin, Joseph K;

    2004-01-01

    disorders as measured by admission to a psychiatric hospital among women seeking cosmetic surgery. METHODS: Cohort study of 2761 women who underwent cosmetic breast implant surgery at private clinics of plastic surgery or public hospitals, 7071 women who underwent breast reduction surgery at public......BACKGROUND: Epidemiologic studies indicate that women with cosmetic breast implants have a significantly increased risk of suicide. Our objectives were to examine mortality among Danish women who underwent cosmetic breast implant surgery and to evaluate the baseline prevalence of psychopathological...... hospitals, and 1736 women who attended private clinics for cosmetic surgery other than breast implantation, between 1973 and 1995. Causes of death through 1999 were identified through the Danish Mortality Files. Information on admission to psychiatric hospitals prior to cosmetic surgery was obtained from...

  14. Study of the radiation effect in breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Moreno T, L. R.; Ramirez R, A., E-mail: lumor2000@yahoo.com.mx [Universidad Autonoma Metropolitana, Unidad Azcapotzalco, Departamento de Ciencias Basicas, Av. San Pablo No. 180, Col. Reynosa Tamaulipas, 02200 Mexico D. F. (Mexico)

    2013-10-01

    This breast cancer is one of the most important death causes in women. Among the more frequently medical treatment for advanced breast cancer is the mastectomy. This situation leads to silicone implants as an esthetic option. There have been cases in patients with implants where cancer was frequently detected, in which a conventional radiotherapy is required. In this work is presented a study of the probable adverse effects caused by the application of high power X-rays (6-10 MV) to the silicone implants and to the surrounding tissues. In the research carried out at the clinic, none Bolus effect was detected in patients with implants. Our results prescribe that in the case of patients with implants and frequent breast cancer, the removal of implants is not necessary due radiotherapy works directly in the damaged tissues. (Author)

  15. The clinical implications of poly implant prothèse breast implants: an overview.

    Science.gov (United States)

    Wazir, Umar; Kasem, Abdul; Mokbel, Kefah

    2015-01-01

    Mammary implants marketed by Poly Implant Prothèse (PIP) were found to contain industrial grade silicone and this caused heightened anxiety and extensive publicity regarding their safety in humans. These implants were used in a large number of patients worldwide for augmentation or breast reconstruction. We reviewed articles identified by searches of Medline, PubMed, Embase, and Google Scholar databases up to May 2014 using the terms: "PIP", "Poly Implant Prothèse", "breast implants" and "augmentation mammoplasty" "siloxanes" or "silicone". In addition the websites of regulating bodies in Europe, USA, and Australia were searched for reports related to PIP mammary implants. PIP mammary implants are more likely to rupture than other implants and can cause adverse effects in the short to the medium term related to the symptoms of rupture such as pain, lumps in the breast and axilla and anxiety. Based on peer-reviewed published studies we have calculated an overall rupture rate of 14.5% (383/2,635) for PIP implants. However, there is no evidence that PIP implant rupture causes long-term adverse health effects in humans so far. Silicone lymphadenopathy represents a foreign body reaction and should be treated conservatively. The long-term adverse effects usually arise from inappropriate extensive surgery, such as axillary lymph node dissection or extensive resection of breast tissue due to silicone leakage.

  16. Customized planning for radioactive 125I seed implantation

    International Nuclear Information System (INIS)

    Objective: To customize the optimal plans for radioactive 125I seeds volumetric implants in selected regular target volumes. Methods: 125I seeds were symmetrically and uniformly implanted into 3 spherical targets with the diameters of 1, 2 and 3 cm and 7 ellipsoidal targets with the 3 dimensions of 1 cm×1 cm×2 cm, 1 cm×1 cm×3 cm, 1 cm×2 cm×2 cm, 1 cm×2 cm×3 cm, 1 cm ×3 cm ×3 cm, 2 cm×2 cm×3 cm and 2 cm×3 cm×3 cm. The activity and inter-space of seeds were adjusted to obtain the conformal and uniform dose distribution, with the prescribed D90 (the dose delivered to 90% of the targets) greater than 145 Gy. The inter-space of seeds was changed from 1 cm to 0.75 cm, to improve the conformity and uniformity of dose distribution. Plan quality was assessed using homogeneity index (HI), external index (EI) and conformal index (CI). The activity and number of seeds implanted were also recorded and compared. Results: For the spherical target with the diameter of 1 cm, when seeds were implanted with the inter-space of 1 cm and 0.75 cm, the HI were 40.0% and 55.9%, the EI were 98.3% and 95.1%, the CI were 0.44 and 0.44, respectively. For the spherical target with the diameter of 3 cm and the target with the 3 dimensions of 1 cm × 2 cm × 2 cm, the implant with the inter-space of 1 cm provided better indices of HI, EI and CI than those with the inter-space of 0.75 cm. For the other targets, the implants with the inter-space of 0.75 cm provided better indices of EI and CI than those with the inter-space of 1 cm, although they displayed a little worse homogeneity in terms of HI. The activity per seed was 17.0-27.8 MBq and 30.0-58.8 MBq in the implants with the inter-spaces of 0.75 cm and 1 cm, respectively. 2-10 more seeds were needed in the implants with the inter-space of 0.75 cm. Conclusions: For the studied targets except the spherical targets with the diameter of 1 cm and 3 cm and the ellipsoidal target with the dimension of 1 cm × 2 cm × 2 cm, 125I seeds

  17. Sjögren’s syndrome after silicone breast implantation

    Science.gov (United States)

    Akyol, Lütfi; Önem, Soner; Özgen, Metin; Sayarlıoğlu, Mehmet

    2015-01-01

    Sjögren’s syndrome, an autoimmune disease characterized by lymphocytic infiltration of the lacrimal and salivary glands, leads to dryness of the mouth and eyes. Herein, we present a case of Sjögren’s syndrome that developed after silicone breast implantation. A cause-effect relationship between breast implantation and Sjögren’s syndrome has not been established. However, the possibility of such an association should be considered when a patient with silicone implants is admitted to the hospital for treatment of Sjögren’s syndrome.

  18. Silicone Breast Implants: A Rare Cause of Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Imam H. Shaik

    2015-01-01

    Full Text Available Pleural effusions are one of the rarest complications reported in patients with silicone gel filled breast implants. The silicone implants have potential to provoke chronic inflammation of pleura and subsequent pulmonary complications such as pleural effusion. Herein, we report a 44-year-old female who presented with left sided pleural effusion, six weeks after a silicone breast implantation surgery. The most common infectious, inflammatory, and malignant causes of pleural effusion were excluded with pleural fluid cytology and cultures. With recurrent effusion in the setting of recent surgery, the chemical reaction to silicone breast implants was sought and exploration was performed which revealed foreign body reaction (FBR to silicone material. The symptoms dramatically improved after the explantation.

  19. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction.

    Science.gov (United States)

    Kobraei, Edward M; Cauley, Ryan; Gadd, Michele; Austen, William G; Liao, Eric C

    2016-05-01

    There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches.

  20. Chemical fingerprinting of silicone-based breast implants.

    Science.gov (United States)

    Keizers, Peter H J; Vredenbregt, Marjo J; Bakker, Frank; de Kaste, Dries; Venhuis, Bastiaan J

    2015-01-01

    With millions of women worldwide carrying them, silicone-based breast implants represent a large market. Even though silicone breast implants already have a history of use of more than 50 years, the discussion on their safety has not yet come to an end. To improve safety assessment, regulatory authorities should have the availability of a set of tests to be able to determine parameters of implant identity and quality. Therefore, the gels and envelopes of various brands and types of silicone-based breast implants have been subjected to infrared, Raman and NMR spectroscopy. We show that by using a combination of complementary spectroscopic techniques breast implants of various origins can be distinguished on typical chemical hallmarks. It was found that typical silicone-based implants display a surplus of vinyl signals in the gel, cyclosiloxane impurities are tolerable at low levels only and a barrier layer is present in the implant envelope. The techniques presented here and the results obtained offer a good starting point for market surveillance studies. PMID:25459933

  1. Chemical fingerprinting of silicone-based breast implants.

    Science.gov (United States)

    Keizers, Peter H J; Vredenbregt, Marjo J; Bakker, Frank; de Kaste, Dries; Venhuis, Bastiaan J

    2015-01-01

    With millions of women worldwide carrying them, silicone-based breast implants represent a large market. Even though silicone breast implants already have a history of use of more than 50 years, the discussion on their safety has not yet come to an end. To improve safety assessment, regulatory authorities should have the availability of a set of tests to be able to determine parameters of implant identity and quality. Therefore, the gels and envelopes of various brands and types of silicone-based breast implants have been subjected to infrared, Raman and NMR spectroscopy. We show that by using a combination of complementary spectroscopic techniques breast implants of various origins can be distinguished on typical chemical hallmarks. It was found that typical silicone-based implants display a surplus of vinyl signals in the gel, cyclosiloxane impurities are tolerable at low levels only and a barrier layer is present in the implant envelope. The techniques presented here and the results obtained offer a good starting point for market surveillance studies.

  2. In vitro antimicrobial effects of grape seed extract on peri-implantitis microflora in craniofacial implants

    Institute of Scientific and Technical Information of China (English)

    Binit Shrestha; ML Srithavaj Theerathavaj; Sroisiri Thaweboon; Boonyanit Thaweboon

    2012-01-01

    To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Candida albicans (C. albicans) and clinical strains of S. aureus, Klebsiella pneumonia (K. pneumonia) and Candida parapsilosis (C. parapsilosis) by disk diffusion test. Minimum inhibitory concentrations (MIC) and minimum cidal concentrations (MCC) were determined using modified agar dilution millpore method. The extract was further combined with polyethylene glycol and propylene glycol, and was tested for antimicrobial effects. Results: Grape seed extract showed positive inhibitory effects with S. aureus at MIC of 0.625 mg/mL and MCC of 1.25 mg/mL respectively. However the extracts showed minimal or no reactivity against strains of E. coli, K. pneumonia, C. parapsilosis and C. albicans. The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus. Conclusions: The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skin-abutment interface of craniofacial implants.

  3. In vitro antimicrobial effects of grape seed extract on peri-implantitis microflora in craniofacial implants

    Institute of Scientific and Technical Information of China (English)

    Binit; Shrestha; M.L.Srithavaj; Theerathavaj; Sroisiri; Thaweboon; Boonyanit; Thaweboon

    2012-01-01

    Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.

  4. Suggestions on technical guide of implantation of radioactive seeds

    International Nuclear Information System (INIS)

    Implantation of radioactive seeds is an effective therapeutic option for the treatment of malignant tumors. With the development of imaging technique and the use of treatment planning system (TPS) it has been more and more employed in clinical settings. The technique has been widely practiced in various malignant tumors, such as prostate cancer, lung caner, pancreatic cancer, hepatocarcinoma, etc. In order to standardize the clinical application of this technology, the authors propose some suggestions concerning the management of radioactive seeds, the indications and contraindications as well as the method of operation as a technical guidance. (authors)

  5. The double capsules in macro-textured breast implants.

    Science.gov (United States)

    Giot, Jean-Philippe; Paek, Laurence S; Nizard, Nathanael; El-Diwany, Mostafa; Gaboury, Louis A; Nelea, Monica; Bou-Merhi, Joseph S; Harris, Patrick G; Danino, Michel A

    2015-10-01

    Breast implants are amongst the most widely used types of permanent implants in modern medicine and have both aesthetic and reconstructive applications with excellent biocompatibility. The double capsule is a complication associated with textured prostheses that leads to implant displacement; however, its etiology has yet to be elucidated. In this study, 10 double capsules were sampled from breast expander implants for in-depth analysis; histologically, the inner capsular layer demonstrated highly organized collagen in sheets with delamination of fibers. At the prosthesis interface (PI) where the implant shell contacts the inner capsular layer, scanning electron microscopy (SEM) revealed a thin layer which mirrored the three-dimensional characteristics of the implant texture; the external surface of the inner capsular layer facing the intercapsular space (ICS) was flat. SEM examination of the inner capsule layer revealed both a large bacterial presence as well as biofilm deposition at the PI; a significantly lower quantity of bacteria and biofilm were found at the ICS interface. These findings suggest that the double capsule phenomenon's etiopathogenesis is of mechanical origin. Delamination of the periprosthetic capsule leads to the creation of the ICS; the maintained separation of the 2 layers subsequently alters the biostability of the macro-textured breast implant.

  6. Long-term health status of Danish women with silicone breast implants

    DEFF Research Database (Denmark)

    Breiting, Vibeke B; Hölmich, Lisbet R; Brandt, Bodil;

    2004-01-01

    undergone breast reduction surgery and with 149 women from the general population. Breast implant and reduction surgeries were performed from 1973 to 1988 at one public hospital and one private plastic surgery clinic. Among women with breast implants, the average implantation time was 19 years, 60 percent...

  7. Microbial Load Analysis in Silicone Gel Breast Implants

    Directory of Open Access Journals (Sweden)

    Glaucia Cristina Mello Santos

    2010-06-01

    Full Text Available Silicone breast implants consist of biomaterials widely used in breast reconstitution surgeries or in mammary augmentation for esthetic reasons. A preliminary stage of the implant production process is vulcanization, which consists of heating the implant to 165±5°C for approximately 9 hours. The aim of this work was to evaluate the bioburden of silicone breast implants prior to the vulcanization process and the decline in bioburden due to this process, and to confirm the sterility of the gel contained in the membrane. Breast implant production stages were evaluated by microbial counting in different steps, according to the USP 32 methodology. To evaluation of decrease in microbial load, spores strips were introduced inside the implant, and after vulcanization cycles the strips were removed from the implant. The strips were transferred to tubes containing TSB, followed by incubation for 7 days at 30-35°C. The results obtained showed that the level of microbial contamination of gel implants is relatively low, and that vulcanization allowed for the inactivation of up to 108 spores. This study led us to the conclusion that vulcanization leaded to sterility of the gel inside the product. Thus, the final sterilizing process contributed to an increase in the Sterility Assurance Level 1. Keywords: Silicone. Breast implant. Sterilization. Dry heat. Vulcanization. Bioburden. RESUMO Análise da Carga Microbiana de Implantes Mamários de Silicone Os implantes mamários de silicone constituem-se em biomateriais que têm sido amplamente utilizados em cirurgias para reconstituição da mama ou para o aumento do tamanho da mama por motivos estéticos. Uma etapa preliminar do processo produtivo do implante é a vulcanização, que consiste no aquecimento do implante a 165±5°C por aproximadamente 9 horas. O objetivo deste estudo foi avaliar a carga microbiana dos implantes mamários de silicone antes do processo de vulcanização, o decaimento da carga

  8. Local complications after cosmetic breast implant surgery in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; McLaughlin, Joseph K; Pakkanen, Matti;

    2004-01-01

    Concerns regarding potential health effects of silicone breast implants have recently shifted from long-term illnesses to postoperative local complications. In this study, occurrence of local complications and treatment procedures were evaluated in a population of 685 Finnish women who received c...

  9. A novel curvilinear approach for prostate seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun K.; Dicker, Adam P.; Hutapea, Parsaoran; Darvish, Kurosh; Yu Yan [Department of Radiation Oncology, Leo Jenkins Cancer Center, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27834 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Department of Mechanical Engineering, Temple University, Philadelphia, Pennsylvania 19122 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States)

    2012-04-15

    Purpose: A new technique called ''curvilinear approach'' for prostate seed implantation has been proposed. The purpose of this study is to evaluate the dosimetric benefit of curvilinear distribution of seeds for low-dose-rate (LDR) prostate brachytherapy. Methods: Twenty LDR prostate brachytherapy cases planned intraoperatively with VariSeed planning system and I-125 seeds were randomly selected as reference rectilinear cases. All the cases were replanned by using curved-needle approach keeping the same individual source strength and the volume receiving 100% of prescribed dose 145 Gy (V{sub 100}). Parameters such as number of needles, seeds, and the dose coverage of the prostate (D{sub 90}, V{sub 150}, V{sub 200}), urethra (D{sub 30}, D{sub 10}) and rectum (D{sub 5}, V{sub 100}) were compared for the rectilinear and the curvilinear methods. Statistical significance was assessed using two-tailed student's t-test. Results: Reduction of the required number of needles and seeds in curvilinear method were 30.5% (p < 0.001) and 11.8% (p < 0.49), respectively. Dose to the urethra was reduced significantly; D{sub 30} reduced by 10.1% (p < 0.01) and D{sub 10} reduced by 9.9% (p < 0.02). Reduction in rectum dose D{sub 5} was 18.5% (p < 0.03) and V{sub 100} was also reduced from 0.93 cc in rectilinear to 0.21 cc in curvilinear (p < 0.001). Also the V{sub 150} and V{sub 200} coverage of prostate reduced by 18.8% (p < 0.01) and 33.9% (p < 0.001), respectively. Conclusions: Significant improvement in the relevant dosimetric parameters was observed in curvilinear needle approach. Prostate dose homogeneity (V{sub 150}, V{sub 200}) improved while urethral dose was reduced, which might potentially result in better treatment outcome. Reduction in rectal dose could potentially reduce rectal toxicity and complications. Reduction in number of needles would minimize edema and thereby could improve postimplant urinary incontinence. This study indicates that the

  10. Implantable magnetic nanocomposites for the localized treatment of breast cancer

    Science.gov (United States)

    Kan-Dapaah, Kwabena; Rahbar, Nima; Soboyejo, Wole

    2014-12-01

    This paper explores the potential of implantable magnetic nanocomposites for the localized treatment of breast cancer via hyperthermia. Magnetite (Fe3O4)-reinforced polydimethylsiloxane composites were fabricated and characterized to determine their structural, magnetic, and thermal properties. The thermal properties and degree of optimization were shown to be strongly dependent on material properties of magnetic nanoparticles (MNPs). The in-vivo temperature profiles and thermal doses were investigated by the use of a 3D finite element method (FEM) model to simulate the heating of breast tissue. Heat generation was calculated using the linear response theory model. The 3D FEM model was used to investigate the effects of MNP volume fraction, nanocomposite geometry, and treatment parameters on thermal profiles. The implications of the results were then discussed for the development of implantable devices for the localized treatment of breast cancer.

  11. Cancer risk among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Friis, Søren; Hölmich, Lisbet R; McLaughlin, Joseph K;

    2006-01-01

    -up of our earlier cohort study of Danish women with cosmetic breast implants by 7 years, yielding 30 years of follow-up for women with longest implant duration. The study population consisted of women who underwent cosmetic breast implant surgery at private clinics of plastic surgery (n = 1,653) or public...... hospitals (n = 1,110), and a control group of women who attended private clinics for other plastic surgery (n = 1,736), between 1973-95. Cancer incidence through 2002 was ascertained using the Danish Cancer Registry. Risk evaluation was based on computation of standardized incidence ratios (SIR) and Cox...... were found when directly comparing women who had implants at private clinics with women who attended private clinics for other plastic surgery, with rate ratios for cancer overall, breast cancer and non-melanoma skin cancer of 1.1 (95% CI = 0.8-1.6), 0.7 (95% CI = 0.4-1.3) and 1.5 (95% CI = 0...

  12. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival

    International Nuclear Information System (INIS)

    Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects. We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco–Oakland, in Seattle–Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnosed with early or unstaged first primary breast cancer between 1983 and 1989, treated with mastectomy. The women were followed for a median of 12.4 years (n = 4968). Breast implant usage was validated by medical record review. Cox proportional hazards models were used to estimate hazard rate ratios for survival time until death due to breast cancer or other causes for women with and without breast implants, adjusted for relevant patient and tumor characteristics. Twenty percent of cases received postmastectomy breast implants, with silicone gel-filled implants comprising the most common type. Patients with implants were younger and more likely to have in situ disease than patients not receiving implants. Risks of breast cancer mortality (hazard ratio, 0.54; 95% confidence interval, 0.43–0.67) and nonbreast cancer mortality (hazard ratio, 0.59; 95% confidence interval, 0.41–0.85) were lower in patients with implants than in those patients without implants, following adjustment for age and year of diagnosis, race/ethnicity, stage, tumor grade, histology, and radiation therapy. Implant type did not appear to influence long-term survival. In a large, population-representative sample, breast implants following mastectomy do not appear to confer any survival disadvantage following early-stage breast cancer in women younger than 65 years old

  13. Long-term cosmetic outcome after breast implantation

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Breiting, Vibeke B; Fryzek, Jon P;

    2007-01-01

    All women who underwent breast augmentation at 1 public and 1 private clinic in Denmark from 1973 to 1988, and available for follow-up, were invited to participate in a clinical study including a self-administered questionnaire, medical record abstraction, and a clinical examination. One hundred...... of the women (62%) had clinically significant capsular contracture, and only half of the study women were found to have satisfactory overall breast appearance at examination. In contrast, the majority of women reported satisfaction with their implant surgery (60%). The women tended to grade themselves more...

  14. And the Breast is History: Issues Surrounding FDA Regulation of Silicone Breast Implants

    OpenAIRE

    Simme, Jodi L.

    1995-01-01

    The breast implant crisis has raised serious issues for women. On one hand, it is difficult to argue against giving women the right to choose, especially when the choice involves their own bodies. Restricting freedom in that realm is politically unpopular these days. On the other hand, women have been harmed by the lack of conclusive health information and by deceptive and coercive messages sent by media, implant manufacturers and plastic surgeons. For women to benefit from their right to cho...

  15. Dosimetric results in implant and post-implant and low rate in brachytherapy prostate cancer with loose seeds and attached

    International Nuclear Information System (INIS)

    The objective is determine differences dosimetry statistics on the dosimetry of the implant and post-implant in brachytherapy of low rate with implants permanent in prostate using seed of 125-I loose and attached Both in lives and in the post-prostatic plans dosimetric coverage is good and restrictions in urethra and rectum for both groups of patients are met. Not migrating with joined is evident, as well as better dosimetric homogeneity. (Author)

  16. Studies on the physiologic effects of ion implantation on rice seed of single and twin seedlings

    International Nuclear Information System (INIS)

    Dry rice seeds of single and twin seedlings were treated by ion implantation. These seeds have differences as compared with control seeds in respect to the physilogic effects. The germination percentage and the survival seedling rate were lower than the check, but higher than those for γ-roy treated seeds. Ultra weak bioluminescence value of dry seeds treated by ion implantation was higher than that of the check, lower than that of seeds treated by γ-ray. The results also show that seeds treated by ion implantation possess a lower percentage of twin seedling than the comparisons do. It is worthy mentioning that there are more twin seedlings possessed independent two-mesocotyls which is a very meaningful apomictic material in rice selecting

  17. Use of silicone implants in reconstructive plastic surgery for breast cancer

    Directory of Open Access Journals (Sweden)

    D. D. Pak

    2012-01-01

    Full Text Available The paper considers procedures for reconstructive plastic operations, by using silicone implants, in patients with breast cancer. It analyzes 592 primary breast repairs and evaluates their aesthetic effects and complications. The surgical procedures are described.

  18. Cosmetic Breast Implants Linked to Suicide Risk

    Institute of Scientific and Technical Information of China (English)

    Patricia; Reaney; 陶秀耘

    2003-01-01

    选注者言:本文信息极为丰富。首先,我们得知当今美国的三大整容外科是:eyelid surgery,breast reduction and nose reshaping。其次,文章告诉读者,去年(2002年)美国施行隆胸手术的妇女达25万之众;再次,就是本文的标题所言,要求进行隆胸手术的女性中的自杀者比例高于不要求隆胸者。而且,更值得注意的是:If women have a psychological problem and they are given breast implantsthey will still have that problem.(假如一个女性存在心理问题,而且进行了隆胸手术,她们的心理问题依旧存在。)

  19. The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis

    OpenAIRE

    Schiff, Michal; Algert, Charles S; Ampt, Amanda; Sywak, Mark S.; Roberts, Christine L

    2014-01-01

    Background Cosmetic breast augmentation (breast implants) is one of the most common plastic surgery procedures worldwide and uptake in high income countries has increased in the last two decades. Women need information about all associated outcomes in order to make an informed decision regarding whether to undergo cosmetic breast surgery. We conducted a systematic review to assess breastfeeding outcomes among women with breast implants compared to women without. Methods A systematic literatur...

  20. Classical Hodgkin Lymphoma Arising Adjacent to a Breast Implant.

    Science.gov (United States)

    Ryan, Ciara; Ged, Yasser; Quinn, Fiona; Walker, Jan; Kennedy, John; Gillham, Charles; Pittaluga, Stefania; McDermott, Ronan; Vandenberghe, Elisabeth; Grant, Cliona; Flavin, Richard

    2016-08-01

    Breast implant-associated lymphoma has recently gained wide recognition. Anaplastic large cell lymphoma (ALCL) is the most frequently diagnosed subtype in this setting but the spectrum is broadening. A 66-year-old woman developed swelling and itch around her saline implant 6 years after its insertion. Imaging revealed a fluid collection surrounding the implant with an adjacent mass. Microscopy showed sclerotic tissue punctuated by discrete cellular nodules comprising small lymphocytes, eosinophils and interspersed large atypical Hodgkin Reed-Sternberg (HRS)-like cells. The HRS-like cells stained positively for CD30 and CD15 by immunohistochemistry. Small T-lymphocytes formed rosettes around HRS-like cells. Appearances were consistent with classical Hodgkin lymphoma (HL). Multiplex polymerase chain reaction demonstrated no clonal rearrangements of immunoglobulin or T-cell receptor genes, however, a t(14;18)(q32;q21)BCL2-JH translocation involving the major breakpoint region of the bcl2 gene was present. Staging positron emission tomography-computed tomography scan revealed FDG-avid masses in the right axilla and pelvis. Subsequent pathological examination identified low-grade follicular lymphoma (FL) with a t(14;18) translocation at these sites. To our knowledge, this is the first case of HL arising adjacent to a breast implant. An awareness of this diagnosis is important as classical HL, with its prominent mixed inflammatory background, may be overlooked as a reactive process when histologically assessing capsulectomy specimens. It is also important in the differential diagnosis for implant-associated ALCL as both contain large atypical CD30-positive cells highlighting the need for full immunohistochemical and molecular workup in such cases. This case also adds to the large body of literature regarding the association between HL and FL. PMID:26888955

  1. Long-term safety and effectiveness of style 410 highly cohesive silicone breast implants

    DEFF Research Database (Denmark)

    Hedén, Per; Bronz, Giorgio; Elberg, Jens Jørgen;

    2009-01-01

    of 163 subjects (approximately 70% had augmentation [n = 112], 15% had reconstruction [n = 25], and 15% had revision [n = 26]) underwent a physical examination followed by breast magnetic resonance imaging (MRI) for rupture detection. These subjects had been implanted for 5 to 11 years with at least one...... Style 410 shaped gel breast implant before examination. The secondary end points included lactation, reproductive and breast disease history before and after implantation, and quality-of-life measurements and complications after implantation. RESULTS: The implant rupture rate was 1.7% a median of 8...... years after implantation. Capsular contracture was the most common complication noted at the physical examination, occurring for 5.3% of implants, and there were no cases of grade 4 capsular contracture. The postimplantation rates for lactation and reproductive problems and breast disease were lower...

  2. Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants.

    Science.gov (United States)

    Malowany, Janet I; Kundu, Uma; Santiago, Lumarie; Krishnamurthy, Savitri

    2015-01-01

    Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

  3. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    NARCIS (Netherlands)

    N. Lindenblatt (Nicole); K. El-Rabadi (Karem); T. Helbich (Thomas); H. Czembirek (Heinrich); M. Deutinger (Maria); H. Benditte-Klepetko (Heike)

    2014-01-01

    textabstractBackground:Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI) of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Methods:Fi

  4. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Science.gov (United States)

    Seng, Piseth; Alliez, Antoine; Honnorat, Estelle; Menard, Amelie; Casanova, Dominique; Stein, Andreas

    2014-01-01

    Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France. PMID:26793446

  5. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  6. Self-reported musculoskeletal symptoms among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Kjøller, Kim; Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P;

    2004-01-01

    No epidemiological evidence of an association between silicone breast implants and connective tissue disease has been found. Based on case reports, it has been hypothesized that silicone breast implants may be associated with a unique rheumatic symptom cluster termed "atypical connective tissue d...

  7. Idiopathic pseudoaneurysm in a patient with breast implants

    DEFF Research Database (Denmark)

    Khorasani, Hoda; Eiberg, Jonas; Bigaard, Janne

    2016-01-01

    Aneurysms and pseudoaneurysms of the internal mammary artery (IMA) are rare and the etiology uncertain although iatrogenic causes have been described. A 64-year-old woman suffered hematoma and bleeding from a pseudoaneurysm probably originating from a branch of the right IMA 16 years after breast...... implant surgery. After clinical assessment, the patient underwent surgery with resection of the aneurysm and ligation of the arterial branch. No early postoperative complications were reported. Pseudoaneurysms in small vessels such as the IMA or its branches are not well described in the literature...

  8. Percutaneous implantation of (125)iodine seeds for treatment of portal vein tumor thrombosis in hepatocellular carcinoma.

    Science.gov (United States)

    Liu, Yan; Liu, Ruibao; Wang, Ping; Li, Shijie; Shen, Haiyang

    2015-08-01

    The aim of the study is to evaluate the practicability and therapeutic efficacy of (125)iodine seeds implantation percutaneously for portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC). Nineteen patients with HCC accompanied with PVTT received ultrasound-guided implantation of 8-30 (125)iodine seeds, 8 mm apart within the portal vein tumor thrombi. The patients were followed up postoperatively for a period of 3-22 months. The successful rates of the procedure, postoperative changes of liver and renal function, hemogram, complications and therapeutic response were monitored. (125)I seeds were successfully implanted in the portal veins in all patients without serious complications. During the follow-up period, the portal vein tumor thrombi all shrunk obviously. Percutaneous implantation of (125)iodine seeds into the portal vein is an effective and safe treatment for PVTT accompanying HCC.

  9. Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up

    OpenAIRE

    Castel, Nikki; Soon-Sutton, Taylor; Deptula, Peter; Flaherty, Anna; Parsa, Fereydoun Don

    2015-01-01

    Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six month...

  10. The analysis of proteome changes in sunflower seeds induced by N+ implantation

    Indian Academy of Sciences (India)

    Dong Guijun; Pan Weidong; Liu Gongshe

    2006-06-01

    In this work, the proteomic changes induced by N+ ion implantation were investigated using a sunflower seed model by a two-dimensional electrophoretic analysis. To further understand the changes of total protein irradiated with N+ ion, a proteomic analysis of N+ ion implantation seeds was developed. Among approximately 369 total protein spots displayed in 2-D gels, eight specific proteins were found in non-implanted seeds while four proteins were found in implanted seeds. Six proteins were used for MALDI-TOF MS analysis, of which only two had been reported before. The proteins designated as No. 29 showed 23.4% homology to MADS-box transcriptional factor HAM59, while No. 279 protein had 23.20% identity to homeobox-leucine zipper protein HAHB-4. The analysis of proteome changes induced by N+ implantation could provid a new clue to studing mutation mechanism of ion implantation. To our knowledge, this is the first report about the analysis of proteome changes induced by N+ implantation in sunflower seeds.

  11. Preparation and administration of I-125 labeled seeds for localization of nonpalpable breast lesions

    DEFF Research Database (Denmark)

    Langhans, Linnea; Klausen, Thomas Levin; Tvedskov, Tove Holst Filtenborg;

    2016-01-01

    Radioactive seed localization (RSL) is a new technique for surgical identification of nonpalpable breast lesions. We describe the preparation of the needle with I-125 seeds for ultrasound-guided deposition in breast lesions. In a feasibility study we investigated the minimum activity amount neede...

  12. BrachyView: multiple seed position reconstruction and comparison with CT post-implant dosimetry

    Science.gov (United States)

    Alnaghy, S.; Loo, K. J.; Cutajar, D. L.; Jalayer, M.; Tenconi, C.; Favoino, M.; Rietti, R.; Tartaglia, M.; Carriero, F.; Safavi-Naeini, M.; Bucci, J.; Jakubek, J.; Pospisil, S.; Zaider, M.; Lerch, M. L. F.; Rosenfeld, A. B.; Petasecca, M.

    2016-05-01

    BrachyView is a novel in-body imaging system utilising high-resolution pixelated silicon detectors (Timepix) and a pinhole collimator for brachytherapy source localisation. Recent studies have investigated various options for real-time intraoperative dynamic dose treatment planning to increase the quality of implants. In a previous proof-of-concept study, the justification of the pinhole concept was shown, allowing for the next step whereby multiple active seeds are implanted into a PMMA phantom to simulate a more realistic clinical scenario. In this study, 20 seeds were implanted and imaged using a lead pinhole of 400 μ m diameter. BrachyView was able to resolve the seed positions within 1–2 mm of expected positions, which was verified by co-registering with a full clinical post-implant CT scan.

  13. Silicone-selective multishot echo-planar imaging for rapid MRI survey of breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Yasuo; Kumita, Shinichiro; Kumazaki, Tatsuo [Nippon Medical School, Department of Radiology, Tokyo (Japan); Aoki, Ritsu [Nippon Medical School, Department of Plastic Surgery, Tokyo (Japan)

    2007-07-15

    The purpose of this study was to assess the usefulness of silicone-selective multishot echo-planar imaging (EPI) for the rapid magnetic resonance imaging (MRI) survey of breast implants. Twenty patients with bilateral breast implants underwent MRI. The use of inversion recovery and magnetization transfer pulses led to silicone-selective images. The rapid MRI survey required only 43 s, which accurately distinguished between silicone and non-silicone materials in the implants, and therefore induced the final MRI sequences appropriate for the detailed characterization of the implants. In 5 of the 20 patients, the rapid MRI survey showed implanted materials that were not indicated from clinical information. This silicone-selective multishot EPI allows a rapid survey of breast implants, which is useful to avoid unnecessary sequences in these patients. (orig.)

  14. A review of the use of silicone implants in breast surgery.

    Science.gov (United States)

    Chao, Albert H; Garza, Ramon; Povoski, Stephen P

    2016-01-01

    Breast implant surgery is one of the most commonly performed procedures in the field of plastic surgery. While silicone implants are now routinely used in breast surgery, they have previously been the subject of controversy. This was particularly true in the U.S., where there was a moratorium on their use from 1992 to 2006. Following subsequent scientific validation of their safety, silicone implants have re-gained widespread acceptance for clinical use. Modern implant design has aimed to optimize aesthetic outcomes while minimizing implant-related complications, such as capsular contracture and device rupture. One of the most significant advances has been the use of highly cohesive silicone which, through extensive cross-linking, maintains its shape within the body in the presence of physiologic forces. Overall, silicone breast implants are associated with a high degree of patient satisfaction and low rates of complications. Further independent research is necessary to better establish long-term outcomes.

  15. An automated, fast and accurate registration method to link stranded seeds in permanent prostate implants

    International Nuclear Information System (INIS)

    The geometry of a permanent prostate implant varies over time. Seeds can migrate and edema of the prostate affects the position of seeds. Seed movements directly influence dosimetry which relates to treatment quality.We present a method that tracks all individual seeds over time allowing quantification of seed movements. This linking procedure was tested on transrectal ultrasound (TRUS) and cone-beam CT (CBCT) datasets of 699 patients. These datasets were acquired intraoperatively during a dynamic implantation procedure, that combines both imaging modalities.The procedure was subdivided in four automatic linking steps. (I) The Hungarian Algorithm was applied to initially link seeds in CBCT and the corresponding TRUS datasets. (II) Strands were identified and optimized based on curvature and linefits: non optimal links were removed. (III) The positions of unlinked seeds were reviewed and were linked to incomplete strands if within curvature- and distance-thresholds. (IV) Finally, seeds close to strands were linked, also if the curvature-threshold was violated. After linking the seeds an affine transformation was applied. The procedure was repeated until the results were stable or the 6th iteration ended.All results were visually reviewed for mismatches and uncertainties. Eleven implants showed a mismatch and in 12 cases an uncertainty was identified. On average the linking procedure took 42 ms per case.This accurate and fast method has the potential to be used for other time spans, like Day 30, and other imaging modalities. It can potentially be used during a dynamic implantation procedure to faster and better evaluate the quality of the permanent prostate implant. (note)

  16. An automated, fast and accurate registration method to link stranded seeds in permanent prostate implants

    Science.gov (United States)

    Westendorp, Hendrik; Nuver, Tonnis T.; Moerland, Marinus A.; Minken, André W.

    2015-10-01

    The geometry of a permanent prostate implant varies over time. Seeds can migrate and edema of the prostate affects the position of seeds. Seed movements directly influence dosimetry which relates to treatment quality. We present a method that tracks all individual seeds over time allowing quantification of seed movements. This linking procedure was tested on transrectal ultrasound (TRUS) and cone-beam CT (CBCT) datasets of 699 patients. These datasets were acquired intraoperatively during a dynamic implantation procedure, that combines both imaging modalities. The procedure was subdivided in four automatic linking steps. (I) The Hungarian Algorithm was applied to initially link seeds in CBCT and the corresponding TRUS datasets. (II) Strands were identified and optimized based on curvature and linefits: non optimal links were removed. (III) The positions of unlinked seeds were reviewed and were linked to incomplete strands if within curvature- and distance-thresholds. (IV) Finally, seeds close to strands were linked, also if the curvature-threshold was violated. After linking the seeds an affine transformation was applied. The procedure was repeated until the results were stable or the 6th iteration ended. All results were visually reviewed for mismatches and uncertainties. Eleven implants showed a mismatch and in 12 cases an uncertainty was identified. On average the linking procedure took 42 ms per case. This accurate and fast method has the potential to be used for other time spans, like Day 30, and other imaging modalities. It can potentially be used during a dynamic implantation procedure to faster and better evaluate the quality of the permanent prostate implant.

  17. Idiopathic pseudoaneurysm in a patient with breast implants

    Science.gov (United States)

    Khorasani, Hoda; Eiberg, Jonas; Bigaard, Janne

    2016-01-01

    Aneurysms and pseudoaneurysms of the internal mammary artery (IMA) are rare and the etiology uncertain although iatrogenic causes have been described. A 64-year-old woman suffered hematoma and bleeding from a pseudoaneurysm probably originating from a branch of the right IMA 16 years after breast implant surgery. After clinical assessment, the patient underwent surgery with resection of the aneurysm and ligation of the arterial branch. No early postoperative complications were reported. Pseudoaneurysms in small vessels such as the IMA or its branches are not well described in the literature. Proper diagnosis with imaging is of importance in order to determine treatment as each case is unique. Some cases can be managed conservatively. PMID:27470014

  18. Inferior dermoglandular flap for autologous breast remodeling following explantation of breast implants in ptotic breasts: a case report and literature search

    Directory of Open Access Journals (Sweden)

    Umar Daraz Khan

    2015-04-01

    Full Text Available Explantation following aesthetic mammoplasty without implant replacement is quite uncommon and often leaves the patient worse off than prior to mammoplasty. A case is presented here in which patient's own tissue was used as an inferior dermoglandular flap for autologous breast remodeling. Inferior dermal flap has been described for breast reconstruction and simultaneous augmentation mammoplasty with mastopexy for prosthesis cover in the lower pole of the breast, but its use following explantation without implant replacement has not been described for breast remodeling and volume conservation.

  19. The temperature effect of low-energy ion beam implantation on seed

    International Nuclear Information System (INIS)

    The temperature effects of low-energy ion beam implantation on the seed germination were studied. Maize dry seeds were covered with copy paper, aluminum foil and without cover, respectively. Results showed that the germination rate of the seeds covered with paper which was the bad heat transmitter was the highest among three treatments, while that covered with aluminum foil which can transmit heat energy well was the least. The germination rate of the seeds covered with nothing was the second. Temperature affected seeds germination markedly. Generally the temperature of the target room inhibited the seeds' germination. After minus the effects of the temperature in the target room, the germination rates of the seeds were modified in this paper. The modified germination rate curve was also provided. (authors)

  20. Urinary morbidity following ultrasound-guided transperineal prostate seed implantation

    International Nuclear Information System (INIS)

    Purpose: To assess the urinary morbidity experienced by patients undergoing ultrasound-guided, permanent transperineal seed implantation for adenocarcinoma of the prostate. Methods and Materials: Between September 1992 and September 1997, 693 consecutive patients presented with a diagnosis of clinically localized adenocarcinoma of the prostate, and were treated with ultrasound-guided transperineal interstitial permanent brachytherapy (TPIPB). Ninety-three patients are excluded from this review, having received neoadjuvant antiandrogen therapy. TPIPB was performed with 125I in 165 patients and with 103Pd in 435 patients. Patients treated with implant alone received 160 Gy with 125I (pre TG43) or 120 Gy with 103Pd. One hundred two patients received preimplant, pelvic external beam radiation (XRT) to a dose of either 41.4 or 45 Gy because of high-risk features including PSA ≥ 10 and/or Gleason score ≥ 7. Combined modality patients received 120 Gy and 90 Gy, respectively for 125I or 103Pd. All patients underwent postimplant cystoscopy and placement of an indwelling Foley catheter for 24-48 h. Follow-up was at 5 weeks after implant, every 3 months for the first 2 years, and then every 6 months for subsequent years. Patients completed AUA urinary symptom scoring questionnaires at initial consultation and at each follow-up visit. Urinary toxicity was classified by the RTOG toxicity scale with the following adaptations; grade 1 urinary toxicity was symptomatic nocturia or frequency requiring none or minimal medical intervention such as phenazopyridine; grade 2 urinary toxicity was early obstructive symptomatology requiring alpha-blocker therapy; and grade 3 toxicity was considered that requiring indwelling catheters or posttreatment transurethral resection of the prostate for symptom relief. Log-rank analysis and Chi-square testing was performed to assess AUA score, prostate size, isotope selection, and the addition of XRT as possible prognosticators of postimplant

  1. Algorithm and techniques for using Sientra's silicone gel shaped implants in primary and revision breast augmentation.

    Science.gov (United States)

    Schwartz, Michael R

    2014-07-01

    With the 2006 Food and Drug Administration approval of round silicone gel breast implants in the United States, there still remained a lack of versatility in implant options. The approval of Sientra's shaped cohesive implants in 2012 brought with it the innovations needed to address varying patient needs. Because access to shaped devices is still fairly recent in the United States, some surgeons remain uncomfortable with implementing shaped cohesive gel implants into their practice. The author outlines surgical techniques and algorithms from experience with the Sientra shaped device, covering the preoperative stage, measurements (base diameter, sternal notch to nipple, tissue pinch, and nipple to inframammary fold), ideal first candidates, operative techniques, and complication avoidance, as well as important factors for shaped-implant selection, including chest base diameter, implant height, implant volume, and implant projection for the patient's desired outcome. With experience, surgeons will find new utility with shaped implants for a variety of patients in their practices.

  2. Adverse health outcomes in offspring of mothers with cosmetic breast implants : A review

    NARCIS (Netherlands)

    Kjoller, Kim; Friis, Soren; Lipworth, Loren; McLaughlin, Joseph K.; Olsen, Jorgen H.

    2007-01-01

    Background: To assess whether maternal cosmetic breast implants are associated with adverse health outcomes among offspring, the authors examined published findings of epidemiologic studies that addressed this hypothesis. Methods: Four epidemiologic studies, ail from Scandinavia, were identified. Wo

  3. Five-year Safety Data for Eurosilicone’s Round and Anatomical Silicone Gel Breast Implants

    Directory of Open Access Journals (Sweden)

    Franck Duteille, MD

    2014-04-01

    Conclusions: Eurosilicone S.A.S. prospective study involving 1010 Eurosilicone silicone gel breast implants in both round and shaped profiles demonstrated a low rupture rate and an excellent safety profile through 5 years.

  4. Radiotherapy for breast cancer is not associated with increased risk of cied implantation

    DEFF Research Database (Denmark)

    Johansen, J. B.; Rehammar, J. C.; Jorgensen, O. D.;

    2015-01-01

    Introduction: Radiotherapy is an important treatment in early stage breast cancer but it is claimed that radiotherapy causes damage to the cardiac conduction system and increases the risk implantation of CIED (pacemaker or ICD). However, this paradigm is based on smaller series of case reports. Due...... to the anatomy, radiotherapy will potential mainly affect the conduction system in left sided breast cancer. The aim of this study was to evaluate risk of implantation of a CIED subsequent to radiotherapy for breast cancer by comparing left- versus right sided radiotherapy in a nationwide cohort. Methods: From...... the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to radiotherapy. The rate...

  5. Silicone gel breast implant adverse event reports to the Food and Drug Administration, 1984-1995.

    OpenAIRE

    Brown, S.L.; Parmentier, C M; Woo, E K; Vishnuvajjala, R L; Headrick, M L

    1998-01-01

    OBJECTIVES: To characterize the adverse event reports on silicone gel breast implants (SGBIs), including death reports, submitted to the Food and Drug Administration (FDA) from 1984 through 1995 and to analyze changes in the type and complexity of reports following extensive media coverage of breast implants. METHODS: The authors analyzed mandatory and voluntary reports from the adverse events reporting system for medical devices at the FDA. RESULTS: In 1988, adverse event reports related to ...

  6. Dosimetric response of radioactive bio glass seeds implants on rabbit brain

    International Nuclear Information System (INIS)

    Interstitial implants of radioactive seeds are used as an efficient way of treating brain tumors. Bio glasses is an interesting alternative to the metallic implanted materials, because they can be absorbed by the organism, reducing the possibilities of side effects. The present paper investigates the dosimetry by the implants performed on rabbit's brain on the NRI/UFMG research group. The spatial distribution of the specific ionizing energy deposited per unit of mass generated by Sm-153 seeds were evaluated. A computational model of the brain's region was built using the software SISCODES produced by the research group. The sections of the computer tomography of a rabbit, which was included on the experiment, were digitalized. Those were converted in a three dimensional voxel model, including the tissues, its chemical composition and density. A simulation of the particles transport is performed by the stochastic code MCNP5. The implants consist of 15 ceramic Ca-Si-Sm seeds enriched with Sm-153, with 1.1.6 mm of length and 0.3 mm diameter, implanted on the rabbit's brain. It was predicted on the model three ribbons of 5 seeds each, spaced by 1.1.2 mm, since the ribbons were in a triangular topology whose vertices were spaced by 8 mm. The activities were 120 MBq/seed. The results show isodose regions superposed over the rabbits' model, reproducing the spatial energy deposition on the brain region. The absorbed dose predicted was 3.2 Gy per 15 seed; however it was not enough to tumor control. The authors suggest to increase the number of seeds and activity, reduction of the space to 5-6 mm among ribbons, improving dose with the beta emitting. (author)

  7. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Ooi ASH

    2016-09-01

    Full Text Available Adrian SH Ooi,1,2 David H Song1 1Section of Plastic and Reconstructive Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA; 2Department of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, Singapore Abstract: Implant-based procedures are the most commonly performed method for ­postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. Keywords: implant infection, risk reduction, acellular dermal matrix

  8. Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation

    Directory of Open Access Journals (Sweden)

    Sur Monalisa

    2009-04-01

    Full Text Available Abstract Background Primary non-Hodgkin lymphoma (NHL of the breast represents 0.04–0.5% of malignant lesions of the breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL is a rare T-cell lymphoma typically seen in children and young adults with the breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the breast described in the literature. Eight of these cases occurred in proximity to breast implants, four in relation to silicone breast implant and three in relation to saline filled breast implant with three out of the eight implant related cases having previous history of breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML, the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude

  9. Use of gentamicin collagen sponges for the treatment of periprosthetic breast implant infection

    NARCIS (Netherlands)

    O. Lapid

    2011-01-01

    The infection of a breast implant or tissue expander is a major complication with significant psychological and medical ramifications. The incidence has been reported to range from 1.1% in cosmetic augmentations to as high to 24% in a series of reconstructive cases. Gentamicin Surgical Implant is a

  10. Clinical efficacy of CT-guided 125I seed implantation therapy for advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical efficacy of CT-guided radioactive 125I seed implantation treatment for unresectable pancreatic cancer. Methods: Forty patients with inoperable pancreatic cancer were enrolled in this study, including 25 males and 15 females with an median age of 69 years (38-89 years). Treatment planning system (TPS) was used to reconstruct 3-dimensional images of pancreatic tumor and to define the quantity and distribution of 125I seeds. The radioactivity of 125I seeds was 0.5 - 0.8 mCi / seed. The seeds were implanted into pancreatic tumor under CT guidance at intervals of 1 cm and were kept away from vessels, pancreatic duct and other adjacent important organs. The tumor matched peripheral dose (MPD) was 60-140 Gy. The median amount of implanted 125I seeds was 36 (18-68) in number. CT scan was performed immediately after the procedure to check the quality of the seeds. In addition, 10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluororacil (5-Fu) for 3 to 4 therapeutic courses. Results: The median diameter of the tumors was 4.9 cm. The follow-up period was 2 to 28 months. After the treatment the refractory pain was significantly relieved (P 125I seed implantation is a safe, effective and minimally-invasive brachytherapy for unresectable pancreatic cancer with reliable short-term efficacy. It has an excellent anti-pain effect. The curative results can be further improved when chemotherapy is employed together. However, its long-term efficacy needs to be observed. (authors)

  11. Breast implant rupture and connective tissue disease: a review of the literature

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Lipworth, Loren; McLaughlin, Joseph K;

    2007-01-01

    Large-scale epidemiologic studies to date have not found any credible association between silicone breast implants and either well-defined connective tissue diseases or undefined or atypical connective tissue diseases. It has been hypothesized that implant rupture could prompt an immunologic reac...... reaction giving rise to autoimmune or related diseases. In this article, the authors review the available literature on implant ruptures and connective tissue disease....

  12. Peri-implant galactocele following vacuum-assisted core biopsy of the breast: a cautionary tale

    OpenAIRE

    Taylor, Donna; Kulawansa, Sagarika Thushanthi; McCallum, Dugald Dalziel; Saunders, Christobel

    2013-01-01

    A lactating woman in her early 40s with a strong family history of breast cancer presented with a markedly swollen breast days after having a vacuum-assisted core biopsy performed to sample indeterminate microcalcifications in her left breast. Ultrasound showed a large peri-implant fluid collection which yielded milky fluid on aspiration consistent with galactocele formation. Histology of the core specimens revealed a fragment of fibrous capsule suggesting that the core biopsy had created a f...

  13. Aging of retrieved gel breast implants: a comparison between two product generations.

    Science.gov (United States)

    Bodin, F; Jung, C; Dieval, F; Chakfe, N; Wisniewski, S; Bruant Rodier, C; Heim, F

    2015-06-01

    In order to get a marketing authorization, breast implants (BI) must meet a number of standard requirements. French and European standards ISO 14607 list a number of official tests to be performed before an implant can be used clinically. However, the BI material characteristics evolution over implantation time remains a research field which is unexplored. The goal of the present study is to compare the mechanical ageing of two breast implant generations and assess if the use of one generation rather than the other is advantageous in terms of durability. For that purpose, 21 explanted BI were analyzed in terms of biomechanical characteristics and compared. Twelve BI were textured anatomic specimens of 5th generation and 10 BI were round textured specimens of 4th generation. All the specimens were produced by the same manufacturer. Implantation time ranged from 3 to 130 months. Both the shell and the gel of every specimen were analyzed. Results show that the mechanical properties go down with the implantation time for all the implants. Moreover, the shell of round implants appear to be less resistant than the shell of anatomic specimens with 25% lower rupture forces. With regard to the gel, whatever the specimen, results show that the properties change with implantation time. The color changes from transparent to milky to finally become yellow, while the cohesion goes down especially for the round specimens. Globally, the study brings out that BI get degraded with implantation time and provides information which could help predicting the durability of the implant.

  14. CT-guided 125I Radioactive Seed Implantation on Regional Lymph Node Metastasis after Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Shi Liangrong; Wu Jun; Jiang Jingting; Wu Changping

    2013-01-01

    Objective:To evaluate the safety and short-term effect of CT-guided 125I radioactive seed implantation on regional lymph node metastasis after gastrectomy. Methods:Twenty-three patients with regional lymph node metastasis after gastrectomy received CT-guided 125I radioactive seed implantation from June, 2007 to July, 2011 in our hospital. The overall activity and amount of radioactive seeds were calculated by simulating source distribution of radioactive seed implantation plan system before operation. 125I seeds were implanted under the guidance of CT. Effective rate was evaluated according to RECIST criterion, 1, 2 and 3 years of survival rates were calculated by life table method, the effect of relative factors on survival was tested by univariate COX model, and the survival differences between subgroups were compared to draw survival curve by log-rank method. Additionally, systemic therapies were given to 20 patients based on lfuorouracil drugs. Results:No severe complications was observed in all study subjects with 14 complete remission (60.9%), 5 particle remission (21.7%) and 4 progressive diseases (17.4%), while 1, 2 and 3 years of survival rates as well as median survival time being (87±7)%,(47±11)%, (13±9)% and (22.1±5.1) months, respectively. Univariate COX analysis showed that the maximum diameter of tumor could badly inlfuence the prognosis (χ2=9.752, P=0.002), and the subgroups analysis relieved the signiifcant difference (χ2=5.828, P=0.016, log-rank test) with 3 cm being the cut-off value. Conclusion:CT-guided 125I radioactive seed implantation has high local control rate with small trauma and slight complications.

  15. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

    Science.gov (United States)

    Ooi, Adrian SH; Song, David H

    2016-01-01

    Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

  16. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions.

    Science.gov (United States)

    Ooi, Adrian Sh; Song, David H

    2016-01-01

    Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

  17. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    International Nuclear Information System (INIS)

    Highlights: ► We analyzed biological effects of N+ implantation on dry Jatropha curcas seed. ► N+ implantation greatly decreased seedling survival rate. ► At doses beyond 15 × 1016 ion cm−2, biological repair took place. ► CAT was essential for H2O2 removal. POD mainly functioned as seed was severely hurt. ► HAsA–GSH cycle mainly contributed to the regeneration of HAsA. - Abstract: To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N+ with energy of 25 keV was applied to treat the dry seed at six different doses. N+ beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 × 1016 to 15 × 1016 ions cm−2 severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 × 1016 ion cm−2, biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 × 1016 ions cm−2 may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA–GSH cycle appeared to be for regeneration of HAsA.

  18. An Alternative Technique for Immediate Direct-to-Implant Breast Reconstruction—A Case Series

    Science.gov (United States)

    Hedges, Kellee

    2016-01-01

    Background: The practice of breast reconstruction continues to evolve with the introduction of new technologies. The authors describe a unique approach allowing immediate direct-to-implant reconstruction that can be performed on an outpatient basis. Methods: After a nipple-sparing mastectomy, acellular dermal matrix (ADM)-covered implants are placed in a prepectoral position in an immediate reconstruction. Assessment of results was performed via a retrospective review of demographic and procedural data. Results: Forty-five patients (79 breasts), mean age 46.8 years, were treated with direct-to-implant reconstruction using ADM-wrapped implants placed above the muscle with mean follow-up of 23.1 months (median 22 mo). Mean body mass index was 24.3, and 15 patients (33.3%) were current or former smokers. Twenty-seven patients (60%) had prior breast surgery with 22 (49%) exposed to chemotherapy and 34 (76%) radiation. Procedure time averaged 155 minutes and hospital length of stay averaged 0.6 days. Complications included flap necrosis in 22 cases (28%), seroma in 12 (15%), infection in 8 (10%), rippling in 28 (35%), and contracture in 8 (10%). In 14 breasts (18%), postoperative wound complications (flap necrosis or infection) led to implant loss. Conclusions: The availability of ADM and cohesive gel implants has allowed us to perform above-the-muscle implant breast reconstruction in reduced time and often on an outpatient basis. Complication rates were comparable to expected results of standard expander-to-implant, staged breast reconstruction. This technique is a viable option delivering clinically and aesthetically acceptable results in select patients. PMID:27536500

  19. Study on Treating Glioblastoma with 125I Seed Implantation during Operations

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To evaluate the therapeutic efficacy of treating glioblastoma with interstitial irradiation using radioactive seeds.METHODS First, the tumor was removed as completely as possible under an operating microscope. Then 125I seeds which had been selected were implanted in the tumor bed followed by routine radiotherapy after the operation. The time of progression (TTP) and overall survival (OS) of the patients were recorded, and statistically compared with patients who had received only surgery and radiotherapy for glioblastoma during the same period.RESULTS Nineteen patients, who were diagnosed with glioblastoma for the first time, with a mean age of 51.2 years, were involved in this study.Radioactive seeds (8~20) were implanted into the tumor bed after tumorectomy with a mean surrounding therapeutic dose of 31.6 Gy, followed by an external irradiation dose of 42~54 Gy. The average TTP in the group with implanted seeds was 42.1±2.4 w (95% confidence interval, 37.2~46.5 w), and 27.1±2.7 w (95% confidence interval, 24.3~31.8 w) in the control group. The average OS was 66.3±3.2 w (95% confidence interval, 61.9~70.4 w) and 47.7±2.6 w (95% confidence interval, 44.4~50.5 w), respectively. Statistical analysis showed there was a significant difference between two groups.CONCLUSION The survival time of patients with glioblastoma can be prolonged through radioactive seed implantation at the time of operation.This therapeutic method can rapidly reduce the tumor volume with a minimum number of seeds to avoid excessive radiation exposure. Because of some shortcomings of this study, such as a small number of patients, and because implantation was performed under the naked eye so that the seed alignment could not be verified accurately, the experience of combining implantation of seeds with external irradiation needs to be investigated further.

  20. Measurement uncertainty analysis of low-dose-rate prostate seed brachytherapy: post-implant dosimetry.

    Science.gov (United States)

    Gregory, Kent J; Pattison, John E; Bibbo, Giovanni

    2015-03-01

    The minimal dose covering 90 % of the prostate volume--D 90--is arguably the most important dosimetric parameter in low-dose-rate prostate seed brachytherapy. In this study an analysis of the measurement uncertainties in D 90 from low-dose-rate prostate seed brachytherapy was conducted for two common treatment procedures with two different post-implant dosimetry methods. The analysis was undertaken in order to determine the magnitude of D 90 uncertainty, how the magnitude of the uncertainty varied when D 90 was calculated using different dosimetry methods, and which factors were the major contributors to the uncertainty. The analysis considered the prostate as being homogeneous and tissue equivalent and made use of published data, as well as original data collected specifically for this analysis, and was performed according to the Guide to the expression of uncertainty in measurement (GUM). It was found that when prostate imaging and seed implantation were conducted in two separate sessions using only CT images for post-implant analysis, the expanded uncertainty in D 90 values were about 25 % at the 95 % confidence interval. When prostate imaging and seed implantation were conducted during a single session using CT and ultrasound images for post-implant analysis, the expanded uncertainty in D 90 values were about 33 %. Methods for reducing these uncertainty levels are discussed. It was found that variations in contouring the target tissue made the largest contribution to D 90 uncertainty, while the uncertainty in seed source strength made only a small contribution. It is important that clinicians appreciate the overall magnitude of D 90 uncertainty and understand the factors that affect it so that clinical decisions are soundly based, and resources are appropriately allocated.

  1. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Genebes, Caroline, E-mail: genebes.caroline@claudiusregaud.fr [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Filleron, Thomas; Graff, Pierre [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Jonca, Frédéric [Department of Urology, Clinique Ambroise Paré, Toulouse (France); Huyghe, Eric; Thoulouzan, Matthieu; Soulie, Michel; Malavaud, Bernard [Department of Urology and Andrology, CHU Rangueil, Toulouse (France); Aziza, Richard; Brun, Thomas; Delannes, Martine; Bachaud, Jean-Marc [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France)

    2013-11-15

    Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3 urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes.

  2. CT guided radioactive seed 125I implantation in treating hilar hepatic tumor and metastatic lymph nodes

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of CT guided radioactive seed 125I implantation in treating hilar hepatic tumor and metastatic lymph nodes. Methods: 32 patients with pancreatic cancer accepted CT guided radioactive seeds 125I implantation were enrolled in this study. The average tumor dimension was 4.2 cm. In this series, there were 8 cases of hepatocellular carcinoma, 12 cases of hilar cholangio carcinoma, 6 cases of hepatic metastasis and 6 of hepatic hilar tumor and metastatic lymph nodes. Among these patients, 14 cases had cholangiectasis and 22 cases had cirrhosis. Under CT guidance, 125I seeds of 0.6-0.9 mCi were implanted into the pancreatic cancer at a distance of 1.0-1.5 cm according to TPS. Results: Two cases died on account of metastasis and three died through liver function failure. Among CT followed-up of 32 patients in 2 months, 2 obtained CR, 20 obtained PR, 5 NC and 5 PD. The responsive rate was 68.8%. The side effects occurred during the procedure including pneumothorax in 1 case with lung compression less than 30%; 7 seeds migration in liver and 3 seeds in lung. WBC decreased slightly in 1 cases during 2 months follow up. No massive bleeding, biliary fistula, intestinal fistula, intestinal hemorrhage, acute pancreatitis, enterorrhagia and intra-abdominal abscess were encountered. Conclusions: CT guided radioactive seed 125I implantation procedure is a safe and effective method in treating hilar hepatic tumor and metastatic lymph nodes with good clinical effects of minimal damage and few complications. (authors)

  3. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim;

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...... an MRI examination. Twenty-four of 109 implants were clinically diagnosed with possible rupture or rupture. Eighteen of the 24 implants were ruptured according to the MRI examination (75%). Eighty-five implants were clinically classified as intact, and 43 of these were actually ruptured at MRI (51...... to identify implant rupture, neither the sensitivity nor the specificity is acceptable....

  4. Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective.

    Science.gov (United States)

    Ben-David, Merav; Granot, Hila; Gelernter, Ilana; Scheflan, Michael

    2016-01-01

    Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts, heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50Gy. For plans excluding IMN coverage, mean Dmean for right and left reconstructed breasts was 49.09Gy (98.2% of the prescribed dose) and 48.51Gy (97.0%), respectively. For plans including IMNs, mean Dmean was 49.15Gy (98.3%) for right and 48.46Gy (96.9%) for left reconstructed breasts; the mean IMN Dmean was 47.27Gy (right) and 47.89Gy (left). Heart Dmean was below 1.56Gy for all plans. Mean total lung volume receiving a dose of ≥ 20Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.

  5. Physico-chemical characteristics of coated silicone textured versus smooth breast implants differentially influence breast-derived fibroblast morphology and behaviour.

    Science.gov (United States)

    Valencia-Lazcano, Anai A; Alonso-Rasgado, Teresa; Bayat, Ardeshir

    2014-12-01

    Capsule formation is an inevitable consequence of silicone breast implantation. Clinically challenging dense fibrocollagenous capsular contractures occur at different rates between smooth compared to textured surfaces. Host response is influenced by several factors including implant surface texture, chemistry and interactions between cells and the extracellular matrix (ECM). Specific coatings can modify the physico-chemical properties of implant surfaces eliciting specific cellular reactions. Therefore, we evaluated the physico-chemical characteristics of coated smooth versus textured silicone breast implants on breast-derived fibroblast morphology and behaviour using (a) confocal laser microscopy, (b) Raman spectroscopy and (c) the effect of four unique protein and glycosaminoglycan (GAG) coatings (aggrecan, collagen I, fibronectin and hyaluronic acid) on breast-derived fibroblast attachment, proliferation, morphology, spreading, cytotoxicity and gene expression. Collagen I, fibronectin and hyaluronic acid coatings exhibited satisfactory fibroblast adhesion (pimplants demonstrated improved cell proliferation than uncoated surfaces (pbreast fibroblasts following the application of specific coatings on breast implant surfaces.

  6. Estimation of breast implant volumes: error assessment of the subjective judgment method

    Directory of Open Access Journals (Sweden)

    Henseler, Helga

    2016-01-01

    Full Text Available Background: The degree of error in subjective estimation of breast implant volume remains unknown. Methods: Nine silicone breast implants were used by 16 examiners for subjective, blinded, implant volume estimation. The figures on the stamps were taken as the true breast implant volumes for comparison. The examiners were divided into two groups of equal size: experienced examiners (consultant breast surgeons and unexperienced examiners (trainees. Fourteen examiners repeated the tests after about 2 weeks.Results: In both groups of doctors, the implant volumes were underestimated by a mean ± standard deviation of 61.6 ± 58.1 cc (21.9% ± 20.1% in the first test and 37.9 ± 59.1 cc (13.6% ± 20.7% in the second test. The absolute deviation independent of volume overestimation or underestimation was 77.3 ± 36.9 cc (27.2% ± 12.8% in the first test and 58.1 ± 41.3 cc (20.6% ± 14.6% in the second test. In terms of absolute figures, the experienced examiners showed significantly better results than did the unexperienced examiners during the first test. The unexperienced examiners showed increasing deviations with increasing implant volumes. The degree of estimation error was lower in the second test.Conclusions: These blinded subjective estimations of breast implant volume exhibited limited accuracy and reproducibility. Estimation errors were quantified and increased with increasing implant volumes. Experienced examiners performed considerably better than unexperienced examiners, and results of the second test were better in both groups. The subjective volume estimations deviated from the true volumes by around 70 cc (underestimated by around 50 cc.Level of evidence: Level III

  7. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    Directory of Open Access Journals (Sweden)

    Lindenblatt N

    2014-07-01

    Full Text Available Nicole Lindenblatt,1 Karem El-Rabadi,2 Thomas H Helbich,2 Heinrich Czembirek,3 Maria Deutinger,4 Heike Benditte-Klepetko5 1Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland; 2Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna - General Hospital Vienna, 3Department of Radiology, Hospital Wiener Privatklinik, 4Department of Plastic and Reconstructive Surgery, Hospital Rudolfstiftung, Vienna, Austria; 5Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands Background: Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Methods: Fifty consecutive patients with 85 silicone gel implants were included in the study. The mean age of the patients was 51 (range 21–72 years, with a mean duration of implantation of 3.8 (range 1–28 years. All patients underwent clinical examination and breast MRI. Intraoperative implant rupture was diagnosed by the operating surgeon. Results: Nineteen of the 50 patients suffered from clinical symptoms. An implant rupture was diagnosed by MRI in 22 of 85 implants (26%. In seven of 17 removed implants (41%, the intraoperative diagnosis corresponded with the positive MRI result. However, only 57% of these patients were symptomatic. Ultrasound imaging of the harvested implants showed signs of interrupted inner layers of the implant despite integrity of the outer shell. By microsurgical separation of the different layers of the implant shell, we were able to reproduce this phenomenon and to produce signs of implant rupture on MRI. Conclusion: Our results show that rupture of only the inner layers of the implant shell with integrity of

  8. Anaplastic large cell lymphoma (ALCL) and breast implants: breaking down the evidence.

    Science.gov (United States)

    Ye, Xuan; Shokrollahi, Kayvan; Rozen, Warren M; Conyers, Rachel; Wright, Penny; Kenner, Lukas; Turner, Suzanne D; Whitaker, Iain S

    2014-01-01

    Systemic anaplastic large cell lymphoma (ALCL) is a distinct disease classification provisionally sub-divided into ALCL, Anaplastic Lymphoma Kinase (ALK)(+) and ALCL, ALK(-) entities. More recently, another category of ALCL has been increasingly reported in the literature and is associated with the presence of breast implants. A comprehensive review of the 71 reported cases of breast implant associated ALCL (iALCL) is presented indicating the apparent risk factors and main characteristics of this rare cancer. The average patient is 50 years of age and most cases present in the capsule surrounding the implant as part of the periprosthetic fluid or the capsule itself on average at 10 years post-surgery suggesting that iALCL is a late complication. The absolute risk is low ranging from 1:500,000 to 1:3,000,000 patients with breast implants per year. The majority of cases are ALK-negative, yet are associated with silicone-coated implants suggestive of the mechanism of tumorigenesis which is discussed in relation to chronic inflammation, immunogenicity of the implants and sub-clinical infection. In particular, capsulotomy alone seems to be sufficient for the treatment of many cases suggesting the implants provide the biological stimulus whereas others require further treatment including chemo- and radiotherapy although reported cases remain too low to recommend a therapeutic approach. However, CD30-based therapeutics might be a future option.

  9. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim;

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...

  10. The Impact of Breast Implant Location on the Risk of Capsular Contraction

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Sørensen, Jens Ahm

    2016-01-01

    developing CC with subglandular compared to submuscular placement of the breast implant. METHODS: A total of 1,283 studies were identified from December 2003 to December 2013 by PUBMED and MEDLINE searches and a manual search strategy. Two levels of screening resulted in 10 studies suitable for meta......-analysis, providing data on a total of 17,520 breast implants. All statistical calculations were performed with Review Manager (RevMan) version 5.2.7. RESULTS: Random-effect (RE) pooled relative risk (RR) and confidence intervals (CI) were calculated for capsular contraction. The risk of developing capsular....... CONCLUSION: This analysis demonstrated a more than 2-fold increase in the risk of capsular contraction with subglandular compared to submuscular breast implant location.Clinical Question: Risk....

  11. Silicone granuloma from ruptured breast implants as a cause of cervical lymphadenopathy.

    Science.gov (United States)

    Borghol, K; Gallagher, G; Skelly, B L

    2016-09-01

    A 56-year-old woman with a 10-year history of bilateral silicone breast implants presented to the ear, nose and throat outpatient clinic with a 2-month history of a right-sided neck lump. She was found to have a 1.3cm supraclavicular lymph node that gave the clinical impression of being reactive. Ultrasonography guided fine needle aspiration was inconclusive and initial review of subsequent computed tomography failed to identify a cause. This was followed by excisional biopsy of the lymph node, which revealed a silicone granuloma that was linked to a ruptured right-sided breast implant placed ten years previously. This case highlights the importance for otolaryngologists to consider silicone granuloma among the differential diagnoses of cervical lymphadenopathy in patients with a history of silicone breast implants. Recognising this differential diagnosis could avoid undue anxiety for patient and clinician regarding more serious pathology.

  12. Interstitial implantation as a radiation boost for high risk patients treated with breast conservation therapy

    International Nuclear Information System (INIS)

    Purpose: As part of a prospective institutional protocol for breast conservation treatment which employed aggressive therapy to the tumor-bearing quadrant, interstitial implantation was the preferred method of boost after 50.4 Gy whole breast irradiation for 'high risk' patients with tumor margins ≤ 2 mm. An analysis of clinical outcomes with respect to local tumor control and breast cosmesis was performed. Patients and Methods: From 1982-1994, 128 patients received an implant boost and a comparison data base was drawn from a total experience of 501 treated breasts. The median age of the implanted patients was 51 yrs and the median follow-up was 75 mos (range 10-150 mos). The implant target volume was determined by clinical assessment of post-operative induration and pre- and post-excisional mammograms. All implants were constructed in accordance with a pre-planning algorithm designed to maximize dose homogeniety within a prescription isodose goal of 50 cGy/hr. Local control and cosmetic outcome were evaluated with respect to extent of tumor, histopathology, margin status, extent of surgery, and systemic adjuvant therapy. Implant quality was assessed using four calculated parameters: strand separation product (SSP), planar separation product (PSP), global separation product (GSP), and dose homogeneity index (DHI). The mean implant volume was 47.9 ± 20.2 cc, the mean prescribed dose rate was 46.2 ± 8.5 cGy/hr and the mean total implant dose was 1993.8 ± 151.0 cGy. The final excision margin was positive, >0<1 mm, 1-2 mm, and indeterminate in 50%, 19%, 21%, and 15%, respectively. Results: Cosmetic outcome was good/excellent in 91% of patients which was not statistically different from non-implant patients. Logistic regression analysis revealed that re-excision, elevated SSP, and decreased DHI were associated with adverse cosmesis. There were 10 local failures in the implanted patients (4 within the prescribed isodose volume, 5 at the periphery and 1 elsewhere in

  13. Application of "CD-4" Theory for Determining the Width of Implant in Breast Augmentation

    Institute of Scientific and Technical Information of China (English)

    Jie Cai; Yang Zhou

    2015-01-01

    Background:The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation.The aim of this study was to introduce a new method to determine the width of the implant (W) and explain the reasons to do so in details.Methods:From January 2006 to June 2014,the authors have found and applied "CD-4" theory to determine the width of breast implant (W) in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 560 patients."CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold.W =CD-4 (or 3.5) cm.Results:The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm.Their CDs are from 14.5 cm to 17 cm.About 78% of the patients have got followed up from 1 month to 5 years postoperatively.Except for four patients who got unilateral capsular contractions,all the other patients are satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm,and lateral borders of the breast are on the area of the AAL.Conclusions:W (width of the implant) =CD-4 (cm) when doing dual plan Ⅰ or Ⅱ breast augmentation.For the very thin patient,4 should be 3.5.

  14. Application of "CD−4" Theory for Determining the Width of Implant in Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Jie Cai

    2015-01-01

    Full Text Available Background: The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation. The aim of this study was to introduce a new method to determine the width of the implant (W and explain the reasons to do so in details. Methods: From January 2006 to June 2014, the authors have found and applied "CD −4" theory to determine the width of breast implant (W in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL on the lateral chest wall through the horizontal level on inferior mammary fold. W = CD − 4 (or 3.5 cm. Results: The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm. Their CDs are from 14.5 cm to 17 cm. About 78% of the patients have got followed up from 1 month to 5 years postoperatively. Except for four patients who got unilateral capsular contractions, all the other patients are satisfied with their nature new breast shapes and volumes. Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL. Conclusions: W (width of the implant = CD − 4 (cm when doing dual plan I or II breast augmentation. For the very thin patient, 4 should be 3.5.

  15. MRI evaluation of post-mastectomy irradiated breast implants: prevalence and analysis of complications

    International Nuclear Information System (INIS)

    Aim: To evaluate the effect of post-mastectomy radiation therapy (RT) on breast implants as detected by magnetic resonance imaging (MRI) searching for short-term complications. Materials and methods: One hundred and forty patients (total of 144 implants) were evaluated by MRI; 80 (group 1) had undergone RT, whereas the remaining 60 patients (group 2) underwent mastectomy with implant reconstruction without RT. Two radiologists evaluated MRI images searching for implant rupture signs, sub-capsular seromas, capsular contracture, soft-tissue oedema, peri-implant fluid collections. Implant ruptures were classified as severe complications; seromas and capsular contractures as moderate complications; oedema and fluid collections as mild complications. The prevalence of MRI findings in the two groups was calculated and compared by unpaired t-test. Cohen's kappa statistics was used to assess interobserver agreement. Results: Sixty-nine out of 144 (48%) implants presented pathological findings at MRI with complication rates of 47.5 and 48.4 for groups 1 and 2, respectively. Two (5%) severe complications, 10 (26%) moderate complications, and 26 (69%) mild complications occurred in group 1 and surgical treatment was performed in 10 cases. Two (6%) severe complications, seven (23%) moderate complications, and 22 (71%) mild complications occurred in group 2 and surgical treatment was performed in eight cases. No significant difference between the two groups was found (p>0.1). Almost perfect agreement between the two radiologists was found for MRI image detection (k=0.86). Conclusion: RT does not seem to cause a significant effect on breast implants in terms of complication rate in patients undergoing implant-based breast reconstruction. One-stage immediate implant-based breast reconstruction performed at the same time as mastectomy could be proposed. -- Highlights: •RT could increase complication rates of implant-based breast reconstruction (IBR). •No general consensus

  16. The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants.

    Science.gov (United States)

    Sampaio Goes, João Carlos; Munhoz, Alexandre Mendonça; Gemperli, Rolf

    2015-10-01

    This article presents an overview of the subfascial approach to primary and secondary breast augmentation with form-stable implants associated with autologous fat grafting. Although breast augmentation is a well-studied procedure, there are few previous reports concerning the subfascial technique and, especially, this technique associated with lipofilling. Consequently, the authors present their experience with a form-stable, anatomically shaped silicone gel breast implant, which has recently been approved in the United States following FDA clinical trials. Primary and secondary breast augmentations using form-stable implants resulted in satisfactory outcomes.

  17. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    Science.gov (United States)

    Xu, Gang; Wang, Xiao-teng; Gan, Cai-ling; Fang, Yan-qiong; Zhang, Meng

    2012-09-01

    To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N+ with energy of 25 keV was applied to treat the dry seed at six different doses. N+ beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 × 1016 to 15 × 1016 ions cm-2 severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 × 1016 ion cm-2, biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 × 1016 ions cm-2 may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA-GSH cycle appeared to be for regeneration of HAsA.

  18. Bilateral Breast Reconstruction with Extended Thoracodorsal Artery Perforator Propeller Flaps and Implants

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Børsen-Koch, Mikkel; Nielsen, Henrik Toft;

    2015-01-01

    We present our experience of bilateral total breast reconstruction using a double-sided extended thoracodorsal artery perforator propeller flap in a case series of 10 patients. Reconstruction was successfully achieved in all cases with few complications. The median time for surgery was 275 minutes...... (200-330), and the average implant size used was 350 cm(3) (195-650). We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium...

  19. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.;

    2015-01-01

    . Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early......-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on pacemaker implants subsequent to radiotherapy. Rate ratios (RR) of pacemaker implantation for left versus right sided breast cancer were calculated. Results: Among 18......,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a pacemaker implanted subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. The unadjusted RR was 1.02 (0.76-1.36 95% CI, p=0.91) and the RR adjusted for year, age and time since...

  20. Versatility of Capsular Flaps in the Salvage of Exposed Breast Implants

    Directory of Open Access Journals (Sweden)

    Beniamino Brunetti, MD

    2015-03-01

    Full Text Available Summary: Breast implant exposure due to poor tissue coverage or previous irradiation represents a surgical challenge both in the reconstructive and aesthetic plastic surgery practice. In case of implant extrusion or incipient exposure, the commonly suggested strategies, such as targeted antibiotic therapy, drainage and lavage of the cavity, fistulectomy, and primary closure, may be ineffective leading the surgeon to an unwanted implant removal or to adopt more invasive flap coverage procedures. Breast implant capsule, in its physiological clinical behavior, can be considered as a new reliable source of tissue, which can be used in a wide range of clinical situations. In our hands, capsular flaps proved to be a versatile solution not only to treat breast contour deformities or inframammary fold malpositions but also to salvage exposed breast implants. In this scenario, the use of more invasive surgical techniques can be avoided or simply saved and delayed for future recurrences.(Plast Reconstr Surg Glob Open 2015;3:e340; doi:10.1097/GOX.0000000000000307; Published online 30 March 2015.

  1. Linear 125I seeds strand implantation combined with biliary stenting for the treatment of malignant biliary obstruction

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic efficacy of linear 125I seeds strand implantation combined with biliary stenting in treating malignant biliary obstruction. Methods: Linear 125I seeds strand implantation combined with biliary stenting was carried out in 28 patients with malignant biliary obstruction. The technical success rate, the clinical efficacy, the postoperative complications and the survival rate were analyzed. Results: Both biliary stenting and 125I seeds strand implantation were successfully accomplished in all patients. No serious complications occurred. After the procedure the biliary obstruction symptoms were markedly improved and the bilirubin level was significantly reduced (P125I seeds strand implantation together with biliary stenting is safe and effective although its long-term efficacy needs to be further studied. (authors)

  2. Intrathoracic migration of a breast implant after minimally invasive cardiac surgery.

    Science.gov (United States)

    Songcharoen, Somjade Jay; McClure, Michael; Aru, Roberto G; Songcharoen, Somprasong

    2015-03-01

    The aging population, in combination with the popularity of breast augmentation with implants, presents surgeons with a growing number of cases involving women undergoing minimally invasive cardiac surgery (MICS) who have breast implants. We present an unusual complication involving the delayed migration of a subpectoral implant into the chest cavity through an iatrogenic defect after a minimally invasive mitral valve repair. This chest wall defect was ultimately repaired with a latissimus dorsi flap. Although MICS has been described in women with breast implants, the documented experience remains limited. Most authors classically recommend explantation of the prosthesis to provide access to the chest wall; however, some have later suggested preserving the implant capsule in situ while performing the cardiac procedure with gentle retraction. From our literature review and experience, we recommend that the posterior capsule should remain intact. If this is not possible, then the chest wall closure should be reinforced with either mesh, soft tissue, or both. Soft tissue options include the conversion from a subpectoral to a subglandular position to use the pectoralis major, or a latissimus dorsi muscle flap. With the increasing number of these cases along with the complexities of minimally invasive procedures, close communication and planning should be undertaken between both cardiothoracic and plastic surgeons when taking care of these patients. Above all, when faced with postoperative complications after MICS, the plastic surgeon must maintain a high index of clinical suspicion and consider the possibility of intrathoracic migration of an implant so that proper workup and planning may be initiated.

  3. Radiation protective nursing intervene of 125I seed implantation in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Lung cancer is the most common primary malignant tumor. Because most sufferers have already been in later stage in their first diagnosis, the lump body infringing upon the important organs often influences the excision of tumor. 125I seeds permanent implantation is a new method for tumor brachytherapy, which contributes to kill the tumor completely, ensures the normal physiological functions of organs,reduces tissue injuries and treatment of complications, and raises the survival rate of sufferers. The rapid promotion of this technique is also followed by radiation risks in the treatment. Currently, the researches of 125I seeds implantation is limited to the aspects of treatment means and effects, with no detailed study in intraoperative usage, disinfection and protection. Although a satisfactory curative effect is the key in the treatment,the studies in protection principles, means and technological upgradation are also too important to be ignored. (authors)

  4. [Radiological trap and oncological precautions in a patient who has undergone a permanent withdrawal of PIP breast implants].

    Science.gov (United States)

    Koutsomanis, A; Bruant-Rodier, C; Roedlich, M-N; Bretz-Grenier, M-F; Perrot, P; Bodin, F

    2015-12-01

    We report the case of a 57-year-old patient who presented radiological images similar to ruptured breast implants one year after the supposed withdrawal of the latter. This woman had benefited for the first time from cosmetic PIP breast implants in 2000. Early in 2014, she requested the removal of the implants without renewal because she was feeling pain and functional discomfort. A few months after the operation, she consulted for breast swelling in the upper pole of the breast. Radiological assessment showed liquid formations compatible with the presence of implants. At our request, the rereading of the MRI by the radiologist definitively concluded on a bilateral seroma within the persistent fibrous capsule. In the absence of symptoms, clinical monitoring had been decided. But at the recrudescence of anaplastic large cell lymphoma cases associated with breast implants, a cytological sampling was intended. In case of cytological abnormality or recurrence of the seroma, a surgical procedure should be performed. In conclusion, the removal of a breast implant without capsulectomy may result in the formation of a seroma whose images resemble those of an implant. It is always worthwhile to provide precise clinical data to the radiologist in order to help him to make informed interpretations. Every serous effusion in a breast lodge having contained a silicone implant must evoke the diagnosis of anaplastic large cell lymphoma.

  5. Treatment of portal vein tumor thrombus using ~(125)Iodine seed implantation brachytherapy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    We reported two cases of liver metastasis with portal vein tumor thrombus that developed after liver transplantation for hepato cellular carcinoma (HCC). Both the patients were women aged 43 and 55 years, who had liver metastasis and portal vein tumor thrombus formation after liver transplantations for HCC. For the treatment of portal vein tumor thrombus, 125I seeds were implanted into the hepatic tissue under the guidance of preoperative computed tomography (CT) images with a total radiation dose of 130 Gy...

  6. SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

    Directory of Open Access Journals (Sweden)

    Julia Matena

    2015-04-01

    Full Text Available To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF, high mobility group box 1 (HMGB1 and chemokine (C-X-C motif ligand 12 (CXCL12. As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI. Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release.

  7. Innovative combination of therapeutic mammoplasty and expandable-implant breast augmentation for immediate partial breast reconstruction

    Directory of Open Access Journals (Sweden)

    A.M.H. Choo

    2016-01-01

    Conclusion: A “novel” oncoplastic technique herein termed “augmentation-therapeutic mastopexy” is described for partial breast reconstruction during the treatment of a patient with bilateral breast cancer. It enabled adequate treatment of her cancer while reshaping the breast and achieving the desired larger breast size. It should be considered in selected breast-conservation patients who wish to maintain or increase their breast size.

  8. Biological effects of low energy nitrogen ion implantation on Jatropha curcas L. seed germination

    Energy Technology Data Exchange (ETDEWEB)

    Xu Gang, E-mail: xg335300@yahoo.com.cn [Center for Research and Development of Fine Chemicals, Guizhou University, Guiyang 550025 (China); Institute of Entomology, Guizhou University, Guiyang 550025 (China); Wang Xiaoteng [Department of Agricultural Resources and Environment, College of Agricultural, Guizhou University, Guiyang 550025 (China); Gan Cailing; Fang Yanqiong; Zhang Meng [College of Life Sciences, Guizhou University, Guiyang 550025 (China)

    2012-09-15

    Highlights: Black-Right-Pointing-Pointer We analyzed biological effects of N{sup +} implantation on dry Jatropha curcas seed. Black-Right-Pointing-Pointer N{sup +} implantation greatly decreased seedling survival rate. Black-Right-Pointing-Pointer At doses beyond 15 Multiplication-Sign 10{sup 16} ion cm{sup -2}, biological repair took place. Black-Right-Pointing-Pointer CAT was essential for H{sub 2}O{sub 2} removal. POD mainly functioned as seed was severely hurt. Black-Right-Pointing-Pointer HAsA-GSH cycle mainly contributed to the regeneration of HAsA. - Abstract: To explore the biological effects of nitrogen ion beam implantation on dry Jatropha curcas seed, a beam of N{sup +} with energy of 25 keV was applied to treat the dry seed at six different doses. N{sup +} beam implantation greatly decreased germination rate and seedling survival rate. The doses within the range of 12 Multiplication-Sign 10{sup 16} to 15 Multiplication-Sign 10{sup 16} ions cm{sup -2} severely damaged the seeds: total antioxidant capacity (TAC), germination rate, seedling survival rate, reduced ascorbate acid (HAsA) and reduced glutathione (GSH) contents, and most of the tested antioxidases activity (i.e. catalase (CAT), ascorbate peroxidase (APX) and superoxide dismutase (SOD)) reached their lowest levels. At a dose of 18 Multiplication-Sign 10{sup 16} ion cm{sup -2}, biological repair took place: moderate increases were found in TAC, germination rate, seedling survival rate, HAsA and GSH contents, and some antioxidant enzyme activities (i.e. CAT, APX, SOD and GPX). The dose of 18 Multiplication-Sign 10{sup 16} ions cm{sup -2} may be the optimum dose for use in dry J. curcas seed mutation breeding. CAT, HAsA and GSH contributed to the increase of TAC, but CAT was the most important. POD performed its important role as seed was severely damaged. The main role of the HAsA-GSH cycle appeared to be for regeneration of HAsA.

  9. 125I seed implant brachytherapy for the treatment of parotid gland cancers in children and adolescents

    International Nuclear Information System (INIS)

    Background and purpose: There is a lack of optimal treatment strategies for managing salivary gland cancers in children and adolescents. This study is aimed at assessing the effect of 125I seed implantation for the treatment of parotid cancers in children and adolescents. Patients and methods: A total of 12 patients younger than 16 years with parotid gland malignant tumors underwent 125I seed implant brachytherapy between October 2003 and November 2008. All patients were assessed after treatment and at the local tumor control appointments. Facial nerve function, maxillofacial development, and radioactive side-effects were assessed. Results: The follow-up period ranged from 41-104 months. One patient with T4b died of pulmonary metastasis. The other patients were alive during the follow-up period. There were no serious radiation-related complications. The treatment did not affect facial nerve function and dentofacial growth in any of the children. Conclusion: For parotid gland cancers in children, 125I seed implant brachytherapy may be an acceptable treatment without serious complications and with satisfactory short-term effects. (orig.)

  10. Quality indicators for permanent I-125 prostate seed implants : seven years post implant dosimetry evaluation

    International Nuclear Information System (INIS)

    Full text: The aim of the current work is to assess the progress of prostate implant quality via post implant dosimetry over a 7-year time period. The roles of post implant dosimetry (PID) after permanent 1-125 implant are to: identify suboptimal implants; assess the dosimetric quality indicators and evaluate dose to organs at risk. The 7-years PID learning-curve shows clear changes in dosimetric trend. Beside the expected improvement in technique the following factors were investigated: the replacement of the computed tomography (CT)-delineation based PID with ultrasound (US)-CT fusion based, and the evolution and influence of parameters such as 090 and V I 00. The correlation between dosimetric parameters and clinical outcome was also evaluated. Results A study on 30 patients showed manual target contouring on CT tends to overestimate the prostate volume when compared to ultrasound data (mean difference 38.3%), translating to CT based D90 values being lower than US-CT D90 by an average of 6%. There was 4.7% patient relapse and urinary retention was reported in 2.7% of the patients. CT-based PID was found less reliable than US-CT fusion due to target overestimation. This result shows the biased interpretation of low D90 based on CT targeting and may not relate to patient relapse data. The low urinary retention statistics are in accordance with the PID data for the organ, as only 5.2% of patients had their PID D I 0 >218 Gy, i.e. above recommended GEC-ESTRO guidelines. Besides the 'learning' component, the 7-years PID D90 curve is influenced by PID technique.

  11. Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders: Why Port and Shell Volumes Matter in Breast Reconstruction, Augmentation, and Revision.

    Science.gov (United States)

    Wenzel, Chad G; Wacholtz, William F; Janssen, David A; Bengtson, Bradley P

    2015-10-01

    There are significant differences in weight and volumetric characteristics between silicone and saline breast implants of which most plastic surgeons are unaware. Phase I of this study was a weight measurement focused on recording differences in the weight of saline volumes instilled versus recorded weights of saline implants and expanders. Phase II compared displaced volume differences of tissue expanders with instilled volumes. As a result of this study, surgeons should now be able to precisely calculate the volume created for breast pocket development, allowing for accurate matching of expander and final breast implant.

  12. Shaped versus Round Implants for Breast Reconstruction: Indications and Outcomes

    Directory of Open Access Journals (Sweden)

    Maurice Y. Nahabedian, MD

    2014-03-01

    Conclusions: Both shaped and round silicone gel devices can result in natural aesthetic outcomes. Shaped devices are preferred for contouring the upper pole and for optimizing breast projection. Round devices are preferred when the upper pole is not deficient and the patient desires softer breasts. Longer follow-up studies will be necessary.

  13. Distribution of implanted ions in seeds and roots of mung bean

    Institute of Scientific and Technical Information of China (English)

    LiuDong-Hua; HouWen-Qiang

    1998-01-01

    Doses of 1×1016,and 2×1016cmand 1×1016,2×1016,3×1016and 3.6×1016cm-2 for iron and cpper ioons are implanted in dry seeds of mung bean,respectively.The results show that the accumulated-copper and -iron ion amounts in the seeds and rrots vary with different doses of ion beam,and the fresh and dry weights of the roots decresase progressively with increasing iron and copper doses,except the treatment of 1×1016 Cu+ ions/cm2,and the accumulated-copper and -iron ion amounts in the seeds of the different test groups can be correlated with the ion distribution in the roots.

  14. Investigation of the silicone structure in breast implants using ¹H NMR.

    Science.gov (United States)

    Formes, Andreas; Diehl, Bernd

    2014-05-01

    Against the background of the scandal about low-grade silicone breast implants of the French manufacturer Poly Implant Prothese (PIP), several types of implants were examined using (1)H NMR spectroscopy. The intention was to classify an implant according to its silicone structure. Therefore, the certificated raw material of the American silicone producer Nusil Technology was analyzed and used as a reference. The list of tested implants consists of implants by PFM medical, PIP, Silimed, Rofil, Eurosilicone, Mentor, Perouse Plastie, Polytech, Nagor, CUI, and McGhan. In the (1)H NMR spectrum the signal of the vinyl group, which is used to cross link silicone rubbers, is visible. It is possible to differentiate between silicones which have a vinyl terminated end group and silicones whose vinyl group is located within the chain of the polymer. The two different types of the vinyl group are one mean to classify the implants. Other categories besides the type of vinyl include the relative amount of the remaining vinyl in the implant and the chemical structure of the material used for the production of the envelope. With these characteristics the examined implants could be grouped into four types. PMID:24342752

  15. Regulatory science of new technology: tendency of medical professionals' interests on silicone breast implants.

    Science.gov (United States)

    Nakazaki, Tomomichi; Ikeda, Koji; Iwasaki, Kiyotaka; Umezu, Mitsuo

    2016-09-01

    New technology related to artificial organs is most attractive for worldwide researchers. We believe they must contribute for the future patients against untreatable diseases. Regulatory science is a new science to establish 'social acceptance' of new technology into the clinical market as soon as possible. In the history of silicone breast implants, we could recognize risks many times; however, we missed such chances to prevent a subsequent crisis. We analyzed the trend of published literature related to silicone breast implants to review the medical professionals' interests on such risks. This trend showed, despite issues of a social acceptance of silicone breast implants in a few countries, other countries' medical professionals had no interest. Our hypothesis is 'medical professionals face the government and do not have contributed to re-establish the social acceptance of new technologies for patients'. Any technology does not have the complete evidence of safety, efficacy and quality, despite regulatory authorities' review and approval with clinical evidences. medical professionals need to conduct subsequently the epidemiological study, to take a meta-analysis periodically and to create/update the guidance for their patients under their professional ethics after the marketing of new technologies. We need to take seriously the 'lesson learned' from the history of silicone breast implants for all kind of new technologies existed in the present.

  16. The clinical course of immediate breast implant reconstruction after breast cancer

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Friis, Søren; Frederiksen, Kirsten;

    2011-01-01

    The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed.......The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed....

  17. Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions.

    Science.gov (United States)

    Citron, Isabelle; Dower, Rory; Ho-Asjoe, Mark

    2016-01-01

    Acellular dermal matrix (ADM) implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI). But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime. We also outline our protocol for the management of ADM associated complications including seroma, simple and complex infection and red breast syndrome, such that the sequelae of complications are minimized and patients achieve a better long-term outcome. PMID:26816672

  18. Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions

    Directory of Open Access Journals (Sweden)

    Citron, Isabelle

    2016-01-01

    Full Text Available Acellular dermal matrix (ADM implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI. But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime. We also outline our protocol for the management of ADM associated complications including seroma, simple and complex infection and red breast syndrome, such that the sequelae of complications are minimized and patients achieve a better long-term outcome.

  19. Clinical application of CT-guided 125I seed interstitial implantation for local recurrent rectal carcinoma

    International Nuclear Information System (INIS)

    The present study aimed to explore the safety profile and clinical efficacy of CT-guided radioactive seed implantation in treating local recurrent rectal carcinoma. CT-guided 125I seed implantation was carried out in 20 patients with locally recurrent rectal carcinoma. 14 of the 20 patient had prior adjuvant external-beam radiation therapy (EBRT). The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 120 Gy (range, 100-160 Gy). Of the 20 patients, 12 were male, 8 were female, and ages ranged from 38 to 78, with a median age of 62. Duration of follow-up was 3-34 months. The response rate of pain relief was 85% (17/20). Repeat CT scan 2 months following the procedure revealed complete response (CR) of the tumor in 2 patients, partial response (PR) in 13 patients, stable disease (SD) in 3 patients, and progressive disease (PD) in 2 patients. 75% of patients had either CR or PR. Median survival time was 18.8 months (95% CI: 3.5-22.4 months). 1 and 2 year survival rates were 75% and 25%, respectively. 4 patients died of recurrent tumor; 4 patients died of distant metastases; 9 patients died of recurrent tumor and distant metastases. 3 patients survived after 2 year follow up. Two patients were found to have mild hematochezia, which was reversible with symptomatic management. CT-guided 125I seed implantation appeared to be a safe, useful and less complicated interventional treatment option for local recurrent rectal carcinoma

  20. The clinical application of TACE together with RFA and 125I seed implantation in treating hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Objective: to assess the clinical value of the combined treatment of transcatheter arterial chemoembolization (TACE), CT-guided radiofrequency ablation (RFA) and radioactive 125I seed implantation for hepatocellular carcinoma (HCC). Methods: During the period from March 2008 to Dec. 2010, 15 patients with HCC were admitted to the hospital. A total of 25 hepatic lesions were detected with the size of 1-8 cm. TACE was carried out first, which was followed by CT-guided RFA and radioactive 125I seed implantation. With the help of treat plan system (TPS), the radioactive 125I seed implantation was conducted to make additional management for the same lesion when RFA was finished, or the radioactive 125I seeds were directly implanted into the areas where RFA could not reach. The radioactive dose was 60-100 Gy. All the patients were followed up and were kept under observation for the signs of related complications. The therapeutic results were evaluated. Results: The combined treatment was successfully accomplished in all patients. All patients were followed up for 3-28 months (mean of 10.6 months). The complete necrosis rate of the tumor was 96%. No serious complications occurred except the immigration of 125I seeds in 1 case. Conclusion: The combined treatment of TACE and CT-guided RFA together with 125I seed implantation is a safe, reliable and effective therapy for HCC with excellent short-term result. (authors)

  1. SU-F-19A-11: Retrospective Evaluation of Thermal Coverage by Thermobrachytherapy Seed Arrangements of Clinical LDR Prostate Implants

    Energy Technology Data Exchange (ETDEWEB)

    Warrell, G; Shvydka, D; Chen, C; Parsai, E [University of Toledo Medical Center, Toledo, OH (United States)

    2014-06-15

    Purpose: The superiority of a properly-administered combination of radiation therapy and hyperthermia over radiation alone in treatment of human cancers has been demonstrated in multiple studies examining radiobiology, local control, and survival. Unfortunately, hyperthermia is not yet a common modality in oncology practice, due in part to the technical difficulty of heating a deep-seated target volume to sufficient temperature. To address this problem, our group has invented a thermobrachytherapy (TB) seed based on a commonly-used low dose-rate permanent brachytherapy seed for implant in solid tumors. Instead of the tungsten radiographic marker of the standard seed, the TB seed contains one of a self-regulating ferromagnetic alloy. Placement of a patient implanted with such seeds in an oscillating magnetic field generates heat via induction of eddy currents. We present the results of studies of the capability of clinically-realistic TB seed arrangements to adequately heat defined target volumes. Methods: Seed distributions for several past LDR prostate permanent implant brachytherapy patients were reproduced in the finite element analysis software package COMSOL Multiphysics 4.4, with the difference that TB seeds were modelled, rather than the radiation-only seeds actually used for their treatments. The implant geometries were mainly of the modified peripheral loading type; a range of prostatic volumes and blood perfusion rates likely to be seen in a clinical setting were examined. Results: According to the simulations, when distributed to optimize radiation dose, TB seeds also produce sufficient heat to provide thermal coverage of the target given proper selection of the magnetic field strength. However, the thermal distributions may be improved by additional use of hyperthermia-only seeds. Conclusion: A dual-modality seed intended as an alternative to and using the same implantation apparatus and technique as the standard LDR permanent implant seed has been

  2. Dosimetric response of radioactive bio glass seeds implants on rabbit brain; Resposta radiodosimetrica de implantes de sementes de biovidros radioativos no cerebro de coelhos

    Energy Technology Data Exchange (ETDEWEB)

    Costa, I.T.; Campos, T.P.R., E-mail: itemponi@yahoo.com.br, E-mail: campos@nuclear.ufmg.br [Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares - Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil)

    2007-07-01

    Interstitial implants of radioactive seeds are used as an efficient way of treating brain tumors. Bio glasses is an interesting alternative to the metallic implanted materials, because they can be absorbed by the organism, reducing the possibilities of side effects. The present paper investigates the dosimetry by the implants performed on rabbit's brain on the NRI/UFMG research group. The spatial distribution of the specific ionizing energy deposited per unit of mass generated by Sm-153 seeds were evaluated. A computational model of the brain's region was built using the software SISCODES produced by the research group. The sections of the computer tomography of a rabbit, which was included on the experiment, were digitalized. Those were converted in a three dimensional voxel model, including the tissues, its chemical composition and density. A simulation of the particles transport is performed by the stochastic code MCNP5. The implants consist of 15 ceramic Ca-Si-Sm seeds enriched with Sm-153, with 1.1.6 mm of length and 0.3 mm diameter, implanted on the rabbit's brain. It was predicted on the model three ribbons of 5 seeds each, spaced by 1.1.2 mm, since the ribbons were in a triangular topology whose vertices were spaced by 8 mm. The activities were 120 MBq/seed. The results show isodose regions superposed over the rabbits' model, reproducing the spatial energy deposition on the brain region. The absorbed dose predicted was 3.2 Gy per 15 seed; however it was not enough to tumor control. The authors suggest to increase the number of seeds and activity, reduction of the space to 5-6 mm among ribbons, improving dose with the beta emitting. (author)

  3. MR and CT image fusion for postimplant analysis in permanent prostate seed implants

    International Nuclear Information System (INIS)

    Purpose: To compare the outcome of two different image-based postimplant dosimetry methods in permanent seed implantation. Methods and materials: Between October 1999 and October 2002, 150 patients with low-risk prostate carcinoma were treated with 125I and 103Pd in our institution. A CT-MRI image fusion protocol was used in 21 consecutive patients treated with exclusive brachytherapy. The accuracy and reproducibility of the method was calculated, and then the CT-based dosimetry was compared with the CT-MRI-based dosimetry using the dose-volume histogram (DVH) related parameters recommended by the American Brachytherapy Society and the American Association of Physicists in Medicine. Results: Our method for CT-MRI image fusion was accurate and reproducible (median shift 100 = 82% vs. 88%, p 90 = 96% vs. 115%, p < 0.05. Those results depend on the institutional implant technique and reflect the importance of lowering inter- and intraobserver discrepancies when outlining prostate and organs at risk for postimplant dosimetry. Conclusions: Computed tomography-MRI fused images allow accurate determination of prostate size, significantly improving the dosimetric evaluation based on DVH analysis. This provides a consistent method to judge a prostate seed implant's quality

  4. Seeding of silicon by copper ion implantation for selective electroless copper plating

    Energy Technology Data Exchange (ETDEWEB)

    Bhansali, S.; Sood, D.K.; Zmood, R.B. [Microelectronic and Materials Technology Centre, Royal Melbourne Institute of Technolgy, Melbourne, VIC (Australia)

    1993-12-31

    We report on the successful use of copper(self) ion implantation into silicon to seed the electroless plating of copper on silicon (100) surfaces. Copper ions have been implanted to doses of 5E14-6.4E16 ions/cm{sup 2} using a MEEVA ion implanter at extraction voltage of 40kV. Dose was varied in fine steps to determine the threshold dose of 2E15 Cu ions/cm{sup 2} for `seed` formation of copper films on silicon using a commercial electroless plating solution. Plated films were studied with Rutherford backscattering spectrometry, scanning electron microscopy, EDX and profilometry . The adhesion of films was measured by `scotch tape test`. The adhesion was found to improve with increasing dose. However thicker films exhibited rather poor adhesion and high internal stress. SEM results show that the films grow first as isolated islands which become larger and eventually impinge into a continuous film as the plating time is increased. (authors). 5 refs., 1 tab., 3 figs.

  5. A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breast cancer

    Institute of Scientific and Technical Information of China (English)

    FAN Lin-jun; JIANG Jun; YANG Xin-hua; ZHANG Yi; LI Xing-gang; CHEN Xian-chun; ZHONG Ling

    2009-01-01

    Background Breast conserving surgery (BCS) has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy (ESM) plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting.Methods From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. Results There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups (P>0.05).The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM (88.4%, 38/43) and BCS (92.6%, 50/54) patients (P>0.05). During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence-one of these patients died of multiple organ metastasis.Conclusions After considering the wide Indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants-the new surgery of choice for breast cancer-warrants serious consideration as the prospective next standard surgical procedure.

  6. Patterns of failure after iodine-125 seed implantation for prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To determine the site of relapse when biochemical failure (BF) occurs after iodine-125 seed implantation for prostate cancer. Materials and methods: From 2001–2009, 500 men underwent implantation in Wellington, New Zealand. Men who sustained BF were placed on relapse guidelines that delayed restaging and intervention until the prostate-specific antigen (PSA) was ⩾20 ng/mL. Results: Most implants (86%) had a prostate D90 of ⩾90%, and multivariate analysis showed that this parameter was not a variable that affected the risk of BF. Of 21 BFs that occurred, the site of failure was discovered to be local in one case and distant in nine cases. Restaging failed to identify the site of relapse in two cases. In nine cases the trigger for restaging had not been reached. Conclusions: If post-implant dosimetry is generally within the optimal range, distant rather than local failure appears to be the main cause of BF. Hormone treatment is therefore the most commonly indicated secondary treatment intervention (STI). Delaying the start of STI prevents the unnecessary treatment of men who undergo PSA ‘bounce’ and have PSA dynamics initially mimicking those of BF

  7. Risk of Needle-track Seeding After Diagnostic Image-guided Core Needle Biopsy in Breast Cancer

    OpenAIRE

    Knight, Rebecca; Horiuchi, Kent; Parker, Steve H.; Ratzer, Erick R.; Fenoglio, Michael E.

    2002-01-01

    Objective: Image-guided core needle biopsy (IGCNB) is an accepted technique for sampling nonpalpable mammographically detected suspicious breast lesions. However, the concern for needle-track seeding in malignant lesions remains. An alternative to IGCNB is needle-localization breast biopsy (NLBB). No study has been done to compare the local recurrence rate of breast cancer after IGCNB versus NLBB. Methods: We have retrospectively reviewed the local recurrence of breast cancer in patients diag...

  8. Intraoperative radiofrequency ablation combined with ~(125)iodine seed implantation for unresectable pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To evaluate the feasibility, efficacy and safety of intraoperative radiofrequency ablation (RFA) combined with 125 iodine seed implantation for unresectable pancreatic cancer. METHODS: Thirty-two patients (21 males and 11 females) at the age of 68 years (range 48-90 years) with unresectable locally advanced pancreatic cancer admitted to our hospital from January 2006 to May 2008 were enrolled in this study. The tumor, 4-12 cm in diameter, located in pancreatic head of 23 patients and in pancreatic body...

  9. Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to measure interfraction prostate bed motion, setup error, and total positioning error in 10 consecutive patients undergoing postprostatectomy radiotherapy. Methods and Materials: Daily image-guided target localization and alignment using electronic portal imaging of gold seed fiducials implanted into the prostate bed under transrectal ultrasound guidance was used in 10 patients undergoing adjuvant or salvage radiotherapy after prostatectomy. Prostate bed motion, setup error, and total positioning error were measured by analysis of gold seed fiducial location on the daily electronic portal images compared with the digitally reconstructed radiographs from the treatment-planning CT. Results: Mean (± standard deviation) prostate bed motion was 0.3 ± 0.9 mm, 0.4 ± 2.4 mm, and -1.1 ± 2.1 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) axes, respectively. Mean set-up error was 0.1 ± 4.5 mm, 1.1 ± 3.9 mm, and -0.2 ± 5.1 mm in the LR, SI, and AP axes, respectively. Mean total positioning error was 0.2 ± 4.5 mm, 1.2 ± 5.1 mm, and -0.3 ± 4.5 mm in the LR, SI, and AP axes, respectively. Total positioning errors >5 mm occurred in 14.1%, 38.7%, and 28.2% of all fractions in the LR, SI, and AP axes, respectively. There was no significant migration of the gold marker seeds. Conclusions: This study validates the use of daily image-guided target localization and alignment using electronic portal imaging of implanted gold seed fiducials as a valuable method to correct for interfraction target motion and to improve precision in the delivery of postprostatectomy radiotherapy

  10. Seed migration after transperineal interstitial prostate brachytherapy by using loose seeds: Japanese prostate cancer outcome study of permanent iodine-125 seed implantation (J-POPS) multi-institutional cohort study

    International Nuclear Information System (INIS)

    The incidence and associated factors of loose seed migration were investigated in cohort 1 of the Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS). The study subjects were 2160 patients, consisting of 1641 patients who underwent permanent iodine-125 seed implantation (PI) and 519 patients who underwent PI combined with external beam radiation therapy (PI + EBRT). The presence or absence of seed migration to the chest and abdominal/pelvic region was determined. Seed migration was observed in 22.7 % of PI group patients and 18.1 % of PI + EBRT group patients (p = 0.0276). Migration to the lungs and abdominal/pelvic region was observed in 14.6 % and 11.1 % of the patients in the PI group, and 11.2 % and 8.5 % of the patients in the PI + EBRT group, respectively. In the PI group, the number of implanted seeds was associated with the seed migration incidence. Neither the PI nor the PI + EBRT group showed any difference in the volume of the prostate receiving 100 % of the prescribed dose (V100 [%]) or the minimal dose received by 90 % of the prostate volume (D90 [Gy]) between the patients with and without seed migration. This prospective cohort study investigating the largest number of past cases showed no difference in D90 (Gy) or V100 (%) between seed migration or the absence thereof in both the PI group and PI + EBRT group

  11. Three-dimensional verification of 125I seed stability after permanent implantation in the parotid gland and periparotid region

    International Nuclear Information System (INIS)

    To evaluate seed stability after permanent implantation in the parotid gland and periparotid region via a three-dimensional reconstruction of CT data. Fifteen patients treated from June 2008 to June 2012 at Peking University School and Hospital of Stomatology for parotid gland tumors with postoperative adjunctive 125I interstitial brachytherapy were retrospectively reviewed in this study. Serial CT data were obtained during follow-up. Mimics and Geomagic Studio software were used for seed reconstruction and stability analysis, respectively. Seed loss and/or migration outside of the treated area were absent in all patients during follow-up (23–71 months). Total seed cluster volume was maximized on day 1 post-implantation due to edema and decreased significantly by an average of 13.5 % (SD = 9.80 %; 95 % CI, 6.82–17.68 %) during the first two months and an average of 4.5 % (SD = 3.60 %; 95 % CI, 2.29–6.29 %) during the next four months. Volume stabilized over the subsequent six months. 125I seed number and location were stable with a general volumetric shrinkage tendency in the parotid gland and periparotid region. Three-dimensional seed reconstruction of CT images is feasible for visualization and verification of implanted seeds in parotid brachytherapy

  12. WE-A-17A-11: Implanted Brachytherapy Seed Movement Due to Transrectal Ultrasound Probe-Induced Prostate Deformation

    International Nuclear Information System (INIS)

    Purpose: To characterize the movement of implanted brachytherapy seeds due to transrectal ultrasound probe-induced prostate deformation and to estimate the effects on prostate dosimetry. Methods: Implanted probe-in and probe-removed seed distributions were reconstructed for 10 patients using C-arm fluoroscopy imaging. The prostate was delineated on ultrasound and registered to the fluoroscopy seeds using a visible subset of seeds and residual needle tracks. A linear tensor and shearing model correlated the seed movement with position. The seed movement model was used to infer the underlying prostate deformation and to simulate the prostate contour without probe compression. Changes in prostate and surrogate urethra dosimetry were calculated. Results: Seed movement patterns reflecting elastic decompression, lateral shearing, and rectal bending were observed. Elastic decompression was characterized by anterior-posterior expansion and superior-inferior and lateral contractions. For lateral shearing, anterior movement up to 6 mm was observed for extraprostatic seeds in the lateral peripheral region. The average intra-prostatic seed movement was 1.3 mm, and the residual after linear modeling was 0.6 mm. Prostate D90 increased by 4 Gy on average (8 Gy max) and was correlated with elastic decompression. For selected patients, lateral shearing resulted in differential change in D90 of 7 Gy between anterior and posterior quadrants, and increase in whole prostate D90 of 4 Gy. Urethra D10 increased by 4 Gy. Conclusion: Seed movement upon probe removal was characterized. The proposed model captured the linear correlation between seed movement and position. Whole prostate dose coverage increased slightly, due to the small but systematic seed movement associated with elastic decompression. Lateral shearing movement increased dose coverage in the anterior-lateral region, at the expense of the posterior-lateral region. The effect on whole prostate D90 was smaller due to the subset

  13. Effects of medium energy ion beam radiation in implantation and penetration on the germination and the growth of wheat seeds

    International Nuclear Information System (INIS)

    The effects of medium energy N ion beam irradiation on the germination and the growth of different kinds of wheat seeds are discussed. According to the results of test in laboratory and the field, the germination and the seedling growth of wheat seeds with irradiation dose were evidently inhibited. Furthermore, there was a larger difference between implantation and penetration. In the course of the seed germination the inhibition resulting from the implantation was clearly stronger than that from the penetration. From survival curves of emergence rates of three different strains in the field, the half-lethal doses of implantation and penetration (D50) are in the range of (107∼108) ions/cm2 and (108∼109) ions/cm2 respectively

  14. Nursing care for patients with local recurrent rectal cancer after CT-guided 125I seed implantation therapy

    International Nuclear Information System (INIS)

    Objective: To discuss the nursing care strategy for patients with local recurrent rectal cancer who has been treated with CT-guided 125I seed implantation therapy. Methods: Twenty patients with local recurrent rectal cancer received a series of nursing interventions, including comfort care and pain care. The clinical results were observed and analyzed. Results: The therapy was smoothly accomplished in all patients. The pain was remarkably relived and the anxiety was alleviated. No displacement of implanted 125I seed occurred. Conclusion: For patients with local recurrent rectal cancer occurred after CT-guided 125I seed implantation therapy, careful nursing can effectively relieve the pain and anxiety feeling,and the living quality can also be markedly improved. (authors)

  15. Radiation testing of the AeroForm co2-based breast tissue expander implant

    International Nuclear Information System (INIS)

    Tissue expanders are used in breast reconstruction after mastectomy to stretch the remaining tissue to create space for placement of permanent breast implants. The AeroForm™ Tissue Expander, developed by AirXpanders™ Inc., contains electronic components designed to activate the release of carbon dioxide from an internal reservoir to inflate the expander. Breast cancer patients who undergo mastectomy and tissue expander/implant-based breast reconstruction may require radiation therapy at doses up to 50–60 Gy while the expander is in place. The ionizing radiation used in postmastectomy radiation therapy interacts with electronic components in medical implants, which may cause degradation in performance above certain levels. Most commercial electronic components used in medical devices, such as complementary metal-oxide semiconductor or bipolar integrated circuits can withstand radiation levels in the 50 Gy range without any performance degradation. Beyond this level, the performance may still be sufficient to guarantee functionality, but this needs to be confirmed at the system and electronic circuit level. We assessed the impact of radiation levels up to 75 Gy on 32 AeroForm™ Tissue Expanders (AirXpanders, Inc., Palo Alto, CA USA) and on the associated internal printed circuit assemblies. The electronics inside the AeroForm™ Tissue Expander implant continued to function properly after exposure to radiation levels up to 75 Gy, which is well above the maximum total dose level typically used in postmastectomy radiation therapy. Standard postmastectomy radiation therapy doses do not damage or affect the functionality of the AeroForm™ Tissue Expander

  16. The inner and outer of our thorax: silicone breast implants and pulmonary alveolar proteinosis

    OpenAIRE

    De Backer, Helene; Darquennes, K; Dooms, Christophe; Yserbyt, Jonas; Coolen, Johan; Verschakelen, Johny; Verbeken, Erik; Vrints, I; Wuyts, Wim

    2015-01-01

    Pulmonary alveolar (phospholipo)proteinosis (PAP) is a rare lung disease, predominantly autoimmune in nature. This case report describes a patient with insidious dyspnoea since 5 years and a milky appearance of her bronchoalveolar fluid, leading to the diagnosis of PAP. The onset of symptoms coincided with an exchange of her silicone breast implants. Giant cell reaction in axillary adenopathies pointed towards silicone leakage. Adjuvants, such as silicone, might boost pre-existing antigen rea...

  17. Bypassing the learning curve in permanent seed implants using state-of-the-art technology

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to demonstrate, based on clinical postplan dose distributions, that technology can be used efficiently to eliminate the learning curve associated with permanent seed implant planning and delivery. Methods and Materials: Dose distributions evaluated 30 days after the implant of the initial 22 consecutive patients treated with permanent seed implants at two institutions were studied. Institution 1 (I1) consisted of a new team, whereas institution 2 (I2) had performed more than 740 preplanned implantations over a 9-year period before the study. Both teams had adopted similar integrated systems based on three-dimensional (3D) transrectal ultrasonography, intraoperative dosimetry, and an automated seed delivery and needle retraction system (FIRST, Nucletron). Procedure time and dose volume histogram parameters such as D90, V100, V150, V200, and others were collected in the operating room and at 30 days postplan. Results: The average target coverage from the intraoperative plan (V100) was 99.4% for I1 and 99.9% for I2. D90, V150, and V200 were 191.4 Gy (196.3 Gy), 75.3% (73.0%), and 37.5% (34.1%) for I1 (I2) respectively. None of these parameters shows a significant difference between institutions. The postplan D90 was 151.2 Gy for I1 and 167.3 Gy for I2, well above the 140 Gy from the Stock et al. analysis, taking into account differences at planning, results in a p value of 0.0676. The procedure time required on average 174.4 min for I1 and 89 min for I2. The time was found to decrease with the increasing number of patients. Conclusion: State-of-the-art technology enables a new brachytherapy team to obtain excellent postplan dose distributions, similar to those achieved by an experienced team with proven long-term clinical results. The cost for bypassing the usual dosimetry learning curve is time, with increasing team experience resulting in shorter treatment times

  18. An algorithm for efficient metal artifact reductions in permanent seed implants

    Energy Technology Data Exchange (ETDEWEB)

    Xu Chen; Verhaegen, Frank; Laurendeau, Denis; Enger, Shirin A.; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de Genie Electrique et Genie Informatique, Laboratoire de Vision et Systemes Numeriques, Universite Laval, Quebec, Quebec G1K 7P4 (Canada); Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands) and Oncology Department, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Departement de Genie Electrique et Genie Informatique, Laboratoire de Vision et Systemes Numeriques, Universite Laval, Quebec, Quebec G1K 7P4 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Co circumflex te du Palais, Quebec, Quebec G1R 2J6 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec, Quebec G1K 7P4 (Canada)

    2011-01-15

    Purpose: In permanent seed implants, 60 to more than 100 small metal capsules are inserted in the prostate, creating artifacts in x-ray computed tomography (CT) imaging. The goal of this work is to develop an automatic method for metal artifact reduction (MAR) from small objects such as brachytherapy seeds for clinical applications. Methods: The approach for MAR is based on the interpolation of missing projections by directly using raw helical CT data (sinogram). First, an initial image is reconstructed from the raw CT data. Then, the metal objects segmented from the reconstructed image are reprojected back into the sinogram space to produce a metal-only sinogram. The Steger method is used to determine precisely the position and edges of the seed traces in the raw CT data. By combining the use of Steger detection and reprojections, the missing projections are detected and replaced by interpolation of non-missing neighboring projections. Results: In both phantom experiments and patient studies, the missing projections have been detected successfully and the artifacts caused by metallic objects have been substantially reduced. The performance of the algorithm has been quantified by comparing the uniformity between the uncorrected and the corrected phantom images. The results of the artifact reduction algorithm are indistinguishable from the true background value. Conclusions: An efficient algorithm for MAR in seed brachytherapy was developed. The test results obtained using raw helical CT data for both phantom and clinical cases have demonstrated that the proposed MAR method is capable of accurately detecting and correcting artifacts caused by a large number of very small metal objects (seeds) in sinogram space. This should enable a more accurate use of advanced brachytherapy dose calculations, such as Monte Carlo simulations.

  19. DermACELL: a novel and biocompatible acellular dermal matrix in tissue expander and implant-based breast reconstruction

    OpenAIRE

    Bullocks, Jamal M.

    2014-01-01

    Background Acellular dermal matrices present a new alternative to supporting expanders and implants for breast reconstruction in breast cancer patients following mastectomy. However, some studies have suggested that acellular dermal matrix may increase the complication rates in certain clinical settings. DermACELL acellular dermal matrix offers advanced processing in order to attempt to decrease bio-intolerance and complications. Methods Ten consecutive patients that presented for breast reco...

  20. Attitudes and treatment outcome of breast conservation therapy for stage I and II breast cancer using peroperative iridium-192 implant boost to the tumour bed

    International Nuclear Information System (INIS)

    Breast conservation therapy for early breast cancer is an established but grossly under-utilized treatment option in India for various reasons. Breast conservation therapy was offered to 200 suitable breast cancer patients between June 1993 and June 1998. Fifty-one patients (25%) opted for breast conservation and the remaining preferred mastectomy. In patients agreeing to conservation therapy, surgery was performed first along with peroperative implantation of iridium-192 to deliver a boost. Whole breast irradiation of 45 Gy was delivered 3-4 weeks after the boost. Cosmesis was assessed at the end of 6 months from completion of therapy. The main reason for refusal of breast conservation therapy was fear of recurrence in the remaining breast (60%). There were no loco-regional failures in our study at a median follow up of 42 months; one patient experienced a systemic relapse. Cosmesis was good to excellent in 80% of patients. Breast conservation therapy using peroperative iridium-192 implant provides excellent loco-regional disease control and cosmesis. The results of our study indicate that patient preference for mastectomy is an important reason for the under-utilization of breast conservation therapy in India. Copyright (2001) Blackwell Science Pty Ltd

  1. Locally advanced breast implant associated anaplastic large cell lymphoma: A case report of successful treatment with radiation and chemotherapy

    Directory of Open Access Journals (Sweden)

    Christopher Fleighton Estes

    2015-02-01

    Full Text Available The development of breast implant associated anaplastic large cell lymphoma (ALCL is a rare phenomenon. A typical presentation is an effusion associated with a breast implant. Less commonly, disease can become more advanced locoregionally or distantly. The optimal treatment schema is a topic of debate: localized ALCL can potentially be cured with implant removal alone, while other cases in the literature, including those that are more advanced, have been treated with varying combinations of surgery, chemotherapy, and external beam radiotherapy. This is a case report of breast implant ALCL with pathologically proven lymph node involvement, the fifth such patient reported. Our patient experienced a favorable outcome with radiation therapy and chemotherapy.

  2. Transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus thrombosis

    International Nuclear Information System (INIS)

    Objective: To assess the therapeutic value of transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus. Methods: The data of 23 patients ranging from 34 to 70 years old [average age ( 56 ± 8) years] with primary hepatic carcinoma with portal vein tumor thrombosis of type Ⅱ and type Ⅲ were retrospectively collected. The tumor number of liver parenchyma ranged from 1 to 15 (median number 4). The average diameter of tumor thrombus was (20.5 ± 1.5) mm and average length was (37.4 ± 2.6) mm. All of the tumors of liver parenchyma in 23 patients were treated by transcatheter arterial chemoembolization (TACE) and tumor thrombus were treated with 125iodine seed implantation. Before the 125iodine seed implantation, the formula dosage, the number, the spatial distribution, the intensity of radioactivity and the matched peripheral dosage of seed were calculated by treatment planning system (TPS). Then the 125iodine seeds were implanted in different levels and locations of port vein thrombosis under CT guided. Results: The follow-up period ranged from 1 to 26 months. The times of transcatheter arterial chemoembolization were 1 to six times (median time 3.1±0.4) and the 125iodine seed implantation in the port vein thrombosis were 1 to 2 times (median time 1.4 ± 0.5). The numbers of implanted 125iodine seeds were 4 to 17 (median number 7.0 ± 1.0). The median survival time was 18.0 months (3-24 months). The 3,6 and 12 months survival rates were 91.3% (21/23), 69.6% (16/23), and 60.9% (14/23). There was no severe side-effect related to therapy. Conclusions: Transcatheter arterial chemoembolization combined 125iodine seed implantation for portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma with portal vein tumor thrombosis. (authors)

  3. The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Wook; Woo, Heon; Jeong, Hyeon Hak; Kim, Kyeong Ah; Kim, Chan Yong; Yoo, Suk Hyun [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-12-15

    To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22-4.17% at A point, 4.06-6.22% at B point, 0.4-0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06-5% at A point, 2.85-4.94% at B point, 0.74-1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is

  4. Radiation protective nursing intervene of 125I seed implantation in non-small cell lung carcinoma guided by CT

    International Nuclear Information System (INIS)

    Objective: To research radiation protective nursing intervene and important notice of 125I seeds minimally invasive implantation in non-small cell lung carcinoma (NSCLC) by CT. Methods: Under the system of therapy planning system (TPS) and posologic validation, 125I seeds were implanted in 89 cases of NSCLC patients. The consistent radiation protective nursing intervene was used in perioperative period management. The operative successful rate, therapeutic effect and complication rate, therapeutic effect and complication rate was observed. Results: The scientific radiation protective nursing intervene can ensure that the radioactive dose distribution of 125I seed implantation brachytherapy is consistent with the principles of effective and minimally invasive. The operative successful rate was 100%. The local control rate and 1 year survival rate respectively was 97.4% and 92.2%. But the early and later incidence rate of radioactive damaging effect was 14.6% and 1.1% respectively. Leakage of radioactive contamination has not occurred. Conclusion: The consistent TPS and posologic validation 125I seeds implantation integrated scientific radiation protective nursing intervene. It is very important to improve the therapeutic effect of NSCLC and reduce the incidence of complications. (authors)

  5. Effects of macrophage-activating lipopeptide-2 (MALP-2) on the vascularisation of implanted polyurethane scaffolds seeded with microvascular fragments.

    Science.gov (United States)

    Grässer, C; Scheuer, C; Parakenings, J; Tschernig, T; Eglin, D; Menger, M D; Laschke, M W

    2016-01-01

    The seeding of scaffolds with adipose tissue-derived microvascular fragments represents a promising strategy to establish a sufficient blood supply in tissue constructs. Herein, we analysed whether a single application of macrophage-activating lipopeptide-2 (MALP-2) at the implantation site further improves the early vascularisation of such microvessel-seeded constructs. Microvascular fragments were isolated from epididymal fat pads of C57BL/6 mice. The fragments were seeded on polyurethane scaffolds, which were implanted into mouse dorsal skinfold chambers exposed to MALP-2 or vehicle (control). The inflammatory host tissue response and the vascularisation of the scaffolds were analysed using intravital fluorescence microscopy, histology and immunohistochemistry. We found that the numbers of microvascular adherent leukocytes were significantly increased in MALP-2-treated chambers during the first 3 days after scaffold implantation when compared to controls. This temporary inflammation resulted in an improved vascularisation of the host tissue surrounding the implants, as indicated by a higher density of CD31-positive microvessels at day 14. However, the MALP-2-exposed scaffolds themselves presented with a lower functional microvessel density in their centre. In addition, in vitro analyses revealed that MALP-2 promotes apoptotic cell death of endothelial and perivascular cells in isolated microvascular fragments. Hence, despite the beneficial pro-angiogenic properties of MALP-2 at the implantation site, the herein evaluated approach may not be recommended to improve the vascularisation capacity of microvascular fragments in tissue engineering applications. PMID:27386841

  6. Stealthy role of size-driven stresses in biomechanics of breast implants capsular contracture.

    Science.gov (United States)

    Fraldi, Massimiliano; Esposito, Luca; Cutolo, Arsenio; Carotenuto, Angelo Rosario; Adamo, Ciro; Molea, Guido

    2016-12-01

    Breast Capsular Contracture (BCC) is one of the adverse complications occurring with greater incidence in breast augmentation surgical procedures. Its formation can be interpreted as the conclusive result of the physiological process known as response to a foreign body. From a biochemical standpoint, the formation of the peri-prosthetic capsule is certainly a multifactorial process: many hypotheses concerning its etiology have been suggested in the literature and a number of related pharmacological protocols have been consequently proposed to clinically treat this pathology with the aim to prevent further complications and avoid future re-interventions. However, the vast majority of these theories seems to be only partially supported by clinical outcomes and thus a shared opinion on this matter is still absent among specialists. Within this framework, by starting from clinical observations which highlighted an unexpected correlation between histo-morphological features of fibrotic capsules and overall size of breast implants, the present study investigates the hypothesis that the biomechanical interaction between prosthesis and host tissue may play a crucial role in the biological processes governing the pathological phenomenon at hand. Therefore, to shed light on the underlying mechanisms which could trigger the breast capsular contracture, both simple analytical solutions, in which elasticity and growth are simultaneously taken into account, and more accurate geometrically faithful Finite Element-based numerical simulations have been exploited. The theoretical findings demonstrate that somehow counter-intuitive radial and hoop stress fields occur at the capsula-implant interface in a way such that their combined action, independently from other possible concurrent factors, results significantly amplified for small-size breast prostheses, localized stress peaks in these cases promoting detaching and rippling phenomena actually observed in BCC clinical

  7. Pepper seed extract suppresses invasion and migration of human breast cancer cells.

    Science.gov (United States)

    Kim, Hyeon-A; Kim, Min-Sook; Kim, Sang-Hyun; Kim, Yoo Kyeong

    2014-01-01

    This study was performed to determine the antimetastatic activities of chili pepper seed on human breast cancer cells. The water extract of chili pepper seeds was prepared and it contained a substantial amount of phenols (131.12 mg%) and no capsaicinoids. Pepper seed extract (PSE) suppressed the proliferation of MDA-MB-231 and MCF-7 cells at the concentration of 10, 25, and 50 μg/ml (MDA-MB-231: IC50 = 20.1 μg/ml, MCF-7: IC50 = 14.7 μg/ml). PSE increased the expression level of E-cadherin up to 1.2-fold of the control in MCF-7 cells. PSE also decreased the secretion of matrix metalloproteinase (MMP)-2 and MMP-9 in MDA-MB-231 and MCF-7 cells at the concentration of 25 and 50 μg/ml. PSE treatment significantly suppressed the invasion of MDA-MB-231 and MCF-7 cells in a dose-dependent manner. The motility of cancer cells was apparently retarded in the wound healing assay by the PSE treatment. Although our data collectively demonstrate that PSE inhibits invasion and migration of breast cancer cells, further study is needed to identify specific mechanisms and bioactive components contributing to antimetastatic effects of chili pepper seed. PMID:24341783

  8. Assessment of I-125 seed implant accuracy when using the live-planning technique for low dose rate prostate brachytherapy

    International Nuclear Information System (INIS)

    Low risk prostate cancers are commonly treated with low dose rate (LDR) brachytherapy involving I-125 seeds. The implementation of a ‘live-planning’ technique at the Royal Adelaide Hospital (RAH) in 2007 enabled the completion of the whole procedure (i.e. scanning, planning and implant) in one sitting. ‘Live-planning’ has the advantage of a more reliable delivery of the planned treatment compared to the ‘traditional pre-plan’ technique (where patient is scanned and planned in the weeks prior to implant). During live planning, the actual implanted needle positions are updated real-time on the treatment planning system and the dosimetry is automatically recalculated. The aim of this investigation was to assess the differences and clinical relevance between the planned dosimetry and the updated real-time implant dosimetry. A number of 162 patients were included in this dosimetric study. A paired t-test was performed on the D90, V100, V150 and V200 target parameters and the differences between the planned and implanted dose distributions were analysed. Similarly, dosimetric differences for the organs at risk (OAR) were also evaluated. Small differences between the primary dosimetric parameters for the target were found. Still, the incidence of hotspots was increased with approximately 20% for V200. Statistically significant increases were observed in the doses delivered to the OAR between the planned and implanted data; however, these increases were consistently below 3% thus probably without clinical consequences. The current study assessed the accuracy of prostate implants with I-125 seeds when compared to initial plans. The results confirmed the precision of the implant technique which RAH has in place. Nevertheless, geographical misses, anatomical restrictions and needle displacements during implant can have repercussions for centres without live-planning option if dosimetric changes are not taken into consideration

  9. Phase II investigation: partial breast irradiation with high-dose brachytherapy using intratissue multicatheter implant

    International Nuclear Information System (INIS)

    Local control, side-effects, and cosmetic results were analyzed in patients with early-stage breast cancer after organpreserving surgery and adjuvant partial accelerated irradiation of the breast using high dose rate brachytherapy and intratissue multicatheter implant. The patients over 50 with solitary tumors < 3 cm invasive ductal carcinoma, differentiation grade I-III, resection R0, N0 (axillary dissection or investigation of signal lymph node) were included in the study. The irradiation was performed twice a day with a 6-hour interval at a single dose of 4 Gy. Total focal dose of 32 Gy was delivered with 8 fractions. With a mean observation period of 31 months (13-46), a local relapse was diagnosed in one patient (1.7 %). Cosmetic results were assessed as good and excellent. Immediate complications of the treatment were minimal. The method can be indicated in a selected group of patients and cannot be a standard of treatment at present.

  10. The inner and outer of our thorax: silicone breast implants and pulmonary alveolar proteinosis.

    Science.gov (United States)

    De Backer, H; Darquennes, K; Dooms, C; Yserbyt, J; Coolen, J; Verschakelen, J; Verbeken, E; Vrints, I; Wuyts, W

    2015-10-01

    Pulmonary alveolar (phospholipo)proteinosis (PAP) is a rare lung disease, predominantly autoimmune in nature. This case report describes a patient with insidious dyspnoea since 5 years and a milky appearance of her bronchoalveolar fluid, leading to the diagnosis of PAP. The onset of symptoms coincided with an exchange of her silicone breast implants. Giant cell reaction in axillary adenopathies pointed towards silicone leakage. Adjuvants, such as silicone, might boost pre-existing antigen reactions of the immune system, potentially leading to autoimmune phenomena. PMID:26083574

  11. Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Antonios Psarras

    2014-01-01

    Full Text Available Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud’s phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.

  12. Narrow safety range of intraoperative rectal irradiation exposure volume for avoiding bleeding after seed implant brachytherapy

    International Nuclear Information System (INIS)

    Rectal toxicity is less common after 125I seed implant brachytherapy for prostate cancer, and intraoperative rectal dose-volume constraints (the constraint) is still undetermined in pioneering studies. As our constraint failed to prevent grade 2 or 3 rectal bleeding (bled-pts) in 5.1% of patients, we retrospectively explored another constraint for the prevention of rectal bleeding. The study population consisted of 197 patients treated with the brachytherapy as monotherapy using real-time intraoperative transrectal ultrasound (US)-guided treatment at a prescribed dose of 145 Gy. Post-implant dosimetry was performed on Day 1 and Day 30 after implantation using computed tomography (CT) imaging. Rectal bleeding toxicity was classified by CTC-AE ver. 3.0 during a mean 29-month (range, 12-48 months) period after implantation. The differences in rV100s were compared among intraoperative, Day 1 and Day 30 dosimetry, and between that of patients with grade 2 or 3 rectal bleeding (the bled-pts) and of the others (the spared-pts). All patients were divided into groups based on provisional rV100s that were increased stepwise in 0.1-cc increments from 0 to 1.0 cc. The difference in the ratios of the bled-pts to the spared-pts was tested by chi-square tests, and their odds ratios were calculated (bled-OR). All statistical analyses were performed by t-tests. The mean values of rV100us, rV100CT-1, and rV100CT-30 were 0.31 ± 0.43, 0.22 ± 0.36, and 0.59 ± 0.68 cc, respectively. These values temporarily decreased (p = 0.020) on Day 1 and increased (p = 0.000) on Day 30. There was no significant difference in rV100s between the bled-pts and spared-pts at any time of dosimetry. The maximum bled-OR was identified among patients with an rV100us value above 0.1 cc (p = 0.025; OR = 7.8; 95% CI, 1.4-145.8); an rV100CT-1 value above 0.3 cc (p = 0.014; OR = 16.2; 95% CI, 3.9-110.7), and an rV100CT-30 value above 0.5 cc (p = 0.019; OR = 6.3; 95% CI, 1.5-42.3). By retrospective analysis

  13. Radiological and echographic aspects of breasts with silicone implants; Aspectos radiologicos e ecograficos das mamas com protese de silicone

    Energy Technology Data Exchange (ETDEWEB)

    Pace Bauab, S. de [Instituto de Radiodiagnostico Rio Preto, Sao Jose do Rio Preto, SP (Brazil)

    1994-10-01

    The silicone prosthesis, its application in breast augmentation mammoplasty and the studies about its association with auto-immune diseases and cancer, are commented. The normal and the pathologic radiologic and echographic aspects of breasts with implants are discussed, concerning to the prosthesis itself and to the adjacent parenchyma. The validity of mammographic and ultrasound mammography in the detection of cancer and of alterations of the implants are emphasized and also the importance of exams of high technical quality.(author). 16 refs, 13 figs.

  14. Treatment of Metastatic Spinal Tumors by Percutaneous Vertebroplasty versus Percutaneous Vertebroplasty Combined with Interstitial Implantation of 125I Seeds

    Energy Technology Data Exchange (ETDEWEB)

    Zuozhang Yang; Lin Xie; Yunchao Huang; Hongpu Sun; Pengjie Liu; Zhongxiong Wu (Dept. of Orthopedics, Tumor Hospital of Yunnan Province, Third Affiliated Hospital of Kunming Medical College, Kunming, Yunnan (China)). e-mail. yangzuozhang@163.com; Dakuan Yang (Second Affiliated Hospital of Kunming Medical College, Kunming Yunnan (China)); Yuqing Sun (Dept. of Orthopedic Oncology, Beijing Jishuitan Hospital, Beijing (China))

    2009-12-15

    Background: As the most frequent bone metastasis, spinal metastases cause severe pain and damage to vertebral bodies such as spinal osteolytic destruction and compression fractures. To avoid the trauma and complications of open surgery, a minimally invasive procedure, percutaneous vertebroplasty (PVP), has recently been developed to treat metastatic spinal tumors. Purpose: To analyze the treatment outcomes of metastatic spinal tumors by percutaneous vertebroplasty (PVP) alone or PVP combined with interstitial implantation of 125I seeds. Material and Methods: 80 patients with metastatic spinal tumors were randomized to receive PVP alone (40 cases) or PVP combined with 125I seed implantation (40 cases). Digital subtraction angiography (DSA)-guided vertebroplasty was performed under local anesthesia, and acrylic bone cement was injected into the vertebra through a bone trocar to the center of the lesion, with or without simultaneous interstitial implantation of 125I seeds. Results: At 6-month follow-up, PVP combined with 125I seed implantation resulted in zero cases with complete relief (CR), 36 with partial relief (PR), four with no changes (NC), and zero with progression of disease (PD), while PVP alone without seed implantation resulted in 0 CR, 31 PR, 7 NC, and 2 PD. While the combined-treatment group and the single-PVP group showed overall clinical benefit rates without significant difference (100% and 95.0%, respectively), their visual analogue pain scales (VAS; 2.26+-1.05 and 5.41+-0.94, respectively) and Karnofsky performance scores (KPS; 92.5+-7.1 and 87.7+-7.3, respectively) were significantly different after treatment (P = 0.028 and P = 0.009, respectively). Patients in both groups had 1-year follow-up, and the mean time to tumor progression (TTP) was 9.0 and 8.9 months, respectively (not significant). Conclusion: PVP is a minimally invasive procedure with small wounds and minor complications. It is effective in the alleviation of pain in metastatic spinal

  15. Cosmetic outcome with interstitial implant as part of breast-conservation therapy in rural population of Maharashtra

    International Nuclear Information System (INIS)

    In early stages of carcinoma breast, breast conservation therapy is the preferred method as it gives local control rate along with survival comparable to more radical surgery. While irradiating the tumor bed by interstitial implant, dose homogeneity is the most important parameter for achieving good cosmesis. As per ICRU (International Commission on Radiation Units and Measurement), dose homogenetity index (DHI) is defined as ratio of peripheral dose to the central dose

  16. CT-guided radioactive 125I-seed implantation for the treatment of pancreatic carcinoma: a clinical observation of 19 cases

    International Nuclear Information System (INIS)

    Objective: To explore the dynamic changes of serum tumor markers after CT-guided radioactive 125I-seed implantation treatment in patients with pancreatic carcinoma and to assess the therapeutic effectiveness of 125I-seed implantation. Methods: CT-guided radioactive 125I-seed implantation was performed in 19 patients with unresectable advanced pancreatic cancer. Treatment planning system was used to reconstruct 3-dimentional images of the tumor, and the quantity and distribution of 125I-seeds to be implanted were thus determined. Under CT guidance 125I-seeds were embedded into pancreatic cancer. Before and after the 125I-seed implantation the levels of serum tumor markers, including CEA, CA19-9 and CA50, were determined by using radioimmunoassay method. The clinical effects were observed and the therapeutic results were statistically analyzed. Results: The pain stared to be relieved 2 to 5 days after implantation. The total effective rate (CR + PR) at one and three months after treatment was 68.42% (13 /19) and 63.16% (12 /19) respectively. One month after 125I-seed implantation, the levels of serum CEA, CA19-9 and CA50 were significantly different to that determined before implantation in all cases (P 125I-seed implantation is a safe and effective interventional treatment for advanced pancreatic cancer with reliable short-term result and remarkable pain-relieving effect. Moreover, this therapy can significantly lower the levels of many serum tumor markers, which play some suggestive roles in evaluating the clinical curativeness. (authors)

  17. Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

    OpenAIRE

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B.; Sheena, Yezen; Niakas, Dimitrios

    2015-01-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results ...

  18. External beam irradiation plus 192Ir implant after breast-preserving surgery in women with early breast cancer

    International Nuclear Information System (INIS)

    Purpose: To provide more information for the clinician and to analyze the impact of the boost with brachytherapy on the local disease-free survival (LDFS), disease-free survival (DFS), specific overall survival (OS), and cosmesis, a retrospective study of external radiation therapy and 192Ir implantation in early breast cancer at Institut Catala d'Oncologia has been undertaken. Patients and Methods: From 1986 to 1996, 530 patients were selected for this study with a median follow-up period of 39.5 months (range, 10-115 months). External radiation therapy (combined with brachytherapy) was administered postoperatively to the breast in all patients. Mean given dose was 48.7 Gy (range, 42-52 Gy) with external radiation therapy to the breast, and 16.8 Gy (range, 10-27 Gy) was the mean dose with brachytherapy. Variables have been tested for cosmesis. Univariate and multivariate analysis have also been carried out. Results: Mean age of the patients was 54 years (range, 28-81 years). Stages were distributed as follows: 350 patients (66%) in Stage I, 173 in Stage II (32.8%), and 7 in Stage III (1.1%). Pathologic distribution was 445 patients with infiltrating ductal carcinoma (84%), 20 patients with infiltrating lobular carcinoma (4%), and 65 patients (12%) of a miscellaneous group. OS for the entire group was 89.4% and 85.9% at 5 and 7 years respectively. Probability of DFS was 81.7% and 70.1% at 5 and 7 years. The LDFS was 94.9% and 91.7% at 5 and 7 years. The MFS probability was 85.5% and 76.9% at 5 and 7 years, respectively. Univariate analysis demonstrated that age (older than 52 years), premenopausal status, moderate and high histologic grades (Grades II-III), and presence of intraductal comedocarcinoma were prognostic factors for local relapse. Multivariate analysis for local disease-free survival demonstrated that only perineural or muscular infiltration remain as prognostic factors. Tumor dose bed of 70 Gy or higher had a negative impact in breast subcutaneous

  19. Tumor seeding after diagnostic vitrectomy for choroidal metastasis in breast cancer.

    Science.gov (United States)

    Kung, Ya-Hsin; Wu, Tsung-Tien; Lin, Chia-Shian

    2012-09-01

    Choroidal metastasis is the most common type of intraocular tumor in adults, and in females the most common primary site is the breast. We report a case of unilateral choroidal metastasis with exudative retinal detachment as the initial presentation of recurrent breast cancer, and subsequent ophthalmic metastasis following diagnostic vitrectomy. A 49-year-old woman with a 7-year-history of well-treated bilateral breast cancer had been suffering from blurred vision in the left eye for 1 week. Ocular examination was normal except for superotemporal retinal detachment in the left eye. Neither retinal break nor choroidal mass was seen. The patient received scleral buckling and pneumatic retinopexy without significant improvement. Fluorescein angiography revealed a suspected choroidal metastasis in the left eye, but ocular ultrasonography did not show a visible choroidal mass. Two consecutive diagnostic vitrectomies with cytology could not confirm malignancy. A systemic workup was also negative. Six months later, two tumor masses were noted over two of the sclerotomy wounds of the left eye. Pathology showed adenocarcinoma compatible with invasive ductal carcinoma of the breast. Ocular metastasis may present as infiltrative choroidal lesions with exudative retinal detachment without a visible mass. Invasive procedures, such as fine-needle aspiration biopsy and diagnostic vitrectomy, may risk tumor seeding.

  20. The Poly Implant Prothèse breast prostheses scandal: Embodied risk and social suffering.

    Science.gov (United States)

    Greco, Cinzia

    2015-12-01

    This article examines the 2010 scandal surrounding the use and subsequent recall of adulterated Poly Implant Prothèse (PIP) silicone breast prostheses in France. It uses a mixed method approach that includes 12 interviews with French PIP prosthesis recipients, analyses of medical literature, policy documents of French and EU regulatory agencies, and an online forum for PIP recipients. These data are used to explain how the definition of "acceptable risk" in the silicone implants controversy of the 1990s in the US influenced the PIP scandal later on in France. Additionally, PIP recipients had an embodied experience of risk that clashed with the definition of risk used by authorities and some surgeons. The coverage of re-implantation was also defined at different policy levels, leading to variation in patients' suffering. The combination of fraud and lack of recognition from part of the medical system constitutes an example of social suffering for the patients involved. The PIP scandal is a useful case for analyzing the interconnection of embodied experience and professional and public policy definitions of medical risk through the concepts of moral economy and biological citizenship.

  1. Implant breast reconstruction followed by radiotherapy: Can helical tomotherapy become a standard irradiation treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Massabeau, Carole, E-mail: cmassabeau@hotmail.com [Department of Radiation Oncology, Institut Curie, Paris (France); Fournier-Bidoz, Nathalie; Wakil, Georges; Castro Pena, Pablo; Viard, Romain; Zefkili, Sofia; Reyal, Fabien; Campana, Francois; Fourquet, Alain; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2012-01-01

    To evaluate the benefits and limitations of helical tomotherapy (HT) for loco-regional irradiation of patients after a mastectomy and immediate implant-based reconstruction. Ten breast cancer patients with retropectoral implants were randomly selected for this comparative study. Planning target volumes (PTVs) 1 (the volume between the skin and the implant, plus margin) and 2 (supraclavicular, infraclavicular, and internal mammary nodes, plus margin) were 50 Gy in 25 fractions using a standard technique and HT. The extracted dosimetric data were compared using a 2-tailed Wilcoxon matched-pair signed-rank test. Doses for PTV1 and PTV2 were significantly higher with HT (V95 of 98.91 and 97.91%, respectively) compared with the standard technique (77.46 and 72.91%, respectively). Similarly, the indexes of homogeneity were significantly greater with HT (p = 0.002). HT reduced ipsilateral lung volume that received {>=}20 Gy (16.7 vs. 35%), and bilateral lungs (p = 0.01) and neighboring organs received doses that remained well below tolerance levels. The heart volume, which received 25 Gy, was negligible with both techniques. HT can achieve full target coverage while decreasing high doses to the heart and ipsilateral lung. However, the low doses to normal tissue volumes need to be reduced in future studies.

  2. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling.

    Science.gov (United States)

    Rüegg, Eva; Cheretakis, Alexandre; Modarressi, Ali; Harbarth, Stephan; Pittet-Cuénod, Brigitte

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months' follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections. PMID:25893122

  3. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling

    Directory of Open Access Journals (Sweden)

    Eva Rüegg

    2015-01-01

    Full Text Available Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months’ follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

  4. Evaluation of radioactive seeds implantation under PET-CT guidance for the treatment of central lung cancer with obstructive atelectasis

    International Nuclear Information System (INIS)

    Objective: To evaluate percutaneous puncturing 125I seed implantation by using PET-CT guided target localization technique in treating central lung cancer complicated by obstructive pulmonary atelectasis. Methods: A total of 30 patients with suspected central lung cancer complicated by obstructive pulmonary atelectasis on preoperative chest films were enrolled in this study. As no clear distinction existed between the tumor and the atelectatic consolidation shadow on plain chest films, CT scanning was carried out in all patients. If CT scan was still not able to determine the margin of the tumor, an additional PET-CT scanning was adopted. After ascertaining the location of the lung cancer, percutaneous puncturing implantation of 125I seeds under PET-CT guidance was performed. The clinical data and the therapeutic results were evaluated. Results: A sharp distinction between the tumor and the atelectatic consolidation shadow was demonstrated on PET-CT scans in 21 cases. The mean volume of the targeted lesion reckoned from PET-CT scans was 26 cm3, and the 125I seeds were implanted. The mean volume of the targeted lesion calculated on CT scans was 37 cm3. Six months after the treatment, the follow-up CT exam showed that the effective rate was 93% (28/30). The one-year survival rate was 100% . The complications included pneumothorax (n = 8), small amount of hemoptysis (n = 12) and fever (n = 2). No displacement or immigration of the implanted seeds occurred. Conclusion: PET-CT scanning is far superior to conventional CT scanning in determining the target area of the tumor in patients with central lung cancer complicated by obstructive pulmonary atelectasis. (authors)

  5. CT-guide coaxial 125I seeds implantation for the treatment of retroperitoneal lymph node metastasis: analysis of 21 cases

    International Nuclear Information System (INIS)

    Objective: To investigate the method, safety and clinical value of CT-guided coaxial percutaneous 125I seed implantation in treating retroperitoneal metastatic lymph nodes. Methods: CT-guided coaxial percutaneous 125II seed implantation, as interstitial brachytherapy, was carried out in 21 patients with retroperitoneal lymph node metastasis. Before operation therapeutic plan system (TPS) was used in all patients to design the distribution of radioactive particles, and after the procedure CT scanning was performed to verify the distribution of radioactive particles. After the treatment, the abdominal pain, abdominal distension, serum tumor marker levels and local reaction of the target lymph nodes were evaluated. Results: The technical success rate was 100%, and after the operation no serious complications such as gastrointestinal perforation, radiation enteritis, vascular injury, bleeding, etc. occurred. Follow-up CT scanning was conducted once every 1-2 months. Six months after the treatment, complete remission (CR) was obtained in 13 cases, partial remission (PR) in 6 cases, stable disease (SD) in 2 cases, and progression disease (PD) in none. The overall response (CR + PR) rate was 90.5%. The abdominal pain and abdominal distension were relieved in different degrees in 16 patients, and the serum tumor marker levels were decreased in different degrees in 14 patients. Conclusion: For the treatment of retroperitoneal lymph node metastasis, CT-guided coaxial percutaneous l25I seed implantation is effective, safe and reliable. This technique provides a new minimally-invasive treatment for retroperitoneal lymph node metastasis. (authors)

  6. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt;

    2016-01-01

    (RT). MATERIAL AND METHODS: All women treated for early-stage BC in Denmark from 1982 to 2005 were identified from the Danish Breast Cancer Cooperative Group. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to RT. Standardized incidence...

  7. Pathological impairments induced by interstitial implantation of 125I Seeds in spinal canal of banna mini-pigs

    Directory of Open Access Journals (Sweden)

    Yang Zuozhang

    2012-03-01

    Full Text Available Abstract Background Use a banna mini-pig to set up 125I implantation model, and investigate the consequence of radiation-related impairments. Methods In present study, 125I seeds were implanted into spinal canal of T13 level of spine in banna mini-pigs. After operation, the pigs were raised up to 8 months, behavior changes were recorded within this period. After 8 months, spinal cords were collected for pathological analysis. Results In this study, a 125I brachytherapy animal model had been successfully established, in the model group, the banna pigs' Tarlov scale decreased from 5 to 2.57 ± 0.36, significant cellular impairments were noted by pathological analysis. Conclusions Without any protection and operation improvement, 125I implantation can cause serious histological impairments and moving difficulty for banna mini-pigs; this present research provides an alternative tool to study spinal 125I brachytherapy.

  8. Iodine-125 seed implantation as an adjunct to surgery in advanced recurrent squamous cell cancer of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Park, R.I.; Liberman, F.Z.; Lee, D.J.; Goldsmith, M.M.; Price, J.C. (Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD (United States))

    1991-04-01

    Survival for extensive recurrent squamous cell carcinomas of the head and neck remains poor, with the major cause of death being local recurrence. Surgical implantation of iodine-125 interstitial seeds allows tumoricidal doses of radiation to be delivered to residual tumor while minimizing radiation doses to the surrounding tissues. From 1978 to 1988, 39 implantations were performed on 35 patients for extensive recurrent squamous cell carcinoma of the head and neck. The decision for implantation was based on positive margins or close to resection margins from frozen sections after salvage resection. The determinate 5-year disease-free survival was 41%, with both the overall and no evidence of disease 5-year survivals being 29%. Significant complications occurred in 36% of all cases. This figure increased to 56% when flap reconstruction was required. Possible reasons for this seemingly high complication rate are discussed. Considering the advanced nature of these recurrent carcinomas, surgical resection with iodine-125 seed implantation appears to be an effective method of managing disease that might otherwise be judged unresectable and treated for palliation only.

  9. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    Directory of Open Access Journals (Sweden)

    Heba G. El-Sheredy

    2016-01-01

    Full Text Available Background: Breast cancer is the most frequent malignant tumor in women worldwide. In recent years, defined reconstruction principles along with numerous surgical techniques with volume replacement have been published. Autologous breast reconstruction is more natural but leaves donor site morbidity. It provides the opportunity to restore the breast mound without the need for scars. This study aims to evaluate the complications of radiotherapy after immediate breast reconstruction with implants in breast cancer patients who submitted to skin sparing mastectomy and nipple sparing mastectomy by taking into consideration the risk factors and management at our institution. Methods: The current study prospectively included patients with invasive breast cancer admitted between January and June 2012 who were scheduled for skin sparing mastectomy or nipple sparing mastectomy and axillary dissection followed by immediate breast reconstruction with implant. Patients received adjuvant chemotherapy followed by conventional fractionated radiation. Complications were classified as either minor or major. The minor complications included capsular contracture (Baker 1-2, seroma, minor skin infection and skin dehiscence without exposure of the implant. Major complications included capsular contracture (Baker 3-4, severe infection and major wound dehiscence with implant exposure. Capsular contracture was scored according to the modified Baker classification. Results: The study included 38 patients. Of these, 28 had skin sparing mastectomy while 10 underwent nipple sparing mastectomy. The overall complication rate was 71%. We observed minor complications in 18 patients while 9 patients had major complications. Complications occurred with a median time of 13 months following radiotherapy completion. All minor complications were managed conservatively whereas all major complications required repeat surgery. No loco-regional recurrences occurred during the follow up

  10. A Direct Comparison of Alloderm-Ready to Use (RTU) and DermACELL in Immediate Breast Implant Reconstruction

    Science.gov (United States)

    Salzberg, C. Andrew

    2016-01-01

    The objective of this study was to compare the 2 leading human acellular dermal matrices in breast reconstruction with implants. This retrospective study draws on the experience of 2 expert surgeons with a history of long-standing use of the Alloderm-RTU (LifeCell Corporation, Branchburg, NJ) product who switched to the DermACELL acellular dermal matrix (LifeNet Health, Virginia Beach, Va) product. The consecutive nature of these data over this change allowed comparison between the 2 products without the confounding effects of patient selection or change in technique. The postoperative complications of seroma, infection, implant loss, and unplanned return to the operating room were studied, and no statistical differences were noted between these 2 products. The overall complications rates were low, with implant loss and infection less than 2% in 249 cases. Recommendations are for continued use of acellular dermal matrix in breast reconstruction and product selection based on price and availability. PMID:27602176

  11. Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority

    Directory of Open Access Journals (Sweden)

    Alexandre Leduey

    2015-01-01

    Full Text Available Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament, the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France. The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%, infection (22.2%, and capsular contracture (13.6%. Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

  12. Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority.

    Science.gov (United States)

    Leduey, Alexandre; Mazouni, Chafika; Leymarie, Nicolas; Alkhashnam, Heba; Sarfati, Benjamin; Garbay, Jean-Rémi; Gaudin, Amélie; Kolb, Frédéric; Rimareix, Françoise

    2015-01-01

    Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament), the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP) breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof) of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France). The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse) were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%), infection (22.2%), and capsular contracture (13.6%). Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

  13. Primary research on neoplasm needle track implantation metastasis after radioactive seeds implantation and preventive measures%放射性粒子植入导致肿瘤针道种植转移及预防

    Institute of Scientific and Technical Information of China (English)

    Juan Wang; Weihong Gong; Huige Fan; Aixia Sui; Na Zhao; Yongqing Shen

    2007-01-01

    Objective: To observe the possibility of neoplasm needle track implantation after radioactive seeds implantation and seek preventive measures to avoid it. Methods: Superficial tissue of 250 seeding needle cores and 250 stylophores employed in neoplasm radioactive seeds implantation was smeared on slides to search for tumor cells. All patients received chemotherapy or endocrine therapy after operations. Ultrasound B-mode or computer tomography (CT) was performed at 10th day, 30th day, 60th day, and 180th day post operation to detect neoplasm implantation metastasis through needle tracks.Results: Positive cells were found on 13 of 250 (5.20%) cores, and 7 of 250 (2.80%) stylophores. The difference was not statistically significant (P > 0.05). The positive cells frequency of needles those traversed distance less than 3 cm in normal tissue was 6.19% (13/210), while the frequency of the others those traversed longer distance in normal tissue was 2.41% (7/290).The positive cells frequency of needles traversing different distances in normal tissues is significantly different (P < 0.05). No neoplasm was detected through needle tracks by ultrasound B-mode or CT in 180 days after operation. Conclusion: Tumor cells could ablate into the needle track during radioactive seed implantation. Some preventive measures, such as optimization of pre-operation and intra-operation treatment plan, chemotherapy or endocrine therapy after operation, may be beneficial to avoid the implantation metastasis of neoplasm in seeding needle tracks.

  14. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    International Nuclear Information System (INIS)

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  15. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    Energy Technology Data Exchange (ETDEWEB)

    Maijers, M.C.; Ritt, M.J.P.F. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Niessen, F.B. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Jan van Goyen Clinic, Department of Plastic Surgery, Amsterdam (Netherlands); Veldhuizen, J.F.H. [MRI Centre, Amsterdam (Netherlands); Manoliu, R.A. [MRI Centre, Amsterdam (Netherlands); VU University Medical Centre, Department of Radiology, Amsterdam (Netherlands)

    2014-06-15

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  16. Implantes mamarios y mastopexía: colgajos mamarios laterales y mediales, una opción técnica Breast Implants and Mastopexy: lateral and Medial Breast Flaps, a Technical Option

    Directory of Open Access Journals (Sweden)

    R. Goulart Jr.

    2012-12-01

    Full Text Available La mastopexia asociada al uso de implantes mamarios es actualmente una de las prácticas más desafiantes en Cirugía Plástica; en ella, el cirujano tiene que utilizar al máximo sus capacidades y conocimientos para decidir con exactitud la mejor relación entre el tamaño ideal del implante y el exceso de piel a retirar. El objetivo de este artículo es presentar una técnica a base de colgajos mamarios laterales y mediales (CMLM para cirugía de mastopexia con implantes mamarios en busca de una mejor definición de la mama y de una mayor duración del resultado final. Esta técnica se crea en base a la circulación mamaria y en los excedentes de tejido al final de la cirugía utilizando la marcación en T. Los resultados inmediatos han sido muy satisfactorios en términos de definición de la forma mamaria, de la solidez de la nueva estructura glandular y de la protección del implante mamario. La duración a largo plazo aún debe ser evaluada. Creemos que se trata de una técnica fácil de ejecutar, que permite un resultado estético satisfactorio, proporciona una percepción de mayor seguridad en el posicionamiento del implante, aunque somos conscientes de que su sostenibilidad y duración a largo plazo aún necesitan tiempo para una mejor evaluación.The breast implant associated with mastopexy actually is one of most difficult plastic surgeries. In fact, it is a surgery where the surgeon has to use his higher capabilities and skills in order to decide with precision the best relationship between ideal sizes of the breast implant and skin excess. The purpose in this paper is to present a breast lateral and medial flaps technique for augmentation mastopexy surgery looking for a better breast design and resistance on the final result. The technique was created on breast circulation basis, skin excess and better definition and resistance about the aesthetical breast results in the augmentation mastopexy surgery utilizing the T scar technique

  17. Dosimetry consequences of the accuracy at the position of the seeds in a seeds implant of I-125 in prostate; Consecuencias dosimetricas de la exactitud en la posicion de las semilla en un implante de semillas de I-125 en prostata

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    The quality control of equipment used to carry out implants of seeds of low rate in prostate, van destined to watch, the activity of seeds and the calculation of planning both positioning them on the inside of the patient. The objective of this work is, using the Nucletron Spot Pro and SeedSelectron, rating dosimetry possible consequences related to the position of the seeds. (Author)

  18. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants

    International Nuclear Information System (INIS)

    Purpose: To assess the role of endorectal coil magnetic resonance imaging (MRI) staging for patients undergoing seed implantation (SI) with or without external beam radiotherapy (EBRT). Methods and Materials: Between October 1994 and December 1998, 390 patients underwent prostate SI (98% Pd-103, 2% I-125). Seventy-six percent of patients had a prostate serum antigen (PSA) 20. Ten percent of patients had a Gleason score (GS) of 4-5, 54% had GS 6, 29% had GS 7, and 7% had GS ≥ 8. Monotherapy was employed in 46% of patients, and the remaining 54% received combined EBRT and SI. Three hundred twenty-seven were staged by high-resolution phased array pelvic coil, or in most cases, an endorectal coil MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of seed distributions. The criteria utilized to determine MRI-based stage were founded on the reported literature from the University of Pennsylvania. All MRI studies were reviewed by C.A., D.B., or W.H., who were unaware of clinical stage at the time of their review. The biopsy report was available to them as the only clinical correlate. Results: Of the 327 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 26% of T1, T2 patients were upstaged to T3. Perineural invasion and the percentage of positive cores predicted for T3 MRI stage (p 3 intermediate-risk group patients treated by combined therapy with a previous study of T3 intermediate-risk group treated by radical prostatectomy (RP) at the University of Pennsylvania. Our 36-month PSA FFP was 94% compared with 21% for the previous study's RP patients. Conclusion: MRI is a valuable staging procedure for prostate cancer patients treated by SI. PSA FFP results appear to be improved by MRI staging. MRI T3 disease can be treated more effectively by SI + EBRT than by RP

  19. Percutaneous transcatheter implantation of 125I iodine seeds for the treatment of liver cancer associated with portal vein tumor thrombus: initial experience in 19 cases

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility and therapeutic efficacy of percutaneous transcatheter implantation of 125I iodine seeds in treating liver cancer associated with portal vein tumor thrombus. Methods: Nineteen patients with primary hepatocellular carcinoma complicated by portal vein tumor thrombus received implantation of 125I iodine seeds via portal vein. The puncturing of portal vein was guided by ultrasound. Under fluoroscopic guidance the 125I iodine seeds were implanted within the portal vein tumor thrombus at 8 mm distance. The number of 125I iodine seeds used in one procedure was 8 to 30 in total. The technical success rate, the postoperative complications, the hepatic and renal functions as well as routine blood test, and the suppression of portal vein tumor thrombus were determined, and the results were analyzed. Results: The implantation of 125I seeds was successfully accomplished in all the patients. No serious procedure-related complications occurred. During the follow-up period lasting for 3-22 months, the portal vein tumor thrombus showed a significant shrinkage in all patients. Conclusion: For the treatment of portal vein tumor thrombus, percutaneous transcatheter implantation of 125I iodine seeds is clinically feasible and effective. (authors)

  20. The clinical application of 125I seeds implantation together with bronchial arterial infusion chemotherapy for the treatment of advanced lung cancer

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of 125I seeds implantation combined with the bronchial arterial infusion chemotherapy in treating advanced lung cancer. Methods: 125I seeds implantation combined with the bronchial arterial infusion chemotherapy was performed in 30 patients with advanced lung cancer. About 3 -70 seeds of 125I (6711 type, 0.7 mCi / seed) were delivered in each patient. In all patients bronchial arterial infusion chemotherapy was carried out at the time of 7 days before the implantation and 30 and 60 days after the implantation. The results and complications were observed. The clinical data were retrospectively analyzed. The therapeutic efficacy was evaluated according to RECIST standards. Results: A total of 40 lesions were detected in all 30 patients and 125I seeds were successfully embedded in all lesions. No procedure-related complications occurred. All patients were followed up for 2 -24 months. The two-year survival rate was 86.6% (26 / 30). Therapeutic evaluation made at four months after the treatment showed that CR, PR, NC and PD was seen in 26, 10, 2 and 2 lesions respectively,with a total effective rate of 90%. Conclusion: 125I seeds implantation combined with the bronchial arterial infusion chemotherapy is a safe and effective therapy for advanced lung cancer with excellent clinical results. (authors)

  1. Complex radiological diagnosis of a breast cancer at women after augmentation mammоplasty of silicone gel implants

    Directory of Open Access Journals (Sweden)

    T. A. Shumakova

    2014-01-01

    Full Text Available One of leading problems of mammology is early diagnostics of a breast cancer. The work purpose studying of opportunities of a complex of radiological research techniques in diagnostics of a breast cancer at women after augmentation mammoplasty silicone gel implants. By results of сomplex kliniko-radiological examination of 630 women aged from 18 till 72 years (middle age made 35 ± 0.43 years with 1260 implants the breast cancer was revealed at 7 (1.1 % patients. The invasive pro-current cancer with local widespread type of body height of tumoral knot is histologically diagnosed. Sensitivity and specificity of methods of radiodiagnosis in identification of a cancer of mammary glands at women after endoprosthesis replacement made mammography – 28.6 % and 66.1 %, ultrasonography – 71.4 % and 85.7 %, magnetic resonance imaging – 85.7 % and 98.2 %, respectively. Thus, complex application of radiology research techniques raises level of diagnostics of breast cancer at patients after augmentation mammoplasty silicone gel implants that allows to choose an adequate method of treatment.

  2. Effect of implant vs. tissue reconstruction on cancer specific survival varies by axillary lymph node status in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Qian Ouyang

    Full Text Available To compare the breast cancer-specific survival (BCSS between patients who underwent tissue or implant reconstruction after mastectomy.We used the database from Surveillance, Epidemiology, and End Results (SEER registries and compared the BCSS between patients who underwent tissue and implant reconstruction after mastectomy. Cox-regression models were fitted, adjusting for known clinicopathological features. The interaction between the reconstruction types (tissue/implant and nodal status (N-stage was investigated.A total of 6,426 patients with a median age of 50 years were included. With a median follow up of 100 months, the 10-year cumulative BCSS and non-BCSS were 85.1% and 95.4%, respectively. Patients who underwent tissue reconstruction had tumors with a higher T-stage, N-stage, and tumor grade and tended to be ER/PR-negative compared to those who received implant reconstruction. In univariate analysis, implant-reconstruction was associated with a 2.4% increase (P = 0.003 in the BCSS compared with tissue-reconstruction. After adjusting for significant risk factors of the BCSS (suggested by univariate analysis and stratifying based on the N-stage, there was only an association between the reconstruction type and the BCSS for the N2-3 patients (10-year BCSS of implant vs. tissue-reconstruction: 68.7% and 59.0%, P = 0.004. The 10-year BCSS rates of implant vs. tissue-reconstruction were 91.7% and 91.8% in N0 patients (P>0.05 and 84.5% and 84.4% in N1 patients (P>0.05, respectively.The implant (vs. tissue reconstruction after mastectomy was associated with an improved BCSS in N2-3 breast cancer patients but not in N0-1 patients. A well-designed, prospective study is needed to further confirm these findings.

  3. Enhanced Survival with Implantable Scaffolds That Capture Metastatic Breast Cancer Cells In Vivo.

    Science.gov (United States)

    Rao, Shreyas S; Bushnell, Grace G; Azarin, Samira M; Spicer, Graham; Aguado, Brian A; Stoehr, Jenna R; Jiang, Eric J; Backman, Vadim; Shea, Lonnie D; Jeruss, Jacqueline S

    2016-09-15

    The onset of distant organ metastasis from primary breast cancer marks the transition to a stage IV diagnosis. Standard imaging modalities often detect distant metastasis when the burden of disease is high, underscoring the need for improved methods of detection to allow for interventions that would impede disease progression. Here, microporous poly(ε-caprolactone) scaffolds were developed that capture early metastatic cells and thus serve as a sentinel for early detection. These scaffolds were used to characterize the dynamic immune response to the implant spanning the acute and chronic foreign body response. The immune cell composition had stabilized at the scaffold after approximately 1 month and changed dramatically within days to weeks after tumor inoculation, with CD11b(+)Gr1(hi)Ly6C(-) cells having the greatest increase in abundance. Implanted scaffolds recruited metastatic cancer cells that were inoculated into the mammary fat pad in vivo, which also significantly reduced tumor burden in the liver and brain. Additionally, cancer cells could be detected using a label-free imaging modality termed inverse spectroscopic optical coherence tomography, and we tested the hypothesis that subsequent removal of the primary tumor after early detection would enhance survival. Surgical removal of the primary tumor following cancer cell detection in the scaffold significantly improved disease-specific survival. The enhanced disease-specific survival was associated with a systemic reduction in the CD11b(+)Gr1(hi)Ly6C(-) cells as a consequence of the implant, which was further supported by Gr-1 depletion studies. Implementation of the scaffold may provide diagnostic and therapeutic options for cancer patients in both the high-risk and adjuvant treatment settings. Cancer Res; 76(18); 5209-18. ©2016 AACR. PMID:27635043

  4. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    International Nuclear Information System (INIS)

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture

  5. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    Energy Technology Data Exchange (ETDEWEB)

    Ribuffo, Diego; Lo Torto, Federico [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Giannitelli, Sara M. [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Urbini, Marco; Tortora, Luca [Surface Analysis Laboratory, Department of Mathematics and Physics, University “Roma Tre”, Via della Vasca Navale 84, 00146 Rome (Italy); INFN — National Institute of Nuclear Physics, Section of Roma Tre, Via della Vasca Navale 84, 00146 Rome (Italy); Mozetic, Pamela; Trombetta, Marcella [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Basoli, Francesco; Licoccia, Silvia [Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, 00173 Rome (Italy); Tombolini, Vincenzo [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome (Italy); Cassese, Raffaele [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Scuderi, Nicolò [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); and others

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture.

  6. Expander/implant breast reconstruction before radiotherapy. Outcomes in a single-institute cohort

    Energy Technology Data Exchange (ETDEWEB)

    Aristei, C.; Palumbo, I. [Perugia Univ. (Italy). Radiation Oncology Section; Santa Maria della Misericordia Hospital, Perugia (Italy); Falcinelli, L.; Petitto, R.P.; Perrucci, E. [Santa Maria della Misericordia Hospital, Perugia (Italy). Radiation Oncology Div.; Bini, V. [Perugia Univ. (Italy). Dept. of Internal Medicine; Farneti, A. [Perugia Univ. (Italy). Radiation Oncology Section; Gori, S. [Santa Maria della Misericordia Hospital, Perugia (Italy). Medical Oncology Div.

    2012-12-15

    Background and purpose: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. Patients and methods: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. Results: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good ({kappa}-value 0.64; 95% CI: 0.48-0.79). Conclusion: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent. (orig.)

  7. Expander/implant breast reconstruction before radiotherapy. Outcomes in a single-institute cohort

    International Nuclear Information System (INIS)

    Background and purpose: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. Patients and methods: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. Results: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good (κ-value 0.64; 95% CI: 0.48-0.79). Conclusion: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent. (orig.)

  8. Anticancer activity of Petroselinum sativum seed extracts on MCF-7 human breast cancer cells.

    Science.gov (United States)

    Farshori, Nida Nayyar; Al-Sheddi, Ebtesam Saad; Al-Oqail, Mai Mohammad; Musarrat, Javed; Al-Khedhairy, Abdulaziz Ali; Siddiqui, Maqsood Ahmed

    2013-01-01

    Pharmacological and preventive properties of Petroselinum sativum seed extracts are well known, but the anticancer activity of alcoholic extracts and oil of Petroselinum sativum seeds on human breast cancer cells have not been explored so far. Therefore, the present study was designed to investigate the cytotoxic activities of these extracts against MCF-7 cells. Cells were exposed to 10 to 1000 μg/ml of alcoholic seed extract (PSA) and seed oil (PSO) of Petroselinum sativum for 24 h. Post-treatment, percent cell viability was studied by 3-(4, 5-dimethylthiazol-2yl)-2, 5-biphenyl tetrazolium bromide (MTT) and neutral red uptake (NRU) assays, and cellular morphology by phase contrast inverted microscopy. The results showed that PSA and PSO significantly reduced cell viability, and altered the cellular morphology of MCF-7 cells in a concentration dependent manner. Concentrations of 50 μg/ml and above of PSA and 100 μg/ml and above of PSO were found to be cytotoxic in MCF-7 cells. Cell viability at 50, 100, 250, 500 and 1000 μg/ml of PSA was recorded as 81%, 57%, 33%, 8% and 5%, respectively, whereas at 100, 250, 500, and 1000 μg/ml of PSO values were 90%, 78%, 62%, and 8%, respectively by MTT assay. MCF-7 cells exposed to 250, 500 and 1000 μg/ml of PSA and PSO lost their typical morphology and appeared smaller in size. The data revealed that the treatment with PSA and PSO of Petroselinum sativum induced cell death in MCF-7 cells. PMID:24289568

  9. A radioactive seed implant on a rabbit's liver following a voxel model representation for dosimetric proposals

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Tarcisio P.R.; Andrade, Joao Paulo Lopes de; Costa, Igor Temponi; Teixeira, Cleuza H. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Programa de Pos-graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg

    2005-07-01

    Animal models have been used in experimentation with ionizing radiation. The evaluation of the energy absorbed per unit tissue mass in vivo transported by nuclear particles is a task to be performed before experimentation. Stochastic or deterministic methodology can be applied, however the dosimetric protocols applied in radiotherapy center cannot be applied directly due to the inherent small geometry and chemical composition of the animal distinct from human. The present article addresses a method in development that will predict the dose distribution into the rabbit thorax based on the solution of the transport phenomena in a voxel model. The model will be applied to simulate a seed implant experiment on a rabbit. Herein, the construction of the three-dimensional voxel model anthropomorphic -anthropometrics to the rabbit is presented. The model is assembling from a set of computer tomography of the rabbit. The computational phantom of the thorax starts at the digitalisation of the CT images, tissue definition, and color image representation of each tissue and organ. The chemical composition and mass density of each tissue is evaluated as similar date presented by ICRU-44. To treat the images, a code namely SISCODES, developed in house, was used. The in vivo experiment that will be simulated is also described. That is a implant of five seeds of 1.6x2 mm performed in a rabbit's liver. The perspective of this work is the application of the model in dosimetric studies predicting the dose distribution around the seed's implanted in vivo experiments. (author)

  10. Multicenter study to assess potential hazards from exposure to lipid peroxidation products in soya bean oil from Trilucent breast implants.

    Science.gov (United States)

    Williams, G M; Caldwell, J; Armstrong, D; Bartsch, H; Bevan, R; Browne, R W; Chipman, J K; Iatropoulos, M J; Jeffrey, A M; Lunec, J; Nair, J; Page, D L; Reeves, B C; Richardson, A; Silverstein, B; Williams, D F

    2009-03-01

    In response to a Hazard Notice by the Medical Devices Agency of the UK in 2000 regarding the Trilucent breast implant (TBI), an expert panel was convened to implement a research program to determine whether genotoxic compounds were formed in the soybean oil filler (SOF) of TBIs and whether these could be released to produce local or systemic genotoxicity. The panel established a research program involving six laboratories. The program recruited 47 patients who had received TBIs (9 patients had received silicone implants previously). A reference group (REBI) of 34 patients who had exchanged either silicone (17 patients) implants (REBI-E) or patients (17) who were to receive primary implantation augmentation with silicone (REBI-PIA), and who were included as needed to increase either the pre- or post-explantation sample number. Of the 17 REBI-E patients, 5 had silicone implants and 12 had saline implants previously (prior to the last exchange). Investigation was undertaken before and after replacement surgery in the TBI patients and before and after replacement or augmentation surgery in the REBI patients. The pre- to post-operative sample interval was 8-12 weeks. Pre-operative samples were collected within 7 days prior to the operation. Information on a variety of demographic and behavioral features was collected. Biochemical and biological endpoints relating to genotoxic lipid peroxidation (LPO) products potentially formed in the SOF, and released locally or distributed systemically, were measured. The SOF of explanted TBIs was found to have substantial levels of LPO products, particularly malondialdehyde (MDA), and low levels of trans-4-hydroxy-2-nonenal (HNE) not found in unused implants. Mutagenicity of the SOF was related to the levels of MDA. Capsules that formed around TBIs were microscopically similar to those of reference implants, but MDA-DNA adducts were observed in capsular macrophages and fibroblasts of only TBI capsules. These cell types are not

  11. Crystalline light chain proximal tubulopathy with chronic renal failure and silicone gel breast implants: 1 case report.

    Science.gov (United States)

    Figueres, Marie-Lucile; Beaume, Julie; Vuiblet, Vincent; Rabant, Marion; Bassilios, Nader; Herody, Michel; Touchard, Guy; Noël, Laure-Hélène

    2015-01-01

    A 39-year-old female patient was admitted to explore chronic renal failure. Clinical history included silicone breast implants. Clinical examination was normal. Urinalysis revealed tubular proteinuria with Bence-Jones κ protein. Monoclonal immunoglobulin G κ and free monoclonal κ-light chains (LCs) were revealed by serum protein immunoelectrophoresis. Bone marrow aspiration with karyotype analysis and skeletal radiologic survey were normal. Kidney biopsy revealed a peculiar pattern of proximal tubular cells with hypertrophy and clarification initially diagnosed as an osmotic nephrosis. Immunofluorescence study, including immunoglobulin LCs conjugates was normal. Immunoelectron microscopy finally revealed a crystalline LC proximal tubulopathy κ. Our case presents some peculiarities: the absence of hematologic malignancy sign and the young patient's age. The silicone breast implants have been reported to be involved in the generation of monoclonal gammopathy.

  12. Skin-sparing mastectomy and immediate breast reconstruction by use of implants: An assessment of risk factors for complications and cancer control in 120 patients

    NARCIS (Netherlands)

    L.A.E. Woerdeman; J.J. Hage; M.J.C. Smeulders; E.J.T. Rutgers; C.M.A.M. van der Horst

    2006-01-01

    Background: Combined skin-sparing mastectomy and immediate reconstruction by use of an implant is increasingly accepted as a therapy for patients with breast cancer or a hereditary risk of breast cancer. Because little and contradictory evidence regarding possible risk factors for postoperative comp

  13. Complications Following Expander/Implant Breast Reconstruction Utilizing Acellular Dermal Matrix: A Systematic Review and Meta-Analysis

    OpenAIRE

    Hoppe, Ian C.; Yueh, Janet H.; Wei, Cindy H.; Ahuja, Naveen K.; Patel, Priti P.; Datiashvili, Ramazi O.

    2011-01-01

    Background: The recent increase in popularity of acellular dermal matrix assistance in immediate expander/implant breast reconstruction has led to variety of viewpoints. Many studies are published indicating an increase in complications with the use of acellular dermal matrix, while others indicate there is no increase in complications. Methods: This meta-analysis utilizes information from available studies that directly compare one specific type of acellular dermal matrix with traditional me...

  14. Cyclic volatile methylsiloxanes in human blood as markers for ruptured silicone gel-filled breast implants.

    Science.gov (United States)

    Rosendahl, Pia; Hippler, Joerg; Schmitz, Oliver J; Hoffmann, Oliver; Rusch, Peter

    2016-05-01

    The replacement of medical-grade silicone with industrial-grade silicone material in some silicone gel-filled breast implants (SBI) manufactured by Poly Implant Prothèse and Rofil Medical Nederland B.V., reported in 2010, which resulted in a higher rupture tendency of these SBI, demonstrates the need for non-invasive, sensitive monitoring and screening methods. Therefore a sensitive method based on large volume injection-gas chromatography coupled to mass spectrometry (LVI-GC/MS) was developed to determine octamethylcyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and dodecamethylcyclo-hexasiloxane (D6) in blood samples from women with intact (n = 13) and ruptured SBI (n = 11). With dichloromethane extraction, sample cooling during preparation, and analysis extraction efficiencies up to 100 % and limits of detection of 0.03-0.05 ng D4-D6/g blood were achieved. Blood samples from women with SBI were investigated. In contrast to women with intact SBI, in blood from women with ruptured SBI higher D4 and D6 concentrations up to 0.57 ng D4/g blood and 0.16 ng D6/g blood were detected. With concentrations above 0.18 D4 ng/blood and 0.10 ng D6/g blood as significant criteria for ruptured SBI, this developed analytical preoperative diagnostic method shows a significant increase of the recognition rate. Finally a higher precision (error rate 17%) than the commonly used clinical diagnostic method, mamma sonography (error rate 46%), was achieved.

  15. Over Troubled Water: An Outbreak of Infection Due to a New Species of Mycobacterium following Implant-Based Breast Surgery.

    Science.gov (United States)

    Scheflan, Michael; Wixtrom, Roger N

    2016-01-01

    Mycobacterial infection is a rare complication associated with breast surgery using implants. Over the course of 5 months, one center experienced 12 such cases, 10 of which were linked to a single surgeon. Most presented 3 to 6 weeks postoperatively with clear serous drainage from the incision, minimal local redness, no fever or other systemic signs of infection, and negative standard bacterial cultures. Patients were given empiric broad-spectrum oral antibiotic therapy. In eight cases, implants were removed and exchanged for new devices after irrigation of the pocket with antibiotics; these patients nonetheless experienced recurrent infection, which led to explantation (without immediate exchange for new implants). The last two patients proceeded straight to explantation. Because mycobacteria grow in water, the water supply and air-conditioning system were initially suspected as the source, and both were disinfected. However, this did not stop the outbreak. Eventually, the source was traced to a new species of mycobacteria isolated from a garden hot tub. These bacteria had then been unwittingly transferred to patients during surgery. A Triclosan-containing shampoo effectively ended the outbreak. This series is unique in several respects: the novelty of the pathogen, the heavy colonization of the surgeon, and the mechanism of transmission (the first occurrence of human-to-human mycobacterial transfer published in the plastic surgery literature). Surgeons who perform breast surgery with implants should be aware of the possibility of mycobacterial infection. Proactive culturing of the organism, use of antibiotics, and reoperation are essential to good outcomes. PMID:26710012

  16. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture.

    Science.gov (United States)

    Ribuffo, Diego; Lo Torto, Federico; Giannitelli, Sara M; Urbini, Marco; Tortora, Luca; Mozetic, Pamela; Trombetta, Marcella; Basoli, Francesco; Licoccia, Silvia; Tombolini, Vincenzo; Cassese, Raffaele; Scuderi, Nicolò; Rainer, Alberto

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture.

  17. Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer – case report and literature review

    Directory of Open Access Journals (Sweden)

    Nowaczyk Piotr

    2016-01-01

    Full Text Available This paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed – histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes. Following surgery the patient was qualified for further treatment – chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.

  18. Implant quality and acute urinary toxicity with 125I permanent seed implantation for clinically localized prostate cancer. Results of the first 30 patients treated at PMCC

    International Nuclear Information System (INIS)

    It is widely recognized that a steep learning curve exists for departments initiating a prostate low-dose radiation (LDR) implant service. Appropriate team credentialing, willingness to accept mentoring and attention toward ongoing QA initiatives are required to ensure that both clinical and dosimetric endpoints consistently achieve standards deemed appropriate. The department of urological services began a prostate seed service in 4/2002. All participating staff were suitably trained in Seattle, Washington with unit protocols based on standard trans-rectal sonographic pre-planning, modified peripheral loading, prescription dose 145Gy and 4 week CT based post implant dosimetry. Patient eligibility paralleled federal medicare guidelines with men presenting with favorable risk disease, gland volumes 15ml/sec) considered potential candidates. a) Presenting Demographics: (n=30) Median age 62 (41-73), T stage 1c:2a:2b:2c = 18:10:1:1, Median PSA 6.3ng/ ml (5.1ng/ml - 11.1ng/ml), Median IPSS 5 (0-12), Mean Qmax 18ml/s (10ml/s -35ml/s).; b) Acute toxicity: No significant peri-procedural complications. One patient developed urinary retention day 3 and was successfully trialed day 10. All patients experienced some degree of sub-acute urinary irritation although three patients followed for at least 12 months have returned to their baseline level of functioning. c) Post implant Dosimetry: Median D90 139Gy (104Gy - 190Gy). 3 Patients received a D90 < 90% with one at 104Gy receiving additional 'top-up' external beam radiation (20Gy). A definable improvement in implant quality was observed over the 12 month study interval. Although acute toxicity was considered acceptable, patients do experience a sub-acute period of low grade albeit persistent urinary irritation and need to be cautioned appropriately. A high level of implant quality was achieved in the majority of patients. Despite 5 years HDR brachytherapy experience, considerable refinement in technique and approach was

  19. The Effect of Radiation on Complication Rates and Patient Satisfaction in Breast Reconstruction using Temporary Tissue Expanders and Permanent Implants.

    Science.gov (United States)

    Anker, Christopher J; Hymas, Richard V; Ahluwalia, Ravinder; Kokeny, Kristine E; Avizonis, Vilija; Boucher, Kenneth M; Neumayer, Leigh A; Agarwal, Jayant P

    2015-01-01

    The optimal method of reconstruction following mastectomy for breast cancer patients receiving radiation therapy (RT) is controversial. This study evaluated patient satisfaction and complication rates among patients who received implant-based breast reconstruction. The specific treatment algorithm analyzed included patients receiving mastectomy and immediate temporary tissue expander (TE), followed by placement of a permanent breast implant (PI). If indicated, RT was delivered to the fully expanded TE. Records of 218 consecutive patients with 222 invasive (85%) or in situ (15%) breast lesions from the Salt Lake City region treated between 1998 and 2009 were retrospectively reviewed, 28% of whom received RT. Median RT dose was 50.4 Gy, and 41% received a scar boost at a median dose of 10 Gy. Kaplan-Meier analyses were performed to evaluate the cumulative incidence of surgical complications, including permanent PI removal. Risk factors associated with surgical events were analyzed. To evaluate cosmetic results and patient satisfaction, an anonymous survey was administered. Mean follow-up was 44 months (range 6-144). Actuarial 5-year PI removal rates for non-RT and RT patients were 4% and 22%, respectively. On multivariate analysis (MVA), the only factor associated with PI removal was RT (p = 0.009). Surveys were returned describing the outcomes of 149 breasts. For the non-RT and RT groups, those who rated their breast appearance as good or better were 63% versus 62%, respectively. Under 1/3 of each group was dissatisfied with their reconstruction. RT did not significantly affect patient satisfaction scores, but on MVA RT was the only factor associated with increased PI removal. This reconstruction technique may be considered an acceptable option even if RT is needed, but the increased complication risk with RT must be recognized.

  20. A neutron activation system for Ho, HoZr and Sm brachytherapy seeds for breast radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Wagner L., E-mail: wagner.leite@ifmg.edu.br [Instituto Federal de Minas Gerais (IFMG), Congonhas, MG (Brazil). Departamento de Fisica; Campos, Tarcisio P.R., E-mail: tprcampos@pq.cnpq.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2015-07-01

    This paper addresses a device designed for transmuting nuclides by means of neutron capture reactions. The device is composed by a neutron generator based on d-d reactions, a neutron moderator and a reflection system, enclosed by a radiation shield. The project was modeled on the CST electromagnetic code. Afterwards, a nuclear investigation was carried out by MCNP5 code, where the final activities of a large set of 0.5 x 1.8 mm cylindrical, biodegradable and biocompatible, Ho-165 (Ho and HoZr) and Sm-152 breast brachytherapy seeds were evaluated, considering the neutron capture reactions. The accelerator-head equipotential profiles and the optical beam of deuterons with its energy map were presented. The neutronic evaluation allowed estimating a neutron yield of 10{sup 13} n s{sup -1}. From the seed's group, an individual Ho-166 seed reached activity of 100 MBq in 58 h operation time. Moreover, Sm-153 seed reached 120 MBq during a period of 64 h of operation. The system shows to be able to provide the neutron activation of brachytherapy seeds with suitable individual specific activity able for controlling breast tumors. (author)

  1. Deleterious effects on MDAMB-231 breast adenocarcinoma cell lineage submitted to Ho-166 radioactive seeds at very low activity

    Energy Technology Data Exchange (ETDEWEB)

    Falcao, Patricia L.; Campos, Tarcisio P.R., E-mail: campos@nuclear.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear; Sarmento, Eduardo V. [Centro de Desenvolvimento de Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Cuperschmid, Ethel M. [Universidade Federal de Minas Gerais (CEMEMOR/UFMG), Belo Horizonte, BR (Brazil). Fac. de Medicina. Centro de Memoria da Medicina

    2011-07-01

    Herein, the deleterious effect of ionizing radiation provided by Ho-166 radioactive seeds at low activity were addressed, based on experimental in vitro assays at the MDA MB231 cell lineage, a breast adenocarcinoma, compared to PBMC - peripheral blood cells. The methodology involves of the MDBMB-231 and PBMC expansion in culture in suitable environment in 30mm well plates and T-25 flasks. Seeds were synthesized with Ho-165 incorporated and characterized previously. Activation was processed at IPR1 reactor at the peripheral table, at 8h exposition. Three groups of seeds were tested: 0,34 mCi, 0,12 mCi activity, and control group. Such seeds were placed on culture and held to a period of 05 half-lives of the radionuclide. The biological responses at these exposure were documented by inverse microscopic photographic in time. Also, MTT essay were performed. A fast response in producing deleterious effects at cancer cell was observed even if for the low activity seeds. Also, a biological response dependent to a radial distance of the seed was observed. At conclusion, viability clonogenic control of MDAMB231 is identified at the exposition to Ho-166 ceramic seeds, even if at low activity of 0,1 to 0,3mCi. (author)

  2. Deleterious effects on MDAMB-231 breast adenocarcinoma cell lineage submitted to Ho-166 radioactive seeds at very low activity

    International Nuclear Information System (INIS)

    Herein, the deleterious effect of ionizing radiation provided by Ho-166 radioactive seeds at low activity were addressed, based on experimental in vitro assays at the MDA MB231 cell lineage, a breast adenocarcinoma, compared to PBMC - peripheral blood cells. The methodology involves of the MDBMB-231 and PBMC expansion in culture in suitable environment in 30mm well plates and T-25 flasks. Seeds were synthesized with Ho-165 incorporated and characterized previously. Activation was processed at IPR1 reactor at the peripheral table, at 8h exposition. Three groups of seeds were tested: 0,34 mCi, 0,12 mCi activity, and control group. Such seeds were placed on culture and held to a period of 05 half-lives of the radionuclide. The biological responses at these exposure were documented by inverse microscopic photographic in time. Also, MTT essay were performed. A fast response in producing deleterious effects at cancer cell was observed even if for the low activity seeds. Also, a biological response dependent to a radial distance of the seed was observed. At conclusion, viability clonogenic control of MDAMB231 is identified at the exposition to Ho-166 ceramic seeds, even if at low activity of 0,1 to 0,3mCi. (author)

  3. One stage implant-based reconstruction of the breast in a single patient: comparison between mesh and modified dual plane technique

    Directory of Open Access Journals (Sweden)

    Egidio Riggio

    2013-08-01

    Full Text Available Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral immediate breast reconstruction (IBR with 470 g implants, using alloplastic mesh in one side and the composed dual-plane pocket in the other. In the case described, the composed dual plane technique gave a better result in terms of absence of rippling and smoother surface at the palpation; the mesh coverage gave a better inframammary contour. Our case suggests that the modified dual-plane technique gives a satisfactory cosmetic outcome. It also reduces costs and avoids mesh-related complications. This technique should therefore be considered as an option to the mesh in implant-based breast reconstruction.

  4. Permanent prostate implant using high activity seeds and inverse planning with fast simulated annealing algorithm: A 12-year Canadian experience

    International Nuclear Information System (INIS)

    Purpose: To report outcomes and toxicity of the first Canadian permanent prostate implant program. Methods and Materials: 396 consecutive patients (Gleason ≤6, initial prostate specific antigen (PSA) ≤10 and stage T1-T2a disease) were implanted between June 1994 and December 2001. The median follow-up is of 60 months (maximum, 136 months). All patients were planned with fast-simulated annealing inverse planning algorithm with high activity seeds ([gt] 0.76 U). Acute and late toxicity is reported for the first 213 patients using a modified RTOG toxicity scale. The Kaplan-Meier biochemical failure-free survival (bFFS) is reported according to the ASTRO and Houston definitions. Results: The bFFS at 60 months was of 88.5% (90.5%) according to the ASTRO (Houston) definition and, of 91.4% (94.6%) in the low risk group (initial PSA ≤10 and Gleason ≤6 and Stage ≤T2a). Risk factors statistically associated with bFFS were: initial PSA >10, a Gleason score of 7-8, and stage T2b-T3. The mean D90 was of 151 ± 36.1 Gy. The mean V100 was of 85.4 ± 8.5% with a mean V150 of 60.1 ± 12.3%. Overall, the implants were well tolerated. In the first 6 months, 31.5% of the patients were free of genitourinary symptoms (GUs), 12.7% had Grade 3 GUs; 91.6% were free of gastrointestinal symptoms (GIs). After 6 months, 54.0% were GUs free, 1.4% had Grade 3 GUs; 95.8% were GIs free. Conclusion: The inverse planning with fast simulated annealing and high activity seeds gives a 5-year bFFS, which is comparable with the best published series with a low toxicity profile

  5. Staphylococcus aureus and Staphylococcus epidermidis Virulence Strains as Causative Agents of Persistent Infections in Breast Implants.

    Directory of Open Access Journals (Sweden)

    Daniela Chessa

    Full Text Available Staphylococcus epidermidis and Staphylococcus aureus are currently considered two of the most important pathogens in nosocomial infections associated with catheters and other medical implants and are also the main contaminants of medical instruments. However because these species of Staphylococcus are part of the normal bacterial flora of human skin and mucosal surfaces, it is difficult to discern when a microbial isolate is the cause of infection or is detected on samples as a consequence of contamination. Rapid identification of invasive strains of Staphylococcus infections is crucial for correctly diagnosing and treating infections. The aim of the present study was to identify specific genes to distinguish between invasive and contaminating S. epidermidis and S. aureus strains isolated on medical devices; the majority of our samples were collected from breast prostheses. As a first step, we compared the adhesion ability of these samples with their efficacy in forming biofilms; second, we explored whether it is possible to determine if isolated pathogens were more virulent compared with international controls. In addition, this work may provide additional information on these pathogens, which are traditionally considered harmful bacteria in humans, and may increase our knowledge of virulence factors for these types of infections.

  6. Immediate Breast Reconstruction Using the Latissimus Dorsi Flap Combined with Breast Implant Optimizes Breast Shape%背阔肌瓣联合假体即刻乳房重建术优化乳房外形

    Institute of Scientific and Technical Information of China (English)

    钱琦; 朱玉兰; 朱春富

    2014-01-01

    目的:研究背阔肌瓣转移联合假体置入即刻乳房重建术在乳腺癌改良根治术患者乳房外形修复中的作用。方法分析20例背阔肌瓣转移联合假体置入即刻乳房重建术患者的临床资料,并与18例单纯假体置入即刻乳房重建术患者的临床资料进行对照研究。结果背阔肌瓣转移联合假体置入即刻乳房重建术修复乳房外形的效果显著优于单纯假体置入术(P=0.042),两组在并发症发生率等方面无显著差异(P>0.05)。结论对于乳腺癌改良根治术假体置入即刻乳房重建患者,选择背阔肌瓣转移覆盖假体,能使术后伤口愈合更佳,乳房外形更加美观,患者满意度更高。%Objective To study the effect of immediate breast reconstruction using the latissimus dorsi flap combined with breast implant on breast shape restoration in patients undergoing modified radical mastectomy. Methods A total of 38 patients with early breast cancer were divided into two groups, Experimental Group (n=20) and Control Group (n=218). All the patients accepted modified radical mastectomy. In Experimental Group, patients underwent immediate breast reconstruction with the latissimus domi flap combined with implants following mastectomy. In Control Group, patients underwent immediate breast reconstruction with breast implant only. Clinical data were collected and analyzed,retrospectively. Results The effect of breast shape optimization in Experimental Group was markedly superior to Control Group (P=0.042).There was no statistical difference in postoperative complications between the two groups. Conclusion Latissimus dorsi flap combined with implants is a reliable method which make the patients more aestheically pleasing and more satisfied for immediate breast reconstruction.

  7. Soft, Brown Rupture: Clinical Signs and Symptoms Associated with Ruptured PIP Breast Implants

    Directory of Open Access Journals (Sweden)

    Yvette Godwin, FRCS

    2014-11-01

    Conclusions: Preoperative signs can be predictive of PIP implant failure. Brown-stained implants are more prone to rupture. The presence of iodine in the gel suggests unacceptable permeability of the shell early in the implant’s life span. A noninvasive screening test to detect brown implants in situ could help identify implants at risk of failure in those who elect to keep their implants.

  8. Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model.

    Science.gov (United States)

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios

    2015-03-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

  9. Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model.

    Science.gov (United States)

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios

    2015-03-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide. PMID:25798383

  10. Effect of Wood Vinegar on Seed Germination and Water Implantation of Com

    Institute of Scientific and Technical Information of China (English)

    ZHOU Ling; JIANG Enchen; LI Bosong

    2009-01-01

    To analyze the effect of wood vinegar on seed germination and seedling growth, the seeds of corn are dipped in wood vinegar of different densities. The results showed that significant effects were found through all the treatments on the seed germination rate, the seed germinating energy and the germinating index. The regress CUBICS curves were developed to describe the relation. The reasonable parameters range was obtained. At the same time, the com was cultivated by wood vinegar of different densities, aiming to study the effect of wood vinegar on biomass. It showed that all treatments had obvious effects on the seedling length and dry weight aboveground, the chlorophyll and dry weight underground were not included. The research results could be used to direct the wood vinegar deeply refining process and product development.

  11. Dosimetric results in implant and post-implant and low rate in brachytherapy prostate cancer with loose seeds and attached; Resultados dosimetricos en el implante y post-impante en braquiterapia de baja tasa en cancer de prostata con semillas sueltas y unidas

    Energy Technology Data Exchange (ETDEWEB)

    Juan-Senabre, X. J.; Albert Antequera, M.; Lopez-Tarjuelo, J.; Santos Serra, A.; Perez-Mestre, M.; Sanchez Iglesias, A. L.; Conde Moreno, A. J.; Gonzalez Vidal, V.; Beltran Persiva, J.; Muelas Soria, R.; Ferrer Albiach, C.

    2015-07-01

    The objective is determine differences dosimetry statistics on the dosimetry of the implant and post-implant in brachytherapy of low rate with implants permanent in prostate using seed of 125-I loose and attached Both in lives and in the post-prostatic plans dosimetric coverage is good and restrictions in urethra and rectum for both groups of patients are met. Not migrating with joined is evident, as well as better dosimetric homogeneity. (Author)

  12. Quality control of system of imaging for rectal ultrasound for implants seed prostate low rate; Control de calidad del sistem de imagen por ecografia rectal para implantes de semillas de prostata de baja tasa

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    In this work, the objective is the evaluation of the image system used in implants of prostate of low rate held at our hospital, for maximum control on the placement of the seeds in the patient and therefore carried out dosimetry. (Author)

  13. Gene expression profiles in promoted-growth rice seedlings that germinated from the seeds implanted by low-energy N+ beam

    International Nuclear Information System (INIS)

    The stimulation effect that some beneficial agronomic qualities have exhibited in present-generation plants have also been observed due to ion implantation on plants. However, there is relatively little knowledge regarding the molecular mechanism of the stimulation effects of ion-beam implantation. In order to extend our current knowledge about the functional genes related to this stimulation effect, we have reported a comprehensive microarray analysis of the transcriptome features of the promoted-growth rice seedlings germinating from seeds implanted by a low-energy N+ beam. The results showed that 351 up-regulated transcripts and 470 down-regulated transcripts, including signaling proteins, kinases, plant hormones, transposable elements, transcription factors, non-coding protein RNA (including miRNA), secondary metabolites, resistance proteins, peroxidase and chromatin modification, are all involved in the stimulating effects of ion-beam implantation. The divergences of the functional catalog between the vacuum and ion implantation suggest that ion implantation is the principle cause of the ion-beam implantation biological effects, and revealed the complex molecular networks required to adapt to ion-beam implantation stress in plants, including enhanced transposition of transposable elements, promoted ABA biosynthesis and changes in chromatin modification. Our data will extend the current understanding of the molecular mechanisms and gene regulation of stimulation effects. Further research on the candidates reported in this study should provide new insights into the molecular mechanisms of biological effects induced by ion-beam implantation. (author)

  14. The micropolyurethane foam-coated Diagon/Gel4Two implant in aesthetic and reconstructive breast surgery – 3-year results of an ongoing study

    Directory of Open Access Journals (Sweden)

    Brunnert, Klaus E.

    2015-12-01

    Full Text Available Background: Breast implants are worldwide in use since 1962. Initially there were some problems with capsular contracture and the palpability of the rim of the implant. In 1968 this led to the introduction of the micropolyurethane foam-coating and then in 1970 to the first micropolyurethane foam-coated implant by F.A. Ashley. As a result of additional technical refinements in manufacturing this new implant design significantly reduced complications i.e. capsular contracture and implant rotation. Methods: This study reports a single surgeon’s experience with aesthetic and reconstructive breast surgery, in primary and secondary cases with the sole use of micropolyurethane foam-coated Diagon/gel4Two implants, partly in combination with the additional use of synthetic meshes, acellular dermal matrices and lipofilling. The trial is a prospective, single center cohort study designed to demonstrate the safety and effectiveness of the new implant design in primary and secondary aesthetic and reconstructive breast surgery. The reported data provide an interim report of the implantations performed from November 2010 to December 2013.Results: 90 patients were admitted to the study with 152 implants. The majority of the implants (n=95, 62.5% were used in reoperative cases for either oncological (n=52, 34.2% or aesthetic reasons (n=43, 28.3%. The median age of the study cohort was 45 years; the median body mass index was 21; the median observation time is 41 months. There was a very low complication rate, both short term within 6 weeks after the implantation of the silicone gel implant and in the follow up in November 2015. There were no serious complications needing explantation, no capsular fibrosis or implant rotation or rupture so far. There were only 4 minor complications (1.97%. There was 1 local recurrence 4 years after skin and nipple sparing mastectomy.Conclusion: The micropolyurethane foam-coated Diagon/gel4Two implant is a very reliable silicone

  15. Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation: Insights from the SEEDS Study

    Institute of Scientific and Technical Information of China (English)

    Yao-Jun Zhang; Ye-Lin Zhao; Bo Xu; Ya-Ling Han; Bao Li; Qiang Liu; Xi Su

    2015-01-01

    Background:Studies have suggested that use of prolonged dual antiplatelet therapy (DAPT) following new generation drug-eluting stent implantation may increase costs and potential bleeding events.This study aimed to investigate the association of DAPT status with clinical safety in patients undergoing everolimus-eluting stent (EES) implantation in the SEEDS study (A Registry to Evaluate Safety and Effectiveness of Everolimus Drug-eluting Stent for Coronary Revascularization) at 2-year follow-up.Methods:The SEEDS study is a prospective,multicenter study,where patients (n =1900) with small vessel,long lesion,or multi-vessel diseases underwent EES implantation.Detailed DAPT status was collected at baseline,6-month,1-and 2-year.DAPT interruption was defined as any interruption of aspirin and/or clopidogrel more than 14 days.The net adverse clinical events (NACE,a composite endpoint of all-cause death,all myocardial infarction (MI),stroke,definite/probable stent thrombosis (ST),and major bleeding (Bleeding Academic Research Consortium Ⅱ-Ⅴ)) were investigated according to the DAPT status at 2-year follow-up.Results:DAPT was used in 97.8% of patients at 6 months,69.5% at 12 months and 35.4% at 2 years.It was observed that the incidence of NACE was low (8.1%) at 2 years follow-up,especially its components of all-cause death (0.9%),stroke (1.1%),and definite/probable ST (0.7%).DAPT was not an independent predictor of composite endpoint of all-cause death/MI/stroke (hazard ratio [HR]:0.693,95%confidence interval [CI]:0.096-4.980,P =0.715) and NACE (HR:1.041,95% CI:0.145-7.454,P =0.968).Of 73 patients who had DAPT interruption,no patient had ST at 12-month,and only 1 patient experienced ST between 1-and 2-year (1.4%).There was a high frequency of major bleeding events (53/65,82.5%) occurred in patients receiving DAPT treatment.Conclusions:Prolonged DAPT use was not associated with improved clinical safety.The study emphasized that duration of DAPT

  16. Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation: Insights from the SEEDS Study

    Directory of Open Access Journals (Sweden)

    Yao-Jun Zhang

    2015-01-01

    Full Text Available Background: Studies have suggested that use of prolonged dual antiplatelet therapy (DAPT following new generation drug-eluting stent implantation may increase costs and potential bleeding events. This study aimed to investigate the association of DAPT status with clinical safety in patients undergoing everolimus-eluting stent (EES implantation in the SEEDS study (A Registry to Evaluate Safety and Effectiveness of Everolimus Drug-eluting Stent for Coronary Revascularization at 2-year follow-up. Methods: The SEEDS study is a prospective, multicenter study, where patients (n = 1900 with small vessel, long lesion, or multi-vessel diseases underwent EES implantation. Detailed DAPT status was collected at baseline, 6-month, 1- and 2-year. DAPT interruption was defined as any interruption of aspirin and/or clopidogrel more than 14 days. The net adverse clinical events (NACE, a composite endpoint of all-cause death, all myocardial infarction (MI, stroke, definite/probable stent thrombosis (ST, and major bleeding (Bleeding Academic Research Consortium II-V were investigated according to the DAPT status at 2-year follow-up. Results: DAPT was used in 97.8% of patients at 6 months, 69.5% at 12 months and 35.4% at 2 years. It was observed that the incidence of NACE was low (8.1% at 2 years follow-up, especially its components of all-cause death (0.9%, stroke (1.1%, and definite/probable ST (0.7%. DAPT was not an independent predictor of composite endpoint of all-cause death/MI/stroke (hazard ratio [HR]: 0.693, 95% confidence interval [CI]: 0.096-4.980, P = 0.715 and NACE (HR: 1.041, 95% CI: 0.145-7.454, P = 0.968. Of 73 patients who had DAPT interruption, no patient had ST at 12-month, and only 1 patient experienced ST between 1- and 2-year (1.4%. There was a high frequency of major bleeding events (53/65, 82.5% occurred in patients receiving DAPT treatment. Conclusions: Prolonged DAPT use was not associated with improved clinical safety. The study

  17. SU-E-J-166: Sensitivity of Clinically Relevant Dosimetric Parameters to Contouring Uncertainty During Post Implant Dosimetry of Prostate Permanent Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S [Sunnybrook Odette Cancer Centre, Toronto, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada); Ravi, A; Morton, G; Song, W [Sunnybrook Odette Cancer Centre, Toronto, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada); Sunnybrook Research Institute, Toronto, ON (Canada)

    2015-06-15

    Purpose: There is a strong evidence relating post-implant dosimetry for permanent seed prostate brachytherpy to local control rates. The delineation of the prostate on CT images, however, represents a challenge as it is difficult to confidently identify the prostate borders from soft tissue surrounding it. This study aims at quantifying the sensitivity of clinically relevant dosimetric parameters to prostate contouring uncertainty. Methods: The post-implant CT images and plans for a cohort of 43 patients, who have received I–125 permanent prostate seed implant in our centre, were exported to MIM Symphony LDR brachytherapy treatment planning system (MIM Software Inc., Cleveland, OH). The prostate contours in post-implant CT images were expanded/contracted uniformly for margins of ±1.00mm, ±2.00mm, ±3.00mm, ±4.00mm and ±5.00mm (±0.01mm). The values for V100 and D90 were extracted from Dose Volume Histograms for each contour and compared. Results: The mean value of V100 and D90 was obtained as 92.3±8.4% and 108.4±12.3% respectively (Rx=145Gy). V100 was reduced by −3.2±1.5%, −7.2±3.0%, −12.8±4.0%, −19.0±4.8%, − 25.5±5.4% for expanded contours of prostate with margins of +1mm, +2mm, +3mm, +4mm, and +5mm, respectively, while it was increased by 1.6±1.2%, 2.4±2.4%, 2.7±3.2%, 2.9±4.2%, 2.9±5.1% for the contracted contours. D90 was reduced by −6.9±3.5%, −14.5±6.1%, −23.8±7.1%, − 33.6±8.5%, −40.6±8.7% and increased by 4.1±2.6%, 6.1±5.0%, 7.2±5.7%, 8.1±7.3% and 8.1±7.3% for the same set of contours. Conclusion: Systematic expansion errors of more than 1mm may likely render a plan sub-optimal. Conversely contraction errors may Result in labeling a plan likely as optimal. The use of MRI images to contour the prostate should results in better delineation of prostate organ which increases the predictive value of post-op plans. Since observers tend to overestimate the prostate volume on CT, compared with MRI, the impact of the

  18. SU-E-J-166: Sensitivity of Clinically Relevant Dosimetric Parameters to Contouring Uncertainty During Post Implant Dosimetry of Prostate Permanent Seed Implants

    International Nuclear Information System (INIS)

    Purpose: There is a strong evidence relating post-implant dosimetry for permanent seed prostate brachytherpy to local control rates. The delineation of the prostate on CT images, however, represents a challenge as it is difficult to confidently identify the prostate borders from soft tissue surrounding it. This study aims at quantifying the sensitivity of clinically relevant dosimetric parameters to prostate contouring uncertainty. Methods: The post-implant CT images and plans for a cohort of 43 patients, who have received I–125 permanent prostate seed implant in our centre, were exported to MIM Symphony LDR brachytherapy treatment planning system (MIM Software Inc., Cleveland, OH). The prostate contours in post-implant CT images were expanded/contracted uniformly for margins of ±1.00mm, ±2.00mm, ±3.00mm, ±4.00mm and ±5.00mm (±0.01mm). The values for V100 and D90 were extracted from Dose Volume Histograms for each contour and compared. Results: The mean value of V100 and D90 was obtained as 92.3±8.4% and 108.4±12.3% respectively (Rx=145Gy). V100 was reduced by −3.2±1.5%, −7.2±3.0%, −12.8±4.0%, −19.0±4.8%, − 25.5±5.4% for expanded contours of prostate with margins of +1mm, +2mm, +3mm, +4mm, and +5mm, respectively, while it was increased by 1.6±1.2%, 2.4±2.4%, 2.7±3.2%, 2.9±4.2%, 2.9±5.1% for the contracted contours. D90 was reduced by −6.9±3.5%, −14.5±6.1%, −23.8±7.1%, − 33.6±8.5%, −40.6±8.7% and increased by 4.1±2.6%, 6.1±5.0%, 7.2±5.7%, 8.1±7.3% and 8.1±7.3% for the same set of contours. Conclusion: Systematic expansion errors of more than 1mm may likely render a plan sub-optimal. Conversely contraction errors may Result in labeling a plan likely as optimal. The use of MRI images to contour the prostate should results in better delineation of prostate organ which increases the predictive value of post-op plans. Since observers tend to overestimate the prostate volume on CT, compared with MRI, the impact of the

  19. MSCs and inflammation: new insights into the potential association between ALCL and breast implants.

    Science.gov (United States)

    Orciani, M; Sorgentoni, G; Torresetti, M; Di Primio, Roberto; Di Benedetto, G

    2016-02-01

    Possible association between anaplastic large cell lymphoma (ALCL) and breast implants has been suggested. In this context, formation of the periprosthetic capsule has been reported as a cause of inflammation, which plays a key role in tumor onset. Tumors take advantage of inflammation to influence and interfere with the host immune response by secreting multiple factors, and their onset and survival is in turn affected by the paracrine effects from mesenchymal stem cells (MSCs). In this study, we tried to clarify how inflammation can modify the immunobiology and the exerted paracrine effect of MSCs. MSCs derived from both inflamed (I-MSCs) and control (C-MSCs) tissues were isolated and co-cultured with an ALCL cell line. Proliferation rate and the expression of selected cytokines were tested. I-MSCs secrete higher levels of cytokine related to chronic inflammation than C-MSCs. After co-cultures with KI-JK cells, C- and I-MSCs show the same variation in the cytokine expression, with an increase of IL2, IL4, IL5, IL10, IL13, TNF-α, TGF-β, and G-CSF. Proliferation of ALCL cells was not influenced by co-cultures. Our results state that (i) inflamed microenvironment affects the immunobiology of MSCs modifying the profile of the expressed cytokines, and (ii) the paracrine effects exerted by MSCs on ALCL cells are not influenced by inflammation. Moreover, it seems that ALCL cells are able to manipulate MSCs' immunoregulatory properties to evade the host immune control. Nevertheless, this ability is not associated with inflammation and the question about BIA-ALCL is not proved by our experiments.

  20. Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients.

    Science.gov (United States)

    Matsuo, Akira; Hamada, Hayato; Takahashi, Hidetoshi; Okamoto, Ayako; Kaise, Hiroshi; Chikazu, Daichi

    2016-09-01

    It remains unclear whether dental implants are a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We retrospectively evaluated the status of dental implants in patients given intravenous bisphosphonates (BPs) in a breast cancer cohort to elucidate the risk for BRONJ at the implant site. We established a BRONJ oral monitoring program for 247 breast cancer patients given intravenous BP in our institution. The 3-year cumulative incidence rate was determined. The systemic and local risk factors of 44 patients who completed comprehensive oral examinations were evaluated by logistic regression analysis. The 3-year cumulative incidence rate of the 247 patients was 0.074 % (8/247, 95 % CI 0.0081-0.014). In the 44 orally examined patients, 6 (13.6 %: 6/44) had dental implants. Of these 6 patients, 1 developed BRONJ at the implant site. There were no significant differences in the age, total BP treatment period, number of residual teeth, time of regular oral monitoring, oral hygiene level, or dental implant insertion. Although a case of ONJ was identified, dental implants which were inserted before intravenous BP administration were not a risk factor for the development of ONJ in breast cancer patients.

  1. Combination of chemical suppression techniques for dual suppression of fat and silicone at diffusion-weighted MR imaging in women with breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Dow-Mu; Hughes, J. [Royal Marsden Hospital, Department of Radiology, Sutton (United Kingdom); Blackledge, M.; Leach, M.O.; Collins, D.J. [Institute of Cancer Research, CR UK-EPSRC Cancer Imaging Centre, Sutton (United Kingdom); Burns, S. [Nuada 3T MRI Centre, London (United Kingdom); Stemmer, A.; Kiefer, B. [Siemens Healthcare, Erlangen (Germany)

    2012-12-15

    Silicone breast prostheses prove technically challenging when performing diffusion-weighted MR imaging in the breasts. We describe a combined fat and chemical suppression scheme to achieve dual suppression of fat and silicone, thereby improving the quality of diffusion-weighted images in women with breast implants. MR imaging was performed at 3.0 and 1.5 T in women with silicone breast implants using short-tau inversion recovery (STIR) fat-suppressed echo-planar (EPI) diffusion-weighted MR imaging (DWI) on its own and combined with the slice-select gradient-reversal (SSGR) technique. Imaging was performed using dedicated breast imaging coils. Complete suppression of the fat and silicone signal was possible at 3.0 T using EPI DWI with STIR and SSGR, evaluated with dedicated breast coils. However, a residual silicone signal was still perceptible at 1.5 T using this combined approach. Nevertheless, a further reduction in silicone signal at 1.5 T could be achieved by employing thinner slice partitions and the addition of the chemical-selective fat-suppression (CHESS) technique. DWI using combined STIR and SSGR chemical suppression techniques is feasible to eliminate or reduce silicone signal from prosthetic breast implants. (orig.)

  2. CT-guided percutaneous vertebroplasty combined with 125I-seed implantation for metastatic vertebral carcinoma involving the spinal canal: analysis of 23 cases

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of CT-guided percutaneous vertebroplasty (PVP) combined with 125I-seed implantation for the treatment of metastatic vertebral carcinoma involving the spinal canal. Methods: A total of 28 involved vertebrae were detected in 23 patients with metastatic vertebral carcinoma. Each patient had 1-2 diseased vertebrae. The lesions included cervical vertebra (n=4), thoracic vertebra (n=13) and lumbar vertebra (n=11). Destroyed posterior vertebral wall was seen in all involved vertebrae. Thirteen vertebrae found in 12 patients showed involvement of the epidural space. According to treatment planning system (TPS) CT-guided implantation of 125I seeds was carried out first for cervical lesions, which was followed by PVP. For the thoracic and lumbar lesions, unilateral or bilateral puncturing with several particle needles was employed to implant the 125I seeds, then, PVP with bone cement injection was performed. The complications and the clinical efficacy were analyzed. Results: Successful operation was obtained in all patients. The number of implanted 125I seeds ranged from 4 to 30 per vertebra, and the volume of injected bone cement was 1-6 ml per vertebra. After the operation the pain relief rate was 86.9% (n=20). The incidence of bone cement leakage was 17.8% (5/28). One patient had radicular pain caused by neuropore leakage, which was relieved after medication. No serious complications, such as spinal cord injury or radiation myelitis, occurred. Conclusion: CT-guided PVP combined with 125I-seed implantation is effective and safe for the treatment of metastatic vertebral carcinoma involving the spinal canal. This therapy can effectively relieve the pain and control the deterioration of tumor, besides, the incidence of bone cement leakage is very low. (authors)

  3. A modified Seeded Region Growing algorithm for vessel segmentation in breast MRI images for investigating the nature of potential lesions

    Science.gov (United States)

    Glotsos, D.; Vassiou, K.; Kostopoulos, S.; Lavdas, El; Kalatzis, I.; Asvestas, P.; Arvanitis, D. L.; Fezoulidis, I. V.; Cavouras, D.

    2014-03-01

    The role of Magnetic Resonance Imaging (MRI) as an alternative protocol for screening of breast cancer has been intensively investigated during the past decade. Preliminary research results have indicated that gadolinium-agent administrative MRI scans may reveal the nature of breast lesions by analyzing the contrast-agent's uptake time. In this study, we attempt to deduce the same conclusion, however, from a different perspective by investigating, using image processing, the vascular network of the breast at two different time intervals following the administration of gadolinium. Twenty cases obtained from a 3.0-T MRI system (SIGNA HDx; GE Healthcare) were included in the study. A new modification of the Seeded Region Growing (SRG) algorithm was used to segment vessels from surrounding background. Delineated vessels were investigated by means of their topology, morphology and texture. Results have shown that it is possible to estimate the nature of the lesions with approximately 94.4% accuracy, thus, it may be claimed that the breast vascular network does encodes useful, patterned, information, which can be used for characterizing breast lesions.

  4. A feasibility study of magnetic resonance imaging of silicone breast implants in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; Boice, John D; McLaughlin, Joseph K;

    2005-01-01

    to determine the feasibility of conducting a magnetic resonance imaging (MRI)-based study of rupture incidence. The pilot investigation included a clinical examination by a plastic surgeon, MRI scan, and self-administered questionnaire. The participation rate was 100%. Implants in our study represented a cross......-section of the different generations of implants in Finland, with implant ages varying from 4 months to 20 years. The average implant size was 215 mL, typical in Finnish cosmetic surgery. MR images were evaluated by two independent readers. The first reader diagnosed six implants with intracapsular rupture, while...

  5. PDR brachytherapy with flexible implants for interstitial boost after breast-conserving surgery and external beam radiation therapy

    International Nuclear Information System (INIS)

    Background and purpose: For radiobiological reasons the new concept of pulsed dose rate (PDR) brachytherapy seems to be suitable to replace traditional CLDR brachytherapy with line sources. PDR brachytherapy using a stepping source seems to be particularly suitable for the interstitial boost of breast carcinoma after breast-conserving surgery and external beam irradiation since in these cases the exact adjustment of the active lengths is essential in order to prevent unwanted skin dose and consequential unfavorable cosmetic results. The purpose of this study was to assess the feasibility and morbidity of a PDR boost with flexible breast implants. Materials and methods: Sixty-five high risk patients were treated with an interstitial PDR boost. The criteria for an interstitial boost were positive margin or close margin, extensive intraductal component (EIC), intralymphatic extension, lobular carcinoma, T2 tumors and high nuclear grade (GIII). Dose calculation and specification were performed following the rules of the Paris system. The dose per pulse was 1 Gy. The pulse pauses were kept constant at 1 h. A geometrically optimized dose distribution was used for all patients. The treatment schedule was 50 Gy external beam to the whole breast and 20 Gy boost. PDR irradiations were carried out with a nominal 37 GBq 192-Ir source. Results: The median follow-up was 30 months (minimum 12 months, maximum 54 months). Sixty percent of the patients judged their cosmetic result as excellent, 27% judged it as good, 11% judged it as fair and 2% judged it as poor. Eighty-six percent of the patients had no radiogenous skin changes in the boost area. In 11% of patients minimal punctiform telangiectasia appeared at single puncture sites. In 3% ((2(65))) of patients planar telangiectasia appeared on the medial side of the implant. The rate of isolated local recurrences was 1.5%. In most cases geometrical volume optimization (GVO) yields improved dose distributions with respect to

  6. A nationwide study of connective tissue disease and other rheumatic conditions among Danish women with long-term cosmetic breast implantation

    DEFF Research Database (Denmark)

    Fryzek, Jon P; Holmich, Lisbet; McLaughlin, Joseph K;

    2007-01-01

    population-based cohort study of Danish women with cosmetic breast implants (n = 2761) and comparison groups of women with other types of cosmetic surgery (n = 8807). All women were followed from January 1977 through December 2001. Hospitalization and outpatient data for CTD and ill-defined and other...... (standardized rate ratio = 1.5; 95% confidence interval = 1.4 to 1.7) cohorts. In analyses of diagnoses validated by chart review, women with cosmetic breast implants compared with those having other types of plastic surgery or consultation for plastic surgery had no statistically significant excess for any...

  7. Nursing care for elderly lung cancer patients treated with CT-guided permanent interstitial co-implantation of 125I seeds and slow-released fluorouracil

    International Nuclear Information System (INIS)

    Objective: To investigate the specific measures and effect of the nursing care for elderly lung cancer patients who were receiving the treatment of CT-guided permanent interstitial co-implantation of 125I seeds and slow-released fluorouracil. Methods: Active care, including adequate preoperative preparation, proper support during operation and postoperative nursing,was carried out for fifty-three elderly patients with lung cancer during their treatment course of CT-guided permanent interstitial brachytherapy with co-implantation of 125I seeds and slow-released fluorouracil. Results: In order to ensure accurate puncture and the smooth particle implantation, the possible conditions which might happen after the procedure were informed to the patients before the surgery and useful advice was given to patients to guide their daily activities. All 53 patients showed no obvious fear before surgery and made good cooperation during the procedure, moreover, they well responded to the therapy and recovered pretty soon. Conclusion: CT-guided permanent interstitial co-implantation of 125I seeds and slow-released fluorouracil is a safe, minimally-invasive and newly-developed technique with reliable effect, which is especially suitable for aged patients. Active and adequate nursing care is essential during the whole therapeutic course. (authors)

  8. Seeding after ultrasound-guided percutaneous biopsy of liver metastases in patients with colorectal or breast cancer

    DEFF Research Database (Denmark)

    Chen, Inna; Lorentzen, Torben; Linnemann, Dorte;

    2015-01-01

    BACKGROUND: Neoplasm seeding is a serious complication after liver metastases biopsy. Reported incidences vary between 10% and 19% for colorectal cancer (CRC) and are unknown for breast cancer (BC). The aim of this retrospective study was to determine the frequency of tumor seeding after ultrasound......-guided percutaneous biopsy of CRC and BC liver metastases. MATERIAL AND METHODS: Unselected liver biopsies performed in the period of 2005-2012 at our institution were extracted from the National Pathology Registry. Medical records including imaging from patients with biopsy-verified BC and CRC liver metastases were...... retrospectively reviewed. The endpoint was the development of abdominal wall recurrence following liver biopsy. RESULTS: Of total 2981 biopsies we identified 278 patients with CRC and 155 patients with BC biopsy-verified liver metastases. During the median follow-up of 25 months after biopsy (range 3-253 months...

  9. One stage rescue procedure after capsular contracture of breast implants with autologous fat grafts collected by water assisted liposuction (“BEAULI Method”

    Directory of Open Access Journals (Sweden)

    Ueberreiter, Klaus

    2013-01-01

    Full Text Available With increasing number of patients with silicone implants for breast augmentation or reconstruction we are confronted with more and more cases of capsular contracture. Not every case is resolved by resection of the capsule and exchange of implants. Many patients rather bear the consequences of severe fibrosis than to have their implants removed. The one stage procedure of implant removal and lipofilling proved to be highly efficient with good to excellent results and high patient satisfaction. Between January 2008 and October 2012 a total of 64 patients (124 breasts with capsular fibrosis Baker III to IV were treated with autologous fat grafts collected with the body-jet by water-assisted liposuction (“BEAULI Method”. Magnetic resonance imaging (MRI of the breasts was performed in 5 patients preoperatively and 6 month postoperatively, a clinical examination and photo documentation of all patients was done on day 1 and after 4 weeks, 12 weeks and 6 months postoperatively. The procedure included implant removal and lipofilling of the subcutaneous and intramuscular space in a single procedure by means of the BEAULI Method. The average gross amount of grafted fat was 260 ml. The average drainage time was one day. The shape of the breast changed to a more natural and ptotic form. Negative side effects like oily cysts or infections were not observed. The time of the overall procedure including liposuction was 70±15 min. Reoccurring capsular contracture is one of the hazards in plastic surgery. Until now the treatment of choice after more than two failed implant changes combined with resection of the capsule is usually the final removal of implants with or without possible additional autologous tissue transfer (microvascular flaps. We could add a relatively simple and efficient procedure to resolve and improve those cases by autologous fat transfer using water-assisted liposuction and the BEAULI Method.

  10. Double-blind, placebo-controlled, randomised phase II trial of IH636 grape seed proanthocyanidin extract (GSPE) in patients with radiation-induced breast induration

    International Nuclear Information System (INIS)

    Background and purpose: Tissue hardness (induration), pain and tenderness are common late adverse effects of curative radiotherapy for early breast cancer. The purpose of this study was to test the efficacy of IH636 grape seed proanthocyanidin extract (GSPE) in patients with tissue induration after high-dose radiotherapy for early breast cancer in a double-blind placebo-controlled randomised phase II trial. Patients and methods: Sixty-six eligible research volunteers with moderate or marked breast induration at a mean 10.8 years since radiotherapy for early breast cancer were randomised to active drug (n=44) or placebo (n=22). All patients were given grape seed proanthocyanidin extract (GSPE) 100 mg three times a day orally, or corresponding placebo capsules, for 6 months. The primary endpoint was percentage change in surface area (cm2) of palpable breast induration measured at the skin surface 12 months after randomisation. Secondary endpoints included change in photographic breast appearance and patient self-assessment of breast hardness, pain and tenderness. Results: At 12 months post-randomisation, ≥50% reduction in surface area (cm2) of breast induration was recorded in13/44 (29.5%) GSPE and 6/22 (27%) placebo group patients (NS). At 12 months post-randomisation, there was no significant difference between treatment and control groups in terms of external assessments of tissue hardness, breast appearance or patient self-assessments of breast hardness, pain or tenderness. Conclusions: The study failed to show efficacy of orally-adminstered GSPE in patients with breast induration following radiotherapy for breast cancer

  11. Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

    Science.gov (United States)

    Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

    2015-11-01

    In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

  12. Direct delayed breast reconstruction with TAP flap, implant and acellular dermal matrix (TAPIA)

    DEFF Research Database (Denmark)

    Børsen-Koch, Mikkel; Gunnarsson, Gudjon L; Udesen, Ann;

    2015-01-01

    BACKGROUND: The latissimus dorsi (LD) flap is considered one of the working horses within the field of breast reconstruction and it offers several advantages. However, donor-site morbidity may pose a problem. This article describes a new and modified technique for delayed breast reconstruction...

  13. Propionibacterium acnes Augments Antitumor, Anti-Angiogenesis and Immunomodulatory Effects of Melatonin on Breast Cancer Implanted in Mice.

    Science.gov (United States)

    Talib, Wamidh H; Saleh, Suhair

    2015-01-01

    Breast cancer is one of the most invasive cancers with high mortality. The immune stimulating Propionibacterium acnes is a Gram positive bacterium that has the ability to cause inflammation and activate Th1-type cytokine immune response. Antitumor response was associated with the inflammation induced by P. acnes, but the antitumor effect of this bacterium was not evaluated in combination with other agents. The aim of this study was to test the antitumor potential of a combination of melatonin and P. acnes against breast cancer implanted in mice. Balb/C mice were transplanted with EMT6/P cell line and in vivo antitumor effect was assessed for P. acnes, melatonin, and a combination of melatonin and P. acnes. Tumor and organs sections were examined using hematoxylin/eosin staining protocol, and TUNEL colorimetric assay was used to detect apoptosis. The expression of vascular endothelial growth factor (VEGF) was measured in tumor sections and serum levels of INF-γ, and IL-4 were measured to evaluate the immune system function. To evaluate the toxicity of our combination, AST and ALT levels were measured in the serum of treated mice. The combination of melatonin and P. acnes has high efficiency in targeting breast cancer in mice. Forty percent of treated mice were completely cured using this combination and the combination inhibited metastasis of cancer cells to other organs. The combination therapy reduced angiogenesis, exhibited no toxicity, induced apoptosis, and stimulates strong Th1-type cytokine antitumor immune response. The combination of melatonin and P. acnes represents a promising option to treat breast cancer. However, carful preclinical and clinical evaluation is needed before considering this combination for human therapy. PMID:25919398

  14. Propionibacterium acnes Augments Antitumor, Anti-Angiogenesis and Immunomodulatory Effects of Melatonin on Breast Cancer Implanted in Mice.

    Directory of Open Access Journals (Sweden)

    Wamidh H Talib

    Full Text Available Breast cancer is one of the most invasive cancers with high mortality. The immune stimulating Propionibacterium acnes is a Gram positive bacterium that has the ability to cause inflammation and activate Th1-type cytokine immune response. Antitumor response was associated with the inflammation induced by P. acnes, but the antitumor effect of this bacterium was not evaluated in combination with other agents. The aim of this study was to test the antitumor potential of a combination of melatonin and P. acnes against breast cancer implanted in mice. Balb/C mice were transplanted with EMT6/P cell line and in vivo antitumor effect was assessed for P. acnes, melatonin, and a combination of melatonin and P. acnes. Tumor and organs sections were examined using hematoxylin/eosin staining protocol, and TUNEL colorimetric assay was used to detect apoptosis. The expression of vascular endothelial growth factor (VEGF was measured in tumor sections and serum levels of INF-γ, and IL-4 were measured to evaluate the immune system function. To evaluate the toxicity of our combination, AST and ALT levels were measured in the serum of treated mice. The combination of melatonin and P. acnes has high efficiency in targeting breast cancer in mice. Forty percent of treated mice were completely cured using this combination and the combination inhibited metastasis of cancer cells to other organs. The combination therapy reduced angiogenesis, exhibited no toxicity, induced apoptosis, and stimulates strong Th1-type cytokine antitumor immune response. The combination of melatonin and P. acnes represents a promising option to treat breast cancer. However, carful preclinical and clinical evaluation is needed before considering this combination for human therapy.

  15. Implantation of 125I seeds for the treatment of non-small cell lung cancer: evaluation of short-term effect

    International Nuclear Information System (INIS)

    Objective: To assess the short-term effect, feasibility and safety of 125I seeds implantation in treating non-small cell lung cancer. Methods: During the period from June 2010 to December 2012 a total of 353 patients with lung cancer were admitted to authors' hospital, of whom 56 met the study standards. The 56 cases were divided into study group (n=24) and control group (n=32). Bronchial artery chemotherapy with subsequent 125I seeds implantation was carried out in the patients of study group, while only bronchial artery chemotherapy was performed in the patients of control group. The median survival time was compared between the two groups. Results: The median survival time of the study group and the control group was (22.8±1.9) months and (14.2±1.3) months respectively. The median survival time of the study group was significantly higher than that of the control group (P=0.006). Conclusion: Compared with simple bronchial artery chemotherapy, permanent implantation of 125I seeds combined with bronchial artery chemotherapy can significantly improve the quality of life and prolong the survival time as well. Therefore, this technique is an effective therapy for advanced lung cancer and should be recommended in clinical practice. (authors)

  16. Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study

    Directory of Open Access Journals (Sweden)

    James J. Drinane, BSci

    2013-10-01

    Conclusions: Triple antibiotic breast irrigation is not associated with a significant reduction in the incidence or severity of capsular contracture compared with sterile saline when high-quality surgical technique is used.

  17. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

    Science.gov (United States)

    Cederna, P S; Yates, W R; Chang, P; Cram, A E; Ricciardelli, E J

    1995-11-01

    Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction. PMID:8579262

  18. 乳腺癌切除即刻乳房再造术中假体的选择%Selection of breast implant during immediate breast reconstruction after mastectomy

    Institute of Scientific and Technical Information of China (English)

    陈戈; 谢春伟; 穆大力; 栾杰

    2014-01-01

    Objective:To demonstrate the selection of breast implant during an immediate breast reconstruction post-mastectomy and analyze the indication of this technique. Methods:From June 2007 to June 2012, a total of 121 patients with breast cancer received immediate breast reconstruction with breast implants. Among the 121 patients, 89 patients had simple mastectomy, while the rest under-went modified radical mastectomy in the Department of Breast Neoplasm, Nanchang No.3 Hospital. The volumes of the resected breast tissues were measured using Archimedes principle. The diameters of the tissues were also determined. Proper breast implants were se-lected according to the measured data. Results: Postoperative complications, such as implant exposure, flap necrosis, and infection, were not found. Follow-up period ranged from 6 months to 12 months. Patients answered a questionnaire that displayed their degree of satisfaction for the breast operation outcome. Results show that 89.3%of the patients (108/121) were very satisfied, 9%were (11/121) satisfied, and 1.7%(2/121) were unsatisfied. Conclusion:Immediate breast reconstruction with breast implant post-mastectomy is an ideal method for rebuilding the breast. This technique is advantageous because it prevents damage to the donor site and retains the maxi-mal elasticity of the skin for breast reconstruction. Accurate parameters of breast implants, which are important to achieve good surgical results, could be obtained using Archimedes principle.%目的:研究乳腺癌切除即刻乳房再造术中选择假体的方法,探讨即刻假体乳房再造的适应证。方法:收集2007年6月至2012年6月南昌市第三医院乳腺肿瘤科的乳腺癌切除术患者121例,其中乳腺癌改良根治术32例、单纯乳腺切除术89例。乳腺切除后根据阿基米德法计算缺失乳房体积,并测量切除组织直径,以切除组织的体积和直径为依据选择乳房假体,并置入胸

  19. Meshed acellular dermal matrix:technique and application in implant based breast reconstruction

    Institute of Scientific and Technical Information of China (English)

    Dino Zammit; Jonathan Kanevsky; Fan-Yi Meng; Tassos Dionisopoulos

    2016-01-01

    Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic surgeons. However, while the overall surgical outcome of breast reconstruction using alloderm has been a success, the economic burden on the health care system makes it a subject of frequent re-evaluations in cost-effectiveness. Prompted by the high price of $3,700 USD for a 6 cm × 16 cm area, our group proposes the meshing of AlloDerm to decrease the total amount needed for breast reconstruction, while achieving comparable surgical outcomes as using unmeshed alloderm.

  20. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Freer, Phoebe [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Lawenda, Brian [21st Century Oncology, Las Vegas, NV (United States); Alm El-Din, Mohamed A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Clinical Oncology, Tanta University Hospital, Tanta (Egypt); Gadd, Michele A.; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence

  1. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall’s tau (τβ) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4–14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome (τβ 0.6, p β 0.5, p β 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias ≥1 cm2. Grade 3–4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose (τβ 0.3–0.5, p ≤ .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence-free survival, and overall survival rate was 85% (95% confidence interval, 70–97%), 72% (95% confidence interval, 54–86%), and 87% (95% confidence

  2. Effects of Zafirlukast on the Capsular Fibrosis of Silicone Breast Implants

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    Emre Hocaoglu

    2014-06-01

    Methods: Forty-eight adult female Sprague-Dawley rats were divided into four groups. Smooth-surfaced, gel-filled prostheses were implanted in 36 rats. Group A: The day of the operation, 12 animals received Zafirlukast treatment for 14 weeks (oral gavage, once a day, 6 days a week, 4 mg/kg/day; Group B: 10 weeks after the operation, 12 animals received Zafirlukast treatment for 4 weeks; Group C: 12 animals were implanted but did not receive treatment; Group D: 12 animals did not have an operation, but for 14 weeks received oral gavage containing water instead of Zafirlukast. At the end of the 14 weeks, the implants with the surrounding capsules were extracted. Blind macroscopic inspectional evaluation of the capsules was performed, and microscopic capsular thickness measurements were made. Results: The mean capsular thickness was 0.033 mm (SD: 0.011 in Group A, and 0.089 mm (SD: 0.023 and 0.125 mm (SD: 0.025 in Groups B and C, respectively. Differences between Groups A and C and between Groups A and B were significant (p0.05. Similarly, Macroscopic Inspectional Fibrosis Scoring showed a significant difference between Groups A and C and a non-significant difference between Groups B and C. Conclusion: Daily prophylactic oral administration of Zafirlukast immediately after implantation significantly diminishes the development of fibrotic capsules around the silicone prostheses. [Arch Clin Exp Surg 2014; 3(3.000: 139-146

  3. Infectious complications in implant based breast surgery and implications for plastic surgeons [Infektiöse Komplikationen bei alloplastischen Brustoperationen und Implikationen für Plastische Chirurgen

    Directory of Open Access Journals (Sweden)

    Horch, Raymund E.

    2013-07-01

    Full Text Available [english] Implantation of breast prosthesis is still one of the most frequently performed breast reconstructing or contouring procedures. Infectious complications and capsular contracture are inherent problems that may have different causes which are not clearly defined yet in terms of pathophysiology. Recent findings showed bacterial contamination as a major cause of implant failure. Since this has direct implications for the surgical management we report on biofilm development on alloplastic breast prostheses, characteristics and effects after implantation of medical devices in general. This article gives a review of the current literature and discusses possible issues to solve the problem of infection after implantation of breast prosthesis. In conclusion the reinsertion of single-use devices should not be recommended and should be strictly avoided when a device related infection has occured. According to current knowledge contaminated implants should be removed, the infection then be cured and if necessary, a new prosthesis may be implanted after a regeneration period. Alternatively a change in therapy towards autologous tissue reconstruction should be considered if previous attempts with alloplastic prostheses have failed and if radiation therapy has worsened the local tissue situation in the recipient area.[german] Implantationen von Brust-Prothesen sind für Brustrekonstruktionen oder Konturierungen noch immer die am häufigsten durchgeführten Verfahren. Typische inhärente Probleme sind dabei neben infektiösen Komplikationen die Kapselkontrakturen, deren unterschiedliche Ursachen bezüglich der Pathophysiologie noch nicht eindeutig geklärt sind.Neuere Erkenntnisse weisen auf bakterielle Kontamination als eine der Hauptursachen von Implantatversagen hin. Da dies direkte Auswirkungen auf die chirurgische Behandlung hat, berichten wir über das Problem der Biofilmentwicklung auf alloplastischen Brustimplantaten sowie über deren Effekte

  4. 高频超声在硅胶乳房植入物检测中的价值%The value of hyperfrequency ultrasound in silicone breast implants

    Institute of Scientific and Technical Information of China (English)

    钟红; 张小曼; 王原路; 程宁新

    2000-01-01

    Objective To determine the value of breast hyperfrequency ultrasonography(US)in the assessment of silicone breast implants.Methods Fourteen implanted breasts of 7 women underwent hyperfrequency US and were surgically removed.Results The ultrasonographic characteristies of an intact implant was showed that shape looks like updown triangle,contour line was straight,there was noice within the implant,the anechoic structure had a band of reverberations anteriorly.The sonographic findings with intracapsular rupture were:the implant shape transformed,echogenic noise,low-level homogeneous echoes,and a contourbulge,horizountl lines.In the extracapsular rupture there were hypoechoic nodules outside the implant.Of 14 implants removed,2 were intact,3 were intraeapsuiar and 9 were extracapsular ruptures.Conclusions Hyperfrequency ultrasonography can detect the silicone breast implants intact,intracapsular and extracapsular rupture.%目的 探讨高频超声在硅胶乳房假体检测中的价值.方法 对7例妇女接受硅胶乳房假体植入术后,硅胶乳房假体破裂的14只乳房采用7.5~10.0 MHz的高频超声检测,均做了植入物清除术,获手术证实.结果 硅胶乳房假体完整的超声图像特征为:假体切面形态呈倒三角形,轮廓线平直,内部呈均匀一致的无回声表现,前壁表现为厚约1 cm的稍强回声带.硅胶乳房假体破裂超声表现为植入物形状改变,囊壁局部膨隆,囊内见细小点状回声及平行带状回声,囊外见无回声或低回声结节.14只硅胶乳房假体中,完整2只,破裂12只(囊内破裂3只,囊外破裂9只).结论 高频超声检查乳房能判断硅胶乳房假体完整或囊内破裂和囊外破裂.

  5. Colocación transpectoral superior de implantes mamarios: Relevancia técnica y anatómica Superior transpectoral insertion of breast implants: Anatomical and technical relevance

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2008-12-01

    Full Text Available Los tres planos de colocación de implantes para aumento mamario tienen particularidades claramente identificables. Cada modificación anatómica y los elementos tisulares acompañantes establecen beneficios y efectos adversos que influyen sobre el resultado final. El presente estudio tiene como objetivo la comunicación temprana de los hallazgos clínicos obtenidos con la creación de una cavidad de implantación en diferentes condiciones, utilizando una combinación de planos y haciendo énfasis en un fundamento anatómico y funcional de gran relevancia. El mejor manejo de los implantes mamarios y de otros biomateriales es el mantenimiento de su integridad y el control de su comportamiento a largo plazo. De manera prospectiva valoramos la colocación de implantes mamarios en una cavidad que es subfascial en la porción caudal de la mama y retropectoral en la porción cefálica. El aislamiento de las rutas linfáticas suprafasciales proporciona un menor riesgo de contaminación del implante. La facilidad técnica se produce al no tener que desinsertar inferior y medialmente el músculo pectoral. En los 15 casos estudiados, no se produjo ningún desplazamiento cefálico de los implantes con la contracción pectoral. Hacemos también una revisión de la sustentación anatómica y funcional del nuevo plano de implantación utilizado. El resultado es una suma de beneficios y la prevención de un frecuente efecto adverso, con lo que cumplimos el objetivo final de reducir la morbilidad e incrementar la seguridad del procedimiento.The particular benefits and adverse effects of the three different planes for breast implant placement are widely known. The search for a safer implantation cavity led to a combination of two dissection planes with different anatomical components placed in continuity. Instead of supporting its value with statistics of good outcomes, emphasis is stressed in the functional and anatomical consequences of the proposed plane of

  6. Selection of the volume and shape of mammary implant in breast augmentation%乳房假体大小与形态的选择

    Institute of Scientific and Technical Information of China (English)

    才杰; 崔鹏; 马海欢

    2012-01-01

    目的 探讨隆乳术中正确选择乳房假体大小与形态的方法.方法 通过502例隆乳术后乳房大小与形态的变化,并参考术前胸部各项测量参数,总结出选择合适的乳房假体大小与形态的方法.结果 术前胸廓的横径即H值是选择乳房假体横径的重要参数,以此推算出的乳房假体横径能满足乳间沟较明显及乳房外侧亦较丰满的要求.胸骨切迹中点S到乳头N的距离SN是选择水滴形乳房假体(解剖型乳房假体)高度的重要参数.假体直径和高度确定后,增大乳房体积主要靠增加假体突度实现.对于胸部扁平、比较消瘦者,水滴形假体是较好的选择.结论 术前胸廓的横径及乳房的大小等参数是选择乳房假体大小与形态的重要指标.圆形假体和水滴形假体具有各自的适应证.%Objective To explore the methodology of choosing the volume and shape of the mammary implant.Methods The changes of the volume and shape were analyzed in 502 cases of breast augmentation,to find out how to select the volume and shape of the mammary implant.Results The thoracic width H was the most important factor of choosing width of the implant; the SN was the important factor of choosing the height of the anatomic implant; After setting the diameter and height of the implant,a bigger breast could be achieved by increasing the projection of implants.For those very thin females with flat chest, anatomic implants were the better choice. Conclusions Thoracic width,breast volume and other data are the most important factors in choosing the mammary implant.Round and anatomic mammary implants have their specific indications.

  7. Breast reconstruction following mastectomy with implants report of 152 cases%乳腺癌术后乳房即刻再造152例报告

    Institute of Scientific and Technical Information of China (English)

    蒋宏传; 李发成; 李杰

    2008-01-01

    目的 探讨乳癌根治术后即时应用单纯假体植入、可调式双囊假体植入和自体组织移植乳房再造术的适应证及疗效.方法 101例在保留皮肤的乳腺癌改良根治术基础上于胸大肌下方植入Mentor假体再造乳房,39例在胸大肌下方植入Becker可调式假体再造乳房,10例用单蒂下腹部横行腹直肌肌皮瓣移植至乳房缺损区再造乳房.2例采用扩大的背阔肌肌皮瓣移植再造乳房.结果 随访152例3~65个月,中位时间28个月,2例13个月后肿瘤局部复发,取出假体.术后乳房外观评价优良率达94%.结论 单纯假体植入适用于乳房较小的患者,可调式假体植入乳房再造适用于乳房较大,或根治术时皮肤缺损较多的患者.%Objective A review of the results obtained from a series of consecutive patients undergoing breast reconstruction following mastectomy with full-size implant, Becker expandable implant, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap and extended latissimus dorsi musculocutanous flap (ELDF) to evaluate the indications, surgical methods and effects. Methods Immediate breast reconstructions were carried out using full-size Mentor implants following skin-sparing mastectomy in 101 patients and Becker expandable implants were used for immediate breast reconstruction in 39 patients. Unilateral pedicled TRAM flaps were used for immediate breast reconstruction in 10 and extended latissimus dorsi musculocutaneous flap (ELDF)was carried out in 2 patients. Results The patients were followed in the past 3~65 months. Tumor was locally recurrent in 2 patients, and the implant was carried out. Minor complications small local skin necrosis of nipple-areola complex and seroma formation. Satisfactory results than 94% of the patients. Conclusions Size implant is ideal for a slender, small-breast women. In patients with large breast or those who received modified mastectomy, expandable implants can be used for immediate

  8. Complementary method of analyzing the quality of the implant I-125 seeds for prostate brachytherapy using ultrasound imaging post-implant; Metodo complementario de analisis de la calidad del implante de semillas de I-125 para braquiterapia de prostata mediante la adquisicion de imagenes ecograficas post-implante

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Dominguez, M.; Carrasco Herrera, M.; Baeza Trujillo, M.; Herrador Cordoba, M.

    2011-07-01

    In this paper we propose a complementary method based on Longitudinal mode ultrasound images acquired the same day of surgery, at the end of the implant. This option will allow us to evaluate the dosimetry end of treatment with the patient in the same position he was planning and to the rectum and bladder just as full. This will permit the identification of bodies and the seeds of interest more easily and will have a reference with which to compare one month later, when the CT images can also detect whether there has been some migration.

  9. Radioactive seed implantation in head and neck neoplasms treatment%放射性粒子植入在头颈恶性肿瘤中的应用

    Institute of Scientific and Technical Information of China (English)

    李磊; 李晓江

    2011-01-01

    近年来,放射性粒子植入以其独特的物理学和放射生物学优势成为各种头颈肿瘤手术治疗或外放射治疗的补充方法,临床治疗效果已得到广泛认同,为头颈部恶性肿瘤的综合治疗增添了一种新颖而有效的手段.%Radioactive seed interstitial implanting is a complementary method for surgery or radiotherapy and also a remedy for postsurgical carcinoma recurrence in head and neck neoplasms. These seeds with unique advantages of physics and radiation biology offer a new effective method for head and neck cancer therapy.

  10. Diagnosis and treatment of breast implant rupture%硅凝胶乳房假体破裂渗漏的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    姜南; 郝媛媛; 申丽; 王月; 徐亚红; 赵艳; 翟宏艳

    2009-01-01

    目的 探讨硅凝胶乳房假体(silieonegel breast implant,SBI)破裂的诊断、治疗和预后.方法 通过临床查体、X线透视、高频彩色多普勒超声仪检查明确诊断;经乳房下皱襞或乳晕切口入路探查并取出硅凝胶(siliconegel,SG)及其硅胶囊与纤维包膜;修整假体腔隙、同期置入SBI.结果 32例单侧(或双侧)同期SBI破裂者再次手术后,乳房形态改观满意,术后除2例发生积液外,其余均Ⅰ期愈合.结论 SBI破裂后,取出SG及其硅胶囊与纤维包膜切除后,充分清理并修整、再造包膜腔隙,同期置入SBI,可以获得满意的治疗结果.%Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.

  11. Implantes mamarios en el plano subfascial en reemplazo del bolsillo subglandular: un cambio lógico Breast implants in the subfascial plane in replacement of the subglandular pocket: a logical change

    Directory of Open Access Journals (Sweden)

    O.D. Ventura

    2006-03-01

    Full Text Available Desde 1999 hemos cambiado el plano subglandular del bolsillo de los implantes mamarios por el plano subfascial (subaponeurótico. Este plano se halla por debajo de la fascia aponeurótica del músculo pectoral mayor, serrato, oblicuo lateral y recto anterior. Este artículo considera 150 casos implantados en este plano (subfascial. Se utilizaron prótesis de superficie texturada. El abordaje fue por una incisión periareolar inferior. En todos los pacientes se consiguió una excelente cobertura del implante, al igual que una forma y movilidad natural. En ningún caso se observó el desagradable ondulado de cuadrantes superiores, conocido como rippling. Cuatro de ellos presentaron procesos capsulares contráctiles grado II de Baker (2,6%. En el postoperatorio inmediato se registró menor edema y una recuperación más rápida de lo habitual, de acuerdo a nuestra experiencia con los otros procedimientos (submuscular y subglandular. Cuando la elección del bolsillo es subglandular, el plano subfascial parecería ser el lugar lógico de la colocación de los implantes mamarios.Since 1999, the subglandular plane of the pocket has been substituted in our practise for the subfascial (subaponeurotic plane in breast implants. This plane lies underneath the aponeurotic fascia of the pectoralis major , the serratus, the lateral oblique and the rectus anterior muscles. This article describes 150 patients with implants in the subaponeurotic plane and textured surface. Patients were approached through an inferior periareolar incision. Excellent coverage of the implant, as well as natural shape and mobility were achieved in all patients. No ondulation (rippling in the upper half of the breast has been observed. Four patients (2,6% had Baker grade II capsular contracture. In the immediate post-op, less edema and faster-than-usual recovery could be seen versus our experience with other (submuscular and subglandular procedures. When a subglandular pocket is the

  12. Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

    International Nuclear Information System (INIS)

    Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. ≥50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

  13. Radiological response of ceramic and polymeric devices for breast brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Batista Nogueira, Luciana, E-mail: lucibn19@yahoo.com.br [Departamento de Propedeutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil); Passos Ribeiro de Campos, Tarcisio, E-mail: campos@nuclear.ufmg.br [Departamento de Engenharia Nuclear, Programa de Pos Graduacao em Ciencias e Tecnicas Nucleares, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil)

    2012-04-15

    In the present study, the radiological visibility of ceramic and polymeric devices implanted in breast phantom was investigated for future applications in brachytherapy. The main goal was to determine the radiological viability of ceramic and polymeric devices in vitro by performing simple radiological diagnostic methods such as conventional X-ray analysis and mammography due to its easy access to the population. The radiological response of ceramic and polymeric devices implanted in breast phantom was determined using conventional X-ray, mammography and CT analysis. - Highlights: Black-Right-Pointing-Pointer Radiological visibility of ceramic and polymeric devices implanted in breast phantom. Black-Right-Pointing-Pointer The barium incorporation in the seed improves the radiological contrast. Black-Right-Pointing-Pointer Radiological monitoring shows the position, orientation and degradation of devices. Black-Right-Pointing-Pointer Simple radiological methods such as X-ray and mammography were used for radiological monitoring.

  14. Influencia de las cargas triboeléctricas y de la contaminación sintomática de los implantes Triboelectric charges and breast implant symptomatic contamination

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2007-12-01

    Full Text Available El hallazgo ocasional de energía estática importante en un implante mamario, generó una revisión sistemática de la información disponible al respecto que restableció una secuencia de eventos y conceptos de importancia, a nuestro juicio, en la práctica clínica Los implantes mamarios son elastómeros resultantes de la polimerización industrial que pueden generar cargas electrostáticas en su superficie. El efecto triboeléctrico puede mantener suficiente energía estática como para atraer partículas de material capaces de producir una contaminación periprotésica sintomática. El desconocer esta propiedad física puede llevar a una práctica clínica de riesgo al colocar implantes mamarios. Adicionalmente se revisa la microbiología involucrada en la formación capsular periprotésica sintomática y la infección por bacterias productoras de "biofilm".An incidental finding of static energy upon the surface of a breast implant, generated a systematic search that led to a link between triboelectric charges and symptomatic periprosthetic infection. Breast implants are industrial elastomers that may result with electrostatic charges on its surface. Its propper resistivity allows silicone to maintain enough static that atracts and adheres particulate matter to become surface contamination with periprosthetic tissue reaction. Recognition of this particular physical property and its clinical implications allows for safer conditions of practice. We review microbiology involved in periprosthetic capsular formation and infection by "biofilm" producer bacteria.

  15. Reconstrucción mamaria con expansor tisular e implante: Indicaciones y experiencia en 24 casos Breast reconstruction with tissue expander: Indications and experience in 24 cases

    Directory of Open Access Journals (Sweden)

    C. Gutiérrez Gómez

    2012-12-01

    Full Text Available En la actualidad, la reconstrucción mamaria forma parte integral del tratamiento del cáncer de mama; la selección de la paciente es crítica para obtener resultados satisfactorios. El presente trabajo recoge nuestra experiencia en reconstrucción mamaria con expansión tisular e implantes, haciendo hincapié en la selección de las pacientes candidatas a este método reconstructivo. Revisamos las reconstrucciones mamarias realizadas en un período comprendido entre los años 1998 y 2008 por la misma cirujana, analizando factores como tipo de mastectomía, edad, tiempo de la reconstrucción (inmediata o diferida, causa de la mastectomía, tipo de expansor y prótesis utilizados, complicaciones y satisfacción de las pacientes. En todas excepto en una, la reconstrucción se realizó en dos tiempos operatorios; durante el primero se hizo la colocación del expansor tisular y en el segundo, el cambio por la prótesis mamaria definitiva. Se realizaron un total de 24 reconstrucciones mamarias en 19 pacientes en el período de 10 años revisado, 14 unilaterales y 5 bilaterales. Las complicaciones presentadas en este grupo de pacientes fueron del 16,6 %. El seguimiento de las pacientes fue de 2 a 10 años. Solamente en 1 caso de cuadrantectomía, se realizó la reconstrucción de forma diferida por antecedente de radioterapia (4,1 %. En nuestra opinión, la reconstrucción mamaria con expansor tisular e implante es un procedimiento seguro, reproducible y con bajo índice de complicaciones, sin el inconveniente añadido de ocasionar morbilidad en el a área donante.Nowadays, breast reconstruction is part of breast carcinoma treatment; patient's selection plays an important role in satisfactory results. The present paper reports our experience in breast reconstruction with tissue expander/implant and emphasizes the importance of choosing the candidates for this method of reconstruction. We review the breast reconstructions realized in a 10 year period

  16. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2009-03-15

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p = 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven

  17. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    International Nuclear Information System (INIS)

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven that

  18. 经脐孔缘切口置人充注式生理盐水假体隆乳术%Transumbilical breast augmentation with insertion of saline-filled breast implants

    Institute of Scientific and Technical Information of China (English)

    余力; 王健; 张波; 朱昌

    2008-01-01

    目的 探讨经脐孔缘切口行充注式生理盐水假体隆乳术的手术方法,为隆乳术提供新切口选择.方法 沿脐孔缘切口,采用特制专用器械分离皮下隧道至乳房下皱襞,然后穿进胸大肌后间隙,分离假体放置空间,先置人扩张器,充注生理盐水后,调整乳房形态以及扩张器位置.然后取出扩张器,更换为充注式生理盐水乳房假体而完成手术.结果 采用经脐孔缘切口行充注式生理盐水假体隆乳术者,均获得了良好的手术效果,无感染、血肿、假体渗水、Baker Ⅲ或Ⅳ级纤维囊挛缩等并发症发生.结论 采用生理盐水充注式乳房假体,经脐孔缘切口可以完成胸大肌下隆乳术,增加了隆乳手术切口的选择范围.%Objective To evaluate the surgical technique and procedures of transumbilieal breast augmentation with an inverse U-shape incision and insertion of saline-filled breast implants. Methods With specialized instruments, the subcutaneous tunnel was undermined to the inframammary crease after inverse U incision made along the umbilical border. The subpectoral space was dissected with a dissector after the advancement of obturator across the inframammary crease. The expander was inserted into the subpectoral pocket to be filled to obtain the high degree of symmetry of the breasts. Finally, the previous-ly prepared implants were inserted after the expander deflated and removed. Results All patients gained satisfactory results with no complications, such as hematoma, infection, implant deflation and Baker Ⅲ or Ⅳ capsular contracture. Conclusions Breast augmentation could be performed through umbilical inci-sion with the usage of saline-filled breast implant. This is an alternative of incisions in breast augmenta-tion.

  19. Influence of polyphenol extract from evening primrose (Oenothera paradoxa seeds on human prostate and breast cancer cell lines

    Directory of Open Access Journals (Sweden)

    Urszula Lewandowska

    2014-02-01

    Full Text Available There is growing interest in plant polyphenols which exhibit pleiotropic biological activities, including anti-inflammatory, antioxidant, and anticancer effects. The objective of our study was to evaluate the influence of an evening primrose extract (EPE from defatted seeds on viability and invasiveness of three human cell lines: PNT1A (normal prostate cells, DU145 (prostate cancer cells and MDA-MB-231 (breast cancer cells. The results revealed that after 72 h of incubation the tested extract reduced the viability of DU 145 and MDA-MB-231 with IC50 equal to 14.5 μg/mL for both cell lines. In contrast, EPE did not inhibit the viability of normal prostate cells. Furthermore, EPE reduced PNT1A and MDA-MB-231 cell invasiveness; at the concentration of 21.75 μg/mL the suppression of invasion reached 92% and 47%, respectively (versus control. Additionally, zymographic analysis revealed that after 48 h of incubation EPE inhibited metalloproteinase-2 (MMP-2 and metalloproteinase-9 (MMP-9 activities in a dose-dependent manner. For PNT1A the activities of MMP-2 and MMP-9 decreased 4- and 2-fold, respectively, at EPE concentration of 29 μg/mL. In the case of MDA-MB-231 and DU 145 the decrease in MMP-9 activity at EPE concentration of 29 μg/mL was 5.5-fold and almost 1.9-fold, respectively. In conclusion, this study suggests that EPE may exhibit antimigratory, anti-invasive and antimetastatic potential towards prostate and breast cancer cell lines.

  20. Influence of polyphenol extract from evening primrose (Oenothera paradoxa) seeds on human prostate and breast cancer cell lines.

    Science.gov (United States)

    Lewandowska, Urszula; Owczarek, Katarzyna; Szewczyk, Karolina; Podsędek, Anna; Koziołkiewicz, Maria; Hrabec, Elżbieta

    2014-02-03

    There is growing interest in plant polyphenols which exhibit pleiotropic biological activities, including anti-inflammatory, antioxidant, and anticancer effects. The objective of our study was to evaluate the influence of an evening primrose extract (EPE) from defatted seeds on viability and invasiveness of three human cell lines: PNT1A (normal prostate cells), DU145 (prostate cancer cells) and MDA-MB-231 (breast cancer cells). The results revealed that after 72 h of incubation the tested extract reduced the viability of DU 145 and MDA-MB-231 with IC50 equal to 14.5 μg/mL for both cell lines. In contrast, EPE did not inhibit the viability of normal prostate cells. Furthermore, EPE reduced PNT1A and MDA-MB-231 cell invasiveness; at the concentration of 21.75 μg/mL the suppression of invasion reached 92% and 47%, respectively (versus control). Additionally, zymographic analysis revealed that after 48 h of incubation EPE inhibited metalloproteinase-2 (MMP-2) and metalloproteinase-9 (MMP-9) activities in a dose-dependent manner. For PNT1A the activities of MMP-2 and MMP-9 decreased 4- and 2-fold, respectively, at EPE concentration of 29 μg/mL. In the case of MDA-MB-231 and DU 145 the decrease in MMP-9 activity at EPE concentration of 29 μg/mL was 5.5-fold and almost 1.9-fold, respectively. In conclusion, this study suggests that EPE may exhibit antimigratory, anti-invasive and antimetastatic potential towards prostate and breast cancer cell lines.

  1. 600 cases feedback of implants breast by silica gel%600余例硅凝胶假体隆乳术的体会

    Institute of Scientific and Technical Information of China (English)

    蒋未台; 蒋铮铮; 蒋伯熙; 潘印

    2013-01-01

    Objective based on 600 cases feedback of implants breast by silica gel, to find a better solution for the surgery. Methods ①Choose a soft and loose breast silica gel. ②Cutting a line under mammary areola 2.5~3cm, and leave enough lacuna from ectopectoralis, implant silica gel breast after stop blood, refill suitable anaesthetic, anticatarrhals.anastaltic.etc. ③Important massage within 2 days after surgery.and positive longer massage 3 months after surgery. Results 2 breasts symmetrical,plump,soft.no effect to suckle. Capsular contracture rate is less than 1%, and satisfaction is more than 98%. Conclusion following conditions are needed to have an ideal implant breast: good breast silica gel, professional doctor.and professional massage.%目的:总结600余例硅凝胶假体隆乳术的临床经验,探讨硅凝胶假体隆乳术的最佳方案.方法:①选择外囊宽松、手感柔软、大小合适的硅凝胶乳房假体;②乳晕下缘2.5 ~ 3cm切口,胸大肌下分离足够大小的腔隙,充分止血后置入假体,腔内置入适量麻醉液、消炎药、止血药等;③术后早期(2天)、到位、持久(3个月以上)的按摩.结果:术后两乳对称、丰满、手感与形态逼真,不影响哺乳.纤维包膜挛缩发生率<1%,医患满意度>98%.结论:要隆出一对手感与形态逼真的乳房的条件是:①好的乳房假体(主要指的是形状、手感、大小合适);②医生的临床经验;③术后早期、到位、持久的按摩;此三点缺一不可.

  2. Early breast cancer: influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy

    International Nuclear Information System (INIS)

    Between December 1981 and December 1988, 329 consecutive patients with stage I and II breast cancers who underwent wide excision (n = 261) or quadrantectomy (n = 68) with (n = 303) or without (n = 26) axillary dissection were referred to radiotherapy. Final margins of resection were microscopically free from tumor involvement in all cases. Radiotherapy consisted in 40-45 Gy over 4-4.5 weeks to the breast, with (n = 168) or without (n = 161) regional nodal irradiation of 45-50 Gy over 4.5-5 weeks. A mean booster dose of 15 Gy was delivered to the primary site by iridium-192 implant in 169 patients (group 1) or by electrons in 160 patients (group 2). Twenty-seven percent (n = 88) of patients received tamoxifen for ≥ 2 years. Adjuvant chemotherapy was administered in 22% (n = 71) of patients. Groups 1 and 2 were not strictly comparable. Group 1 patients were significantly younger, had smaller tumors, were treated with cobalt at 5 x 2 Gy per week and axillary dissection was more frequently performed. Group 2 patients were more frequently bifocal and more frequently treated by quadrantectomy and tamoxifen, and irradiation used accelerator photons at 4 x 2.50 Gy per week. No difference in terms of follow-up and survival rates was observed between the two groups. For all patients the 5- and 10-year local breast relapse rates were 6.7% and 11%, respectively. No difference was observed regarding local control either by the electron or the iridium-192 implant boosts. Axillary dissection and age had an impact on the breast cosmetic outcome. Furthermore, the cosmetic results seemed to be poorer in group 1 than in group 2. This may be related to other factors; group 1 patients were treated with telecobalt and axillary dissection was more frequently performed; on the other hand, group 2 patients were treated with accelarator photons

  3. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  4. 聚丙烯酰胺水凝胶隆乳取出后同期假体置入%Instant implantation of breast after removal of polyacrylamide hydrogel for breast augmentation

    Institute of Scientific and Technical Information of China (English)

    张本寿; 徐志明; 李增男; 解潮; 徐志久; 赵读泽; 赵耀忠

    2014-01-01

    Objective To investigate the clinical indication and effect of instant reconstruction of breast after removal of polyacrylamide hydrogel injection for breast augmentation.Methods Patients had breast ultrasound,MRI check before operation,to define the distribution and level of the injections and tissue infiltration.Depending on tissue degree,capsule integrity and breast degeneration situation,three different methods were chosen,including implantation of silicone gel underneath the breast,pectoralis major or dual-plane.Results 56 patients' incision healed well.Follow-up for 6 months to 3 years showed that breast shapes were good without scars,prosthetic herniapsular,capsular contracture and other complications.Conclusions Instant reconstruction of the breast after removal of polyacrylamide hydrogel injection can improve breast shape and get satisfied effects.%目的 探讨聚丙烯酰胺水凝胶(polyacrylamide hydrogel,PAHG)注射隆乳取出术后,同期行假体置入的临床适应证与疗效.方法 对PAHG注射隆乳后发生并发症者,术前做乳腺超声、磁共振成像(MRI)检查,明确注射物分布层次和组织浸润情况,经乳晕切口行注射物及病变组织彻底清除后,根据组织浸润程度、包膜完整性、胸肌和乳腺变性情况,分别选择乳腺后、胸大肌后、双平面3种方式,同期行硅凝胶假体置入术.结果 56例切口均愈合良好,乳房对称、挺拔.术后随访6个月至3年,乳房外形良好,无瘢痕和假体疝出,无纤维包膜挛缩等并发症发生.结论 依据PAHG取出后乳房畸形特点,同期假体置入重塑乳房形态,既可改善乳房外观,又可缓解心理障碍,效果满意.

  5. Potential Anti-Inflammatory Effects of the Hydrophilic Fraction of Pomegranate (Punica granatum L.) Seed Oil on Breast Cancer Cell Lines

    OpenAIRE

    Susan Costantini; Fabiola Rusolo; Valentina De Vito; Stefania Moccia; Gianluca Picariello; Francesca Capone; Eliana Guerriero; Giuseppe Castello; Maria Grazia Volpe

    2014-01-01

    In this work, we characterized conjugated linolenic acids (e.g., punicic acid) as the major components of the hydrophilic fraction (80% aqueous methanol extract) from pomegranate (Punica granatum L.) seed oil (PSO) and evaluated their anti-inflammatory potential on some human colon (HT29 and HCT116), liver (HepG2 and Huh7), breast (MCF-7 and MDA-MB-231) and prostate (DU145) cancer lines. Our results demonstrated that punicic acid and its congeners induce a significant decrease of cell viabili...

  6. Fine needle aspiration cytology in the diagnosis of complications after breast implant surgery%隆胸术后并发症的针吸细胞学诊断

    Institute of Scientific and Technical Information of China (English)

    龚萍; 佟刚强

    2012-01-01

    Objective To explore the traits of fine needle aspiration cytology (FNAC), differential diagnosis for complications after breast implant surgery and its significance for clinical diagnosis. Methods The clinical data of 10 patients undergoing breast implant diagnosed by FNAC were analyzed and summarized, in terms of clinical manifestation and FNAC trait. Results Of the ten patients, seven received polyacrylamide (PAM) as breast implants, in which one was diagnosed as breast cancer one year after surgery. Three patients had autologous fat as breast implants, and revealed differential morphological traits. Conclusion FNAC is not only efficient and scar-slight in the diagnosis of complications of breast implants, but also simple and accurate. It can be important basis for clinicians to choose the reasonable treatment solution.%目的 探讨隆胸术后并发症的针吸细胞学特点、鉴别诊断及其在临床诊断中的意义.方法 收集我院经针吸细胞学检查诊断10例病例,对其临床表现及针吸细胞学特点进行分析、总结.结果 凝胶聚丙烯酰胺水凝胶假体植入者7例,其中有1例于凝胶假体植入术后一年针吸为乳腺癌;3例为自体脂肪注入,均有较特异的形态学特点.结论 针吸细胞学诊断隆胸术后并发症快速、损伤小、操作简便并且准确率高,可以为临床医生选择合理治疗方案提供重要依据.

  7. Irradiation with external beam and interstitial radioactive implant as primary treatment for early carcinoma of the breast

    International Nuclear Information System (INIS)

    The locoregional control of 60 to 61 patients supports the results published by other centers and compares favorably with results of any surgical series. The cosmetic results are excellent with only three of 61 patients having severe fibrosis of the breast develop. No rib fractures, skin ulcerations, symptomatic radiation pneumonitis, edema of the arm or limitation of arm movement have been observed as complications. Ten of the 28 patients who have had axillary dissection had transient edema of the breast develop. Results of numerous studies suggest that primary radiotherapy without mastectomy is appropriate treatment for early carcinoma of the breast. The accessibility of the breast makes it relatively easy to deliver curative doses of radiation with minimal damage to surrounding normal tissues. The cumulative radiotherapy experience has demonstrated the gratifying results of not only maintaining a rather normal breast but also avoiding the negative physical and psychologic repercussions of the mastectomy. Radiation therapy is an alternative to Halsted's radical mastectomy

  8. Risks of Breast Implants

    Science.gov (United States)

    ... Chest Wall Deformity Chest wall or underlying rib cage appears deformed. Deflation Leakage of the saltwater (saline) ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products

  9. Gamma-ray detector guidance of breast cancer therapy

    Science.gov (United States)

    Ravi, Ananth

    2009-12-01

    Breast cancer is the most common form of cancer in women. Over 75% of breast cancer patients are eligible for breast conserving therapy. Breast conserving therapy involves a lumpectomy to excise the gross tumour, followed by adjuvant radiation therapy to eradicate residual microscopic disease. Recent advances in the understanding of breast cancer biology and recurrence have presented the opportunity to improve breast conserving therapy techniques. This thesis has explored the potential of gamma-ray detecting technology to improve guidance of both surgical and adjuvant radiation therapy aspects of breast conserving therapy. The task of accurately excising the gross tumour during breast conserving surgery (BCS) is challenging, due to the limited guidance currently available to surgeons. Radioimmuno guided surgery (RIGS) has been investigated to determine its potential to delineate the gross tumour intraoperatively. The effects of varying a set of user controllable parameters on the ability of RIGS to detect and delineate model breast tumours was determined. The parameters studied were: Radioisotope, blood activity concentration, collimator height and energy threshold. The most sensitive combination of parameters was determined to be an 111Indium labelled radiopharmaceutical with a gamma-ray detecting probe collimated to a height of 5 mm and an energy threshold at the Compton backscatter peak. Using these parameters it was found that, for the breast tumour model used, the minimum tumour-to-background ratio required to delineate the tumour edge accurately was 5.2+/-0.4 at a blood activity concentration of 5 kBq/ml. Permanent breast seed implantation (PBSI) is a form of accelerated partial breast irradiation that dramatically reduces the treatment burden of adjuvant radiation therapy on patients. Unfortunately, it is currently difficult to localize the implanted brachytherapy seeds, making it difficult to perform a correction in the event that seeds have been misplaced

  10. Ceramic and polymeric devices for breast brachytherapy - Mammographic and CT response

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Luciana B.; Campos, Tarcisio P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares], e-mail: campos@nuclear.ufmg.br

    2009-07-01

    The present research investigates the radiological visibility of ceramic and polymeric devices implanted in breast phantom (in vitro) for future applications in brachytherapy treatments. The main research goal is to investigate the viability of monitoring ceramic and polymeric devices, in vitro based on simple methods of radiological diagnostic, maintaining the easiest access to the population, represented by the conventional X-ray and mammography. The methodology involves the processing of ceramic devices constituted by bioglasses of Sm, SmBa, Ho, HoBa and the production of polymeric devices, such as polymeric membranes incorporating Ho e HoBa. Contrast agent of Barium was introduced in the syntheses of those devices to improve the radiological visibility in breast equivalent-tissue (TE) phantom. The breast phantom is constituted of glandular, adipose and skin TE, reproducing a 5 cm compressed real breast. In the compressed breast phantom, all types of ceramic and polymeric devices were implanted side by side. Radiological images were generated through X-ray equipment, mammography and computerized tomography (TC), for the samples implanted in the compressed breast phantom. The results show that SmBa and HoBa seeds on breast phantom presented suitable radiological visibility, on all the radiological diagnostic methods. However, the X-rays radiological visibility of Sm seeds without contrast was discreet. On mammography and TC images, it was not possible to identify those seeds, because the same ones were degraded after two months immersed in the glandular TE, after placed on the phantom. The Ho seeds were identified on all radiological diagnostic images, although non contrast agent in its constitution was added. However, the holmium polymeric membranes in direct contact with TE did not show Xray radiological visibility. However, the polymeric membranes of HoBa in the same conditions presented efficient X-rays radiological response. For mammography and TC methods

  11. CONTRALATERAL PROPHYLACTIC MASTECTOMY AND SIMULTANEOUS BREAST RECONSTRUCTION WITH IMPLANTS AFTER ONE SIDED BREAST CANCER: ANALYSIS OF 12 CASES IN CONTEXT OF THE CURRENT TRENDS

    Directory of Open Access Journals (Sweden)

    Roman Romansky

    2016-08-01

    Full Text Available The contemporary tendency for increase of prophylactic surgical procedures as part of the sophisticated treatment of breast cancer is the foundation for the present study. Evaluation of risk factors for developing contralateral breast cancer, factors for an increase in prophylactic mastectomies and indications for performing those operations are briefly commented. Analysis of 12 cases of the authors surgical practice is presented regarding treatment approach from the oncological, reconstructive and aesthetic point of view. Results, complications, alternative methods, clinical importance and possible future aspects are discussed.

  12. 背阔肌皮瓣联合假体即刻乳房重建术的应用%Immediate breast reconstruction using the latissimus dorsi flap combined with implants for breast cancer

    Institute of Scientific and Technical Information of China (English)

    钱琦; 朱玉兰; 朱春富

    2013-01-01

    Objective To introduce the clinical experience of immediate breast reconstruction with the latissimus dorsi flap combined with implants following mastectomy in patients with breast cancer.Methods Twenty-six patients with early breast cancer in our department who underwent immediate breast reconstruction with the latissimus domi flap combined with implants following mastectomy were included in the study.The operative technical details,postoperative complications and patient satisfaction were analyzed retrospectively.Results Donor site seroma occurred in 6 patients(23.1%),which disappeared after repeated aspiration and pressure dressing.Capsular contracture occurred in 1 patient (3.85 %),which was improved by reoperation.There was no flap necrosis and no wound infection.Follow-up period ranged from 3 to 44 months (average 32.3 ± 7.02).Cosmetic outcome was judged excellent and good in 84.6 %.Conclusion In selected patients with breast cancer,the latissimus dorsi flap combined with implants is a reliable method with less complication and good operation effect for immediate breast reconstruction.%目的 总结背阔肌皮瓣联合假体即刻乳房重建术的临床经验.方法 回顾性分析26例早期乳腺癌患者接受改良根治同期背阔肌皮瓣转移联合假体乳房重建术的临床资料,总结手术技巧、术后主要并发症,评价术后满意度.结果 手术后背部伤口血清肿6例(占23.1%),均经穿刺抽液及加压包扎后治愈;假体包膜挛缩1例(占3.85%),再次行包膜松解术后好转;无皮瓣坏死,无伤口感染.随访3~44个月,平均(32.3±7.02)个月.全部病例无局部复发及远处转移,无上肢活动明显受限及上肢水肿或功能障碍.再造乳房按美学评分:优秀13例,良好11例,尚可2例,差0例.患者满意率84.6%.结论 对于选择性的早期乳腺癌患者,背阔肌皮瓣联合假体即刻乳房重建术是一种并发症少、手术效果良好的乳房重建方法.

  13. Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy

    Directory of Open Access Journals (Sweden)

    D. Martínez Ramos

    2007-06-01

    Full Text Available Los implantes subcutáneos son una complicación rara tras la punción aspiración con aguja fina de los carcinomas hepatocelulares. Los autores describen un caso de implante subcutáneo neoplásico en una mujer de 70 años con cirrosis hepática por virus C complicada con un carcinoma hepatocelular. Se efectuó una punción aspiración con aguja fina en el segmento II hepático. El implante tumoral se desarrolló en el trayecto de la punción aspiración. La tumoración subcutánea fue extirpada quirúrgicamente y el estudio anatomopatológico confirmó que se trataba de un carcinoma hepatocelular bien diferenciado.Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma.

  14. The evaluation of anti-angiogenic treatment effects for implanted rabbit VX2 breast tumors using functional multi-slice spiral computed tomography (f-MSCT)

    Energy Technology Data Exchange (ETDEWEB)

    Lei Zhen, E-mail: leizhen2004@163.com [Department of Anatomy, Chinese Medical University, No. 92, Beiermalu Road, Heping District, Shenyang, 110001 (China) and Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Ma Heji, E-mail: maheji9831@sina.com [Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Xu Na, E-mail: xuna821230@sohu.com [Department of Radiology, The First Hospital of Liaoning Medical College, No. 2, Wuduan, Renmin Street, Jinzhou, 121001 (China); Xi Huanjiu, E-mail: xihuanjiu2004@yahoo.cn [Anthropology Institute, Liaoning Medical College, No. 40, Sanduan, Songpo Rd, Jinzhou, 121001 (China)

    2011-05-15

    Objective: Investigate the benefit of functional multi-slice spiral computed tomography (f-MSCT) perfusion imaging in the non-invasive assessment of targeted anti-angiogenesis therapy on an implanted rabbit VX2 breast tumor model. Method: 69 female pure New Zealand white rabbits were randomly assigned to one of the 4 groups and received treatment accordingly: control (saline), Endostar, neoadjuvant chemotherapy (Cyclophosphamide, Epirubicin and 5-Fluorouracil, CEF), combination therapy (Endostar and CEF). After 2 weeks of treatment, f-MSCT perfusion scannings were performed for all rabbits and information about blood flow (BF), blood volume (BV), mean transit time (MTT) and surface permeability (SP) was collected. After perfusion imaging, tumor tissues were sampled for immunohistochemistry and the Western blot test of VEGF protein expression. Results: (1) The VEGF expression level, measured by immunohistochemistry and Western blot, decreased by treatment group (control > Endostar > CEF > combination therapy). The same was true for the mean BF, BV, MTT and PS, which decreased from the control group to the combination therapy group gradually. The mean MTT level increased in reverse order from the control to the combination therapy group. The difference between any 2 groups on these measures was statistically significant (P < 0.05). (2) There was moderate positive correlation between VEGF expression and BE, BV, or PS level (P < 0.05) and a negative correlation between VEGF expression and MTT level for all 4 groups (P < 0.05). Conclusion: Therefore, f-MSCT can be used as a non-invasive approach to evaluate the effect of anti-angiogenic therapy for implanted rabbit VX2 breast tumors.

  15. 应用125I粒子植入术治疗眼部肿瘤的临床观察%Clinical observation of 125I seed implantation for the treatment of ocular tumor

    Institute of Scientific and Technical Information of China (English)

    刘白雪; 张珂; 朱豫

    2016-01-01

    目的 观察125I粒子植入治疗眼部肿瘤的可行性、安全性及效果.方法 眼部肿瘤行直视下125I粒子植入术19例,并对其中3例可疑肿瘤扩散者行MRI或CT导航定位下125I粒子补种.19例粒子植入术均按术前计划完成.其中14例1次植入,3例行2次植入,1例行3次植入,1例4次植入.结果 术后观察2周~8年,平均(26.55±5.46)个月.19例中局部病变控制无复发者14例(73.68%);发现新病灶或病变扩散而经补种粒子病变控制者5例(26.32%).未出现病变转移者.19例中除3例(15.79%)眼睑轻度肿胀和少许皮下出血外,其余均未发生与植入手术操作相关的并发症.其他并发症有以下几种:125I粒子放置于眶前中部者1~3个月出现流泪、痒感、分泌物增多、结膜充血及上皮化,6个月后均自动消失;睫毛于1~3个月内可见脱落,4~6个月缓慢生长,6个月后恢复正常;1例粒子植入位置表浅,出现皮肤破溃及瘘管形成,抗炎对症治疗1周后恢复正常.植入泪腺区者:植入后发生干眼1例,6个月后恢复.植入眶中后部者:9个月术后出现组织纤维化、硬化,皮肤色素沉着.并发症均为可恢复性,眼前部并发症一般于术后6个月(3个半衰期)消失.结论 125I粒子植入治疗眼部肿瘤创伤小,疗效确切,并发症少,能最大限度保留视功能及外观,其可行性、安全性及疗效是肯定的.%Objective To observe the feasibiliy,safety and efficacy of 125 I seed implantation for the treatment of ocular tumor.Methods Nineteen patients received 125I seed implantation through intraoperative direct vision.In which 3 patients who had tumor spread received secondary 125I seed implantation through CT or MRI guiding.Nineteen patients received the operation successfully according to the preoperative plan.Fourteen cases were implanted 125I seed once,three cases received twice implantation,one case received implantation for three times,and one case received

  16. Gossypiboma after Breast Augmentation

    OpenAIRE

    Kira Lundin; Allen, Julie E.; Lene Birk-Soerensen

    2013-01-01

    A 39-year-old woman was referred for removal of cosmetic breast implants and related siliconoma. After an exchange of breast implants at a private clinic a year previously, she had asymmetry of the right breast, persistent pain, and a generally unacceptable cosmetic result. An MRI had shown a well-defined area with spots of silicone-like material at the upper pole of the right breast. Surgical removal of presumed silicone-imbibed breast tissue was undertaken, and surprisingly a gossypiboma wa...

  17. 缓释氟尿嘧啶乳腺癌术中植入的临床应用%Intraoperative implant of sustained release fluorouracil for breast carcinoma

    Institute of Scientific and Technical Information of China (English)

    余树青

    2013-01-01

    Objective To investigate the clinical curative effect of intraoperative implant of sustained release fluorouracil for breast carcinoma.Methods The clinical data of 60 cases of breast carcinomas were aralyzed,the patients were divided into observation group and control group according to different treatment methods.Results The WBC,PLT,Cr,ALT,nausea and vomiting,incision infection and axillary effusion had no difference between the two groups (P > 0.05).The local recurrence rate,distant metastasis rate and survival rate in observation group were better than those in control group,the differences were significant (P < 0.05).Conclusions The clinical curative effect of intraoperative implant of sustained release fluorouracil for breast carcinoma is good and has good prognosis,which is worthy to be popularized.%目的 探讨乳腺癌术中植入缓释氟尿嘧啶的临床疗效.方法 分析连平县人民医院收治的60例乳腺癌患者的临床资料,根据治疗方式不同分为观察组30例和对照组30例.结果 两组乳腺癌患者红细胞、白细胞、血肌酐、丙氨酸氨基转移酶、恶心呕吐、切口感染、腋窝积液情况比较差异无统计学意义(P>0.05);观察组局部复发率、远处转移率及生存率优于对照组,差异有统计学意义(P<0.05).结论 乳腺癌术中植入缓释氟尿嘧啶临床疗效显著,预后良好,值得临床推广应用.

  18. Avaliação da biocompatibilidade de implantes mamários de silicone esterilizados por calor seco e pelo óxido de etileno Biocompatibility assessment of silicone gel breast implants sterilized by dry-heat and by ethylene oxide

    Directory of Open Access Journals (Sweden)

    Janice Campos de Azevedo

    2006-06-01

    Full Text Available Os implantes mamários de silicone têm sido empregados, tanto nas cirurgias de aumento de mama, quanto na reconstrução do tecido mamário. A segurança biológica deste tipo de implante deve ser garantida, pois, em função da esterilização estes materiais, podem sofrer alterações oriundas dos processos esterilizantes por comprometimento da estrutura química dos polímeros. O objetivo deste trabalho consistiu na avaliação da biocompatibilidade de implantes mamários preenchidos com gel de silicone, de superfície lisa e texturizada submetidos à esterilização por calor seco e óxido de etileno. Empregou-se, para tanto, método in vitro, avaliando a citotoxicidade pelo método de captura do vermelho neutro, utilizando a linhagem celular NCTC clone 929. Os resultados obtidos demonstraram não haver comprometimento da biocompatibilidade dos biomateriais submetidos aos dois processos (calor seco e óxido de etileno, assim como comprovaram a eficácia de ambos na esterilização dos implantes.Silicone breast implants have been widely used for mammary augmentation and reconstruction surgery. Biological safety of these implants can be altered by sterilization methods. This study consisted of the biocompatibility assessment of smooth and textured silicone gel breast implants sterilized by dry-heat and ethylene oxide through cell viability, employing neutral red uptake method. The NCTC clone 929 cell were employed and the results showed no cytotoxicity of implants after both sterilization processes.

  19. Phenotype Observation and Variation Analysis of F_2 Generation of Ion Implanted Chili Pepper Seeds%离子注入线辣椒F_2代表型观察及变异分析

    Institute of Scientific and Technical Information of China (English)

    汪宁; 许峥; 张丰收; 张涛; 苏颖; 连慕兰; 周云龙

    2011-01-01

    [Objective]The aim was to investigate inheritance of the mutagenic properties caused by ion implantation from F1 to F2 generation in chili pepper.[Method]Chili pepper seeds were implanted with different ion combinations at different doses,and the F1 generation seeds of five groups in which biological mutation occurred were selected to sow in the field.Then the main phenotype changes in F2 generation were observed,the biochemical changes caused by ion implantation were analyzed by determination of peroxidase isozyme.[Result]Seed implanted with 9×1011 P2+/cm2 and 1×1012 Cu2+/cm2(No.21)on its both sides could maintain the superiority in yield per plant to F2 generation,while the mutagenic effects of F1 generation in other groups were not inherited by the F2 generation.[Conclusion]The prominent biological characters induced in the seeds of group No.21 were relatively inherited,so the seeds were worth further breeding.%[目的]观察离子注入线辣椒种子在F1代诱变产生的生物学效应在F2代的遗传特征。[方法]选取经离子注入后发生生物学诱变的5组F1代线辣椒种子继续在田间播种实验,观察F2代主要表型变化,并通过过氧化物同工酶的测定对离子注入引起生物化学变化进行分析。[结果]种子双面分别注入9×1011P2+/cm2和1×1012Cu2+/cm2组(No.21)单株产量在F2代继续保持明显优势,而其他4组F1代的一些生物学优良性状未能在F2代中继续遗传显现。[结论]F1代No.21处理组种子诱变的优良生物学性状在F2代继续得到了遗传,具有进一步选育的价值。

  20. Potential Anti-Inflammatory Effects of the Hydrophilic Fraction of Pomegranate (Punica granatum L. Seed Oil on Breast Cancer Cell Lines

    Directory of Open Access Journals (Sweden)

    Susan Costantini

    2014-06-01

    Full Text Available In this work, we characterized conjugated linolenic acids (e.g., punicic acid as the major components of the hydrophilic fraction (80% aqueous methanol extract from pomegranate (Punica granatum L. seed oil (PSO and evaluated their anti-inflammatory potential on some human colon (HT29 and HCT116, liver (HepG2 and Huh7, breast (MCF-7 and MDA-MB-231 and prostate (DU145 cancer lines. Our results demonstrated that punicic acid and its congeners induce a significant decrease of cell viability for two breast cell lines with a related increase of the cell cycle G0/G1 phase respect to untreated cells. Moreover, the evaluation of a great panel of cytokines expressed by MCF-7 and MDA-MB-231 cells showed that the levels of VEGF and nine pro-inflammatory cytokines (IL-2, IL-6, IL-12, IL-17, IP-10, MIP-1α, MIP-1β, MCP-1 and TNF-α decreased in a dose dependent way with increasing amounts of the hydrophilic extracts of PSO, supporting the evidence of an anti-inflammatory effect. Taken together, the data herein suggest a potential synergistic cytotoxic, anti-inflammatory and anti-oxidant role of the polar compounds from PSO.

  1. 经乳晕切口应用解剖型假体行筋膜后隆乳治疗轻度乳房下垂%Correction of minor breast ptosis by subfascia breast augmentation with periareolar incision and anatomic mammary implant

    Institute of Scientific and Technical Information of China (English)

    才杰; 陈波; 周洋; 马海欢

    2014-01-01

    Objective To correct the minor breast ptosis with minimal breast scar.Methods 32 cases with minor breast ptosis were corrected by subfascia breast augmentation with periareolar incision and anatomic mammary implant.Result Breast ptosis was completely or mostly corrected in all the patitents with periareola scar,avoiding the vertical breast scar.Except for short-time effusion in 2 cases,no other complication happened.Conclusions Subfascia breast augmentation with periareolar incision and anatomic mammary implant can effectively correct minor breast ptosis with minimal breast scar and less complication.%目的 探讨可以使术后乳房表面瘢痕最小化的矫正轻度乳房下垂的手术方法.方法 对32例轻度乳房下垂患者经乳晕切口行筋膜后隆乳术,全部使用解剖型乳房假体.结果 32例患者术后乳房下垂均得到完全或大部分矫正,仅留有与普通隆乳术相同的乳晕切口瘢痕,无乳房表面垂直切口瘢痕.除2例出现术后短期积液外,无其他并发症发生.结论 经乳晕切口应用解剖型假体行筋膜后隆乳术,可有效纠正轻度乳房下垂,并使乳房表面瘢痕最小化,且术后并发症较少.

  2. Capsular contracture in augmentation mammaplasty with smooth versus textured breast implants: a Meta analysis%毛面乳房假体和光面乳房假体隆乳术后包膜挛缩率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    李诗言; 林樾; 王卉丽; 谭谦

    2014-01-01

    Objective To analyze the incidence of capsular contracture in breast augmentation with smooth versus textured breast implants using a Meta method.Methods Terms such as "breast augmentation"," capsular contracture"," smooth implant"," textured implant"," breast implant" were searched in databases such as MEDLINE,EMBASE,Cochrane Library,CBM and VIP.Documents about breast augmentation with textured and smooth implants were totally collected,and the data of these trials were extracted to obtain a pooled odds ratio of capsular contracture and other complications.Meta analyses were performed by RevMan 5.2 software to estimate the combined effect values.Results Eleven clinical controlled trials were included.The results of meta analysis showed that textured implants group and smooth implant group presented the risk of capsular contracture combined OR=0.32 (95% CI,0.18 to 0.58,P=0.0002),and also presented the risk of other complications combined OR=1.31 (95% CI,0.96 to 1.77,P=0.09).Conclusions Compared with smooth implants,textured implants reduce the risk of capsular contracture after breast augmentation.%目的 利用Meta分析方法定量比较光面乳房假体和毛面乳房假体隆乳术后的包膜挛缩发生率.方法 以breast augmentation、capsular contracture、smooth implant、textured implant、隆乳、乳房假体等检索词在MEDLINE数据库、EMBASE数据库、Cochrane图书馆、中国生物医学文献数据库、维普生物数据库等检索,最大限度地收集毛面乳房假体和光面乳房假体隆乳的文献,提取其包膜挛缩和其他并发症的数据进行整合,以获得比值比(odds ratio,OR)合并值.各合并数据使用RevMan 5.2软件进行分析.结果 对11项研究毛面乳房假体和光面乳房假体的临床对照试验进行Meta分析后得出,包膜挛缩发生率的合并OR值为0.32,95%可信区间(CI)为0.18~0.58,P=0.0002.除包膜挛缩外,其他并发症发生率的合并OR值为1.31,95% CI为0.96~1

  3. A Comparative Study of CG CryoDerm and AlloDerm in Direct-to-Implant Immediate Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Jun Ho Lee

    2013-07-01

    Full Text Available Background  To date, various types of acellular dermal matrix (ADM have been developedfor clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breastreconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM thatrequires no drying process. Therefore,theoretically, it has a higher degree of preservation ofthedermalstructuresthan AlloDerm. We conducted thisstudy to compare the clinical course andpostoperative outcomes of patientswho underwent direct-to-implant breastreconstructionsusing AlloDermand thosewho did using CGCryoDerm.Methods  We performed a retrospective analysis ofthemedicalrecordsin a consecutive seriesof 50 patientswho underwent direct-to-implant breastreconstruction usingAlloDerm(n= 31or CryoDerm (n= 19. We then compared the clinical course and postoperative outcomes ofthe two groups based on the overall incidence of complications

  4. Hormetic/cytotoxic effects of Nigella sativa seed alcoholic and aqueous extracts on MCF-7 breast cancer cells alone or in combination with doxorubicin.

    Science.gov (United States)

    Mahmoud, Sherif S; Torchilin, Vladmir P

    2013-07-01

    In this study, we investigate the possible cytotoxic effects of different Nigella sativa seed extracts on human MCF-7 breast cancer cells and screening the effects of a wide range of extracts concentrations and their application as an adjuvant therapy to doxorubicin. The results obtained showed that the cytotoxic solvent dimethyl sulfoxide can be used for permeation assay in concentration range 697.5-0.341 mmol/ml without affecting the viability of MCF-7 cells. N. sativa lipid extract is cytotoxic to MCF-7 cells with LC50 of 2.72 ± 0.232 mg/ml, while its aqueous extract cytotoxicity exhibited when the applied concentration is high as ≈ 50 mg/ml. The results of this study reveal for the first time that low concentrations of aqueous extract of the seed has a hormetic rather than cytotoxic effect. It is also possible to use cell culture medium or bovine serum to dilute the oil extract for the permeation assay. In conclusion, N. sativa aqueous extract should not be used as antitumor compound by its own. The oil is a promising antitumor compound and its cytotoxicity was greatly enhanced with its nanoemulsion formulation. Antitumor activity of doxorubicin was enhanced, as a function of time, when N. sativa extracts were involved as adjunct therapeutic compounds. Adding doxorubicin to the prepared lipid nanoemulsion has a beneficial impact to their bioactivity. These doxorubicin-N. sativa lipid nanoemulsion are promising and potential therapeutic modality. PMID:23242945

  5. Effects of phytoestrogen extracts isolated from pumpkin seeds on estradiol production and ER/PR expression in breast cancer and trophoblast tumor cells.

    Science.gov (United States)

    Richter, Dagmar; Abarzua, Sibylle; Chrobak, Mareike; Vrekoussis, Thomas; Weissenbacher, Tobias; Kuhn, Christina; Schulze, Sandra; Kupka, Markus S; Friese, Klaus; Briese, Volker; Piechulla, Birgit; Makrigiannakis, Antonis; Jeschke, Udo; Dian, Darius

    2013-01-01

    Phytoestrogens have a controversial effect on hormone-dependent tumours. Herein, we investigated the effect of the pumpkin seed extract (PSE) on estradiol production and estrogen receptor (ER)-α/ER-β/progesterone receptor (PR) status on MCF7, Jeg3, and BeWo cells. The PSE was prepared and analyzed by mass spectrometry. MCF7, Jeg3, and BeWo cells were incubated with various concentrations of PSE. Untreated cells served as controls. Supernatants were tested for estradiol production with an ELISA method. Furthermore, the effect of the PSE on ER-α/ER-β/PR expression was assessed by immunocytochemistry. The PSE was found to contain both lignans and flavones. Estradiol production was elevated in MCF7, BeWo, and Jeg3 cells in a concentration-dependent manner. In MCF7 cells, a significant ER-α downregulation and a significant PR upregulation were observed. The above results after properly designed animal studies could highlight a potential role of pumpkin seed's lignans in breast cancer prevention and/or treatment. PMID:23859042

  6. Preliminary simulation of implants breast through the accelerated partial irradiation technique: coverage rates and homogeneity; Simulacion previa de implates de mama mediante la tecnica de irradiacion parcial acelerada: indices de cubrimiento y homegeneidad

    Energy Technology Data Exchange (ETDEWEB)

    Moral Sanchez, S. C.; Paula Carranza, B. de; Erzibengoa, M.; Bragado Alvarez, L.; Guisasola Berasetegui, A.

    2013-07-01

    In this work we present and evaluate the process of pre-simulation we have drawn up when it comes to treatments of accelerated partial irradiation of breast. Previous simulation that we will allow you to have greater control over the location of catheters with respect to the area to radiate. The goodness of this procedure is evaluated through representative quality indexes of the implant. (Author)

  7. Comparison of effects between MRI imaging and Archimedes method for measurement of breast volume on immediate implant breast reconstruction%磁共振成像与阿基米德法测量乳房体积在即刻假体乳房再造中的效果比较

    Institute of Scientific and Technical Information of China (English)

    牛兆河; 徐凤磊; 王海波

    2015-01-01

    Objective To conduct the comparative study of the measurement of breast volume by MRI imaging and Archimedes method in immediate implant breast reconstruction.Methods A total of 44 patients who were diagnosed as breast cancer and undergone immediate implant breast reconstruction were selected from March 2011 to March 2013.22 cases were guided to select suitable breast implants by measuring the breast volume and correlative radial line based on MRI imaging.Control group containing 22 cases were guided to select breast implants by traditional Archimedes method and clinical experience.3 breast surgeons and plastic surgeons who did not participate in the operation were selected to judge the postoperative breast shape.Data of two groups were analyzed by using chisquare test.Results All the patients recovered smoothly after operation without infection,and the wound healed well.The breast shape was evaluated.21 cases (95.5 %) were good in test group and 1 case (4.5%) was poor;16 cases (72.7%) were good in control group and 6 cases (27.3) were poor.The comparison between the test group and control group had statistical significance (P<0.05).Conclusions The method to measure the breast volume and correlative radial line based on MRI imaging has important values for selecting breast implants in immediate implant breast reconstruction.It could be extensively used in clinical practice.%目的 探讨磁共振成像(MRI)与阿基米德法测量乳房体积在即刻假体乳房再造中的临床效果.方法 选择青岛大学附属医院乳腺中心2011年3月至2013年3月行即刻假体乳房再造的乳腺癌患者44例.其中试验组22例,采用基于MRI的乳房体积及相关径线测量方法,指导选择合适的乳房假体;对照组22例,采用传统的阿基米德法及临床经验来选择乳房假体.选择3名未参与手术的乳腺外科及整形外科医师对两组患者术后乳房形态进行评价.结果 44例患者术后恢复均顺利,无1例并

  8. Effects of soy isoflavone extracts on the growth of estrogen-dependent human breast cancer (MCF-7) tumors implanted in ovariectomized nude mice

    Institute of Scientific and Technical Information of China (English)

    WU Qian; JIN NianZu; YU Jing; ZHAO RenChen; YU ZePing; QIAO ShanLei; LU XiaoHe; ZHANG ChunWen

    2009-01-01

    In this study,we explored the effects of soy isoflavone extracts on the growth of estrogen-dependent human breast cancer (MCF-7) tumors implanted in ovariectomized athymic mice.The ovariectomized athymic mice were implanted with MCF-7 cells.They were fed with low,moderate and high doses of soy isoflavone extracts,at dietary concentrations of 6.25,12.5 and 25 g/kg,respectively.The expression of ki-67 was detected by immunohistochemistry.The pS2 expression in tumors was analyzed by real-time PCR.Estrogen level in the serum was measured by chemiluminescence enzyme immunoassay.Com-pared with the control group,dietary soy isoflavone extracts had a significant stimulatory effect on MCF-7 tumor growth in mice (P 0.05).The ki-67 and pS2 mRNA expressions in tumors were signifi-cantly increased by 6.25 and 12.5 g/kg dose of soy isoflavone extracts (P 0.05).And,estrogen level in serum of 6.25 and 12.5 g/kg dose groups was higher than that of control group (P 0.05).In conclusion,in the tested dietary concentration range soy isoflavone extracts had a stimulatory effect on tumor growth.6.25 and 12.5 g/kg doses of soy isoflavone extracts can increase the cell proliferation in tumors and induce estrogen-responsive pS2 expression.

  9. Multi-catheter interstitial brachytherapy for partial breast irradiation: an audit of implant quality based on dosimetric evaluation comparing intra-operative versus post-operative placement

    Science.gov (United States)

    Gurram, Lavanya; Joshi, Kishor; Phurailatpam, Reena; Paul, Siji; Sarin, Rajiv

    2016-01-01

    Purpose The use of multicatheter interstitial brachytherapy (MIB) for accelerated partial breast irradiation (APBI) in early breast cancer (EBC) patients outside the trial setting has increased. Hence, there is a need to critically evaluate implant quality. Moreover, there is a scarcity of reports using an open cavity technique. We report the dosimetric indices of open and closed cavity MIB techniques. Material and methods The dosimetric parameters of 60 EBC patients treated with MIB (open and closed cavity) who underwent three dimensional, computerized tomography (CT) based planning for APBI from November 2011 to July 2015 were evaluated. Coverage Index (CI), Dose Homogeneity Index (DHI), Conformity Index (COIN), Plan Quality Index (PQI), and Dose Non-uniformity Index (DNR) were assessed. Results Forty-one patients underwent open cavity and 19 patients underwent closed cavity placement of brachytherapy catheters. The median number of planes was 4 and median number of needles was 20. Median dose was 34 Gy with dose per fraction of 3.4 Gy, given twice a day, 6 hours apart. The D90 of the cavity and clinical target volume (CTV) were 105% and 89%, respectively. The median doses to the surgical clips were greater than 100%. The median CI of the cavity and CTV was 0.96 and 0.82, respectively. The DHI and COIN index of the CTV was 0.73 and 0.67. There were no significant differences in the dosimetric parameters based on whether the technique was done open or closed. Conclusions Critical evaluation of the dosimetric parameters of MIB-APBI is important for optimal results. While the open and closed techniques have similar dosimetry, our institutional preference is for an open technique which eases the procedure due to direct visualization of the tumor cavity. PMID:27257415

  10. A Ring-D-Seco-Tetranortriterpenoid from Seeds of Carapa procera Active against Breast Cancer Cell Lines.

    Science.gov (United States)

    Dioum, Mbaye Diaw; Seck, Matar; Silvestre, Virginie; Planchat, Aurélien; Loquet, Denis; Lohard, Steven; Barille-Nion, Sophie; Remaud, Gerald S; Robins, Richard J; Tea, Illa

    2016-07-01

    The seeds of Carapa procera are exploited extensively in West African ethnopharmacy for the treatment of several pathologies, including inflammation. They also are effective as insect antifeedants and as a mosquito repellent. With the aim of identifying bioactive principles, an ethyl acetate extract of the defatted seeds was made and fractionated. Two principle compounds were isolated. One of these, 5,6-dehydro-7-deacetoxy-7-oxogedunin (1), while known from another genus of the Meliaceae, is newly identified from the genus Carapa and its X-ray structure is described for the first time. In addition, 1 displayed strong anti-clonogenic activity at 10 µM. The other compound, mexicanolide (2), is known from this species and showed neither cytotoxicity nor anti-clonogenicity. These differences in efficacy are discussed in relation to known structure-activity relationships of limonoids. PMID:27224268

  11. Evaluation of an implantable MOSFET dosimeter designed for use with hypofractionated external beam treatments and its applications for breast and prostate treatments

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, Gloria P.; Kry, Stephen F.; Espenhahn, Eric; Rini, Chris; Boyles, Elyse; Mann, Greg [Medical Physics Services, LLC., Tampa, Florida 33606 and Sicel Technologies, Inc., Morrisville, North Carolina 27560 (United States); Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Sicel Technologies, Inc., Morrisville, North Carolina 27560 (United States)

    2011-08-15

    Purpose: An implantable metal-oxide semiconductor field effect transistors-based dosimeter has recently been developed for the in vivo monitoring of hypofractionated radiotherapy. This DVS-HFT dosimeter is designed for fraction sizes of 340-950 cGy and can also be used for bis in die fraction monitoring. The current work reports on the testing and evaluation of this dosimeter, including both its basic characteristics as well as its performance during simulated clinical treatment plans. Methods: The authors tested the dose rate dependence of this dosimeter (300 MU/min versus 600 MU/min), the treatment time dependence (4 min per treatment versus up to 60 min per treatment), and the dose and energy dependence (6 and 18 MV irradiations of 700-900 cGy per fraction). Additionally, they irradiated the detectors in-phantom with breast and prostate hypofractionated treatments. Results: The detectors showed no significant dose rate, treatment time, energy, or dose dependence. Furthermore, the detectors were found to perform within manufacturer tolerances for all hypofractionated treatments examined, accurately reporting the measured dose (average disagreement of - 0.65%). Conclusions: These dosimeters appear well suited for in vivo monitoring of hypofractionated radiotherapy doses, and thereby, have the potential to improve patient care.

  12. Combined treatment with areola approach for capsular contracture after breast augmentation with implants%经乳晕切口综合处理假体隆乳术后包膜挛缩

    Institute of Scientific and Technical Information of China (English)

    罗盛康; 陈光平; 汪海滨; 孙中生; 徐翔; 伍艳群

    2012-01-01

    目的 探讨经乳晕切口采用多种方法综合处理假体隆乳术后包膜挛缩的效果.方法 2005年2月至2011年6月,对94例168侧假体隆乳术后包膜挛缩进行治疗并置入假体,其挛缩程度均为Baker分类法Ⅲ、Ⅳ级.94例均采用乳晕切口,根据原假体置入腔隙及乳腺、胸大肌厚度等条件,采取重新剥离腔隙、去除或不去除包膜组织,甚至二期手术,于胸大肌或乳腺后间隙置入假体等方法综合处理,术中严格止血.结果 术后94例中46例获得门诊随访,其余病例均获得电话随访,时间6 ~37个月,平均9.9个月,术后包膜挛缩复发Ⅲ级者2例、Ⅳ级者1例,其余病例乳房外观均丰满、挺拔,柔软度较好,电话随访病例均对乳房塑形效果满意.本组病例均无血肿、感染、乳房假体破裂、乳房下垂及上移等并发症发生.结论 应用乳晕切口对假体隆乳术后包膜挛缩进行综合而有效地处理,术后包膜挛缩复发率较低,可以获得较满意的乳房塑形效果.%Objective To investigate the combined treatment with areola approach for capsular contracture after breast augmentation with implants.Methods From Feb.2005 to Jun.2011,94 cases ( 168 sides) with Baker Ⅲ and Ⅳ capsular contracture after breast augmentation with implants were treated with areola approach.The implants cavity was recreated,with or without removal of capsule.The implants were reimplanted behind pectoralis major or breast at the second stage in some patients.Results 46 cases were followed up by clinic visit and the others were followed up by telephone for 6-37 months,with an average of 9.9 months.The capsular contracture was relapsed in 2 cases as Baker Ⅲ and 1 case as Baker Ⅳ.All the other breasts got a good appearance with good soft texture and feeling.No hematoma,infection,implants rupture,breast ptosis or implant displacement happened.Conclusions Combined treatment with areola approach has a good therapeutic effect for

  13. 背阔肌肌皮瓣联合假体在乳腺癌术后二期乳房再造中的应用%Application of Latissimus Dorsi Myocutaneous Flap with Breast Implant in Delayed Breast Reconstruction after Mastectomy

    Institute of Scientific and Technical Information of China (English)

    郑厚兵; 单秀英; 陈祥锦; 张惠灏; 朱有志; 王美水; 王彪

    2015-01-01

    目的:探讨背阔肌肌皮瓣联合假体植入在乳腺癌术后二期乳房再造术中的临床应用。方法2009年至2013年,共8例乳腺癌术后年轻患者接受二期乳房再造手术。术前以排水法测定健侧乳房体积,根据患者健侧乳房形状、大小及背部组织情况,设计胸背部供区皮瓣,术中测量移植皮瓣的容积,然后根据健侧乳房和移植皮瓣的容积差,选择大小合适的乳房假体,将假体埋植于背阔肌-胸大肌后间隙,利用背阔肌肌皮瓣移植联合乳房硅胶假体进行二期乳房再造。结果本组患者术后随访6个月至4年,再造乳房外形较佳,效果满意,供区无明显并发症。结论对于年轻有生育要求的乳腺癌术后乳房缺失患者,健侧乳房较大,利用背阔肌肌皮瓣联合假体进行乳房再造,可取得良好的手术效果。%Objective To explore the application of latissimus dorsi myocutneous flap and breast implant in delayed breast reconstruction surgery after mastectomy. Methods From 2009 to 2013, 8 cases received delayed breast reconstruction operation after mastectomy. The breast volumetry measurement technique was used to determine the mass of the breast preoperatively, then the donor flap was designed at the chest-back region according to the condition of the dorsal skin and the shape of the contralateral breast. The mass of graft flap was measured intraoperatively, then the suitable implant was selected based on the difference between the volume of the contralateral breast and the graft flap. The breast implant was then placed in the interspace between the latissimus dorsi muscle and the pectoralis major muscle to reconstruct the breast (secondary phase). Results All patients were followed up for 6 months to 4 years. The overall appearance of the constructed breast were satisfactory, no significant complications were observed in the donor region. Conclusion For young patients of breast cancer with

  14. WE-A-17A-09: Exploiting Electromagnetic Technologies for Real-Time Seed Drop Position Validation in Permanent Implant Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Racine, E [Departement de Radio-Oncologie et Centre de Recherche du CHU de Quebec, Quebec, QC (Canada); Hautvast, G [Biomedical Systems, Philips Group Innovation, Eindhoven, North Brabant (Netherlands); Binnekamp, D [Integrated Clinical Solutions and Marketing, Philips Healthcare, Best, DA (Netherlands); Beaulieu, L [Centre Hospitalier University de Quebec, Quebec, QC (Canada)

    2014-06-15

    Purpose: To report on preliminary results validating the performance of a specially designed LDR brachytherapy needle prototype possessing both electromagnetic (EM) tracking and seed drop detection abilities. Methods: An EM hollow needle prototype has been designed and constructed in collaboration with research partner Philips Healthcare. The needle possesses conventional 3D tracking capabilities, along with a novel seed drop detection mechanism exploiting local changes of electromagnetic properties generated by the passage of seeds in the needle's embedded sensor coils. These two capabilities are exploited by proprietary engineering and signal processing techniques to generate seed drop position estimates in real-time treatment delivery. The electromagnetic tracking system (EMTS) used for the experiment is the NDI Aurora Planar Field Generator. The experiment consisted of dropping a total of 35 seeds in a prismatic agarose phantom, and comparing the 3D seed drop positions of the EMTS to those obtained by an image analysis of subsequent micro-CT scans. Drop position error computations and statistical analysis were performed after a 3D registration of the two seed distributions. Results: Of the 35 seeds dropped in the phantom, 32 were properly detected by the needle prototype. Absolute drop position errors among the detected seeds ranged from 0.5 to 4.8 mm with mean and standard deviation values of 1.6 and 0.9 mm, respectively. Error measurements also include undesirable and uncontrollable effects such as seed motion upon deposition. The true accuracy performance of the needle prototype is therefore underestimated. Conclusion: This preliminary study demonstrates the potential benefits of EM technologies in detecting the passage of seeds in a hollow needle as a means of generating drop position estimates in real-time treatment delivery. Such tools could therefore represent a potentially interesting addition to existing brachytherapy protocols for rapid dosimetry

  15. Vivo dosimetry using TLD detectors in prostate seed implants of I-125: preliminary results; Dosimetria in vivo mediante detectores de TLD en implantes de prostata con semillas de I-125: resultados preliminares

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Reyes, A.; Pedro, A.; Bassas, P.; Duch, M. A.; Cros, M.; Mane, S.

    2011-07-01

    We present preliminary results of a new in vivo dosimetry technique that could allow to know immediately after implantation of the prostate if the dose distribution determined by the scheduler is similar to the actual dose measured with TLD detectors.

  16. A case of synchronous multiple bilateral breast cancer after breast augmentation

    OpenAIRE

    Yamamoto, Shinya; Chishima, Takashi; Harada, Fumi; Matsubara, Yuka

    2015-01-01

    Breast cancer after breast augmentation is not rare, but cases of bilateral breast cancer after augmentation are not often reported. A 43-year-old woman attended our hospital because of a mass in her left breast. She had undergone breast augmentation by implants 4 years before at a cosmetic surgery clinic. There were operative scars in her bilateral axilla. A detailed examination revealed bilateral breast cancer, and we performed nipple-sparing mastectomy in both breasts. Sentinel lymph node ...

  17. Prostate seed implantation using 3D-computer assisted intraoperative planning vs. a standard look-up nomogram: Improved target conformality with reduction in urethral and rectal wall dose

    International Nuclear Information System (INIS)

    Purpose: To compare dosimetric outcomes between two real-time prostate seed implantation (PSI) techniques to evaluate the impact of three-dimensional (3D) intraoperative computer planning on target coverage, conformality, and preset urethral and rectal dose constraints. Methods and materials: One hundred and fourteen patients with clinically localized prostate cancer underwent ultrasound-guided transperineal PSI of the prostate with 125I sources as monotherapy. From 1999 to 2001, 69 patients were implanted in real-time using a standard look-up nomogram (Group 1: NG-PSI). All patients were implanted with a modified peripheral loading technique in which 75-80% of the calculated total activity was delivered to the gland periphery, with the remaining 20-25% activity placed in the gland interior, to achieve a prescribed dose (PD) of 144 Gy to cover the gland with acceptable homogeneity. No preoperative or intraoperative planning was performed to set dose constraints to the urethra or anterior rectal wall. Dosimetric outcome from this group was compared with 45 patients subsequently implanted after 2001 using an intraoperative 3D computer planning system (Group 2: 3D-PSI). A similar modified peripheral loading technique was used as an option in the planning system. Preoperative dose constraints were placed on the urethra (V150 95% of PD; D90: 140-180 Gy), and rectal wall (V110 125I sources to adhere to urethral and rectal constraints and target coverage goals. Both groups underwent postimplant CT analysis to determine dosimetric outcome with regard toV100prostate, D90prostate, V150urethra, and V110rectum. Univariate and multivariate analysis was performed to determine variables impacting on dosimetric outcome. Results: Analysis of preimplant and postimplant variables demonstrated no difference in the median preimplant gland volume (33 cc vs. 35 cc; p = 0.31), median mCi/seed strengths (0.4 vs. 0.45 mCi; p = 0.23), median V100 (94% vs. 94%), or median D90 at postimplant

  18. Dosimetry of 125l and103 Pd radioactive seeds implantation in therapy of liver cancer%放射性粒子125I和103Pd植入治疗肝癌的计量学研究进展

    Institute of Scientific and Technical Information of China (English)

    王冬冬; 曹秀峰; 王学浩

    2011-01-01

    目的:总结国内外关于放射性粒子125I和103Pd植入治疗肝癌的计量学研究.方法:应用Medline及CNKI期刊全文数据库系统,以"肝癌,碘-125,钯-103"为关键词,检索2000-01-2010-06相关文献.纳入标准:1)125I和103Pd的物理学和生物学性质;2)125I和103Pd在治疗肝癌的相关计量学;3)疗效评价及适应证、禁忌证.根据纳入标准分析28篇文献.结果:粒子植入治疗肝癌简单易行,抑瘤效果明显,总体抑瘤有效率(完全缓解+部分缓解)可以达到>70%,并发症很少,止痛效果好,疼痛缓解率>70%,明显改善了患者的生存质量,取得了很好的临床疗效.粒子植入治疗肝癌关键是设置合理的周边匹配剂量,125I的周边匹配剂量(MPD)设置在80~100 Gy,103Pd的MPD为90~130 Gy是合理的.迄今为止,125I和103Pd粒子植入治疗肝癌没有统一的剂量标准,更没有形成系统性规范,需要进一步的研究和探讨.结论:制定出适用于125I和103Pd植入治疗肝癌精确、科学的剂量学标准是非常有必要的.%OBJECTIVE:To sum up domestic and abroad articles related to dosimetry of 125l and103Pd implantation in therapy of liver cancer. METHODS: “Liver cancer,125 I and 103Pd ”were searched as key words by medline and CNKI series fulltext database retrieval system from 2000-01 to 2010-06. Choice criteria: 1) the physical and biological characters of 125Ⅰ and 103 Pd. 2)dosimetry of 125 Ⅰand 103 Pd implantation in therapy of liver cancer. 3)Curative Efficacy evaluation, indication, contraindication. By extraction according to choice criteria,28 paper were analyzed. RESULTS: Radioactive seeds implantation are simple and easy to perform with lower postoperative morbidity, high tumor inhibition rate (overall effective rate > 70 %) and good analgesic effect (the remission rate of the pain > 70%).They improve the quality of life significantly, and achieve good clinical efficacy. It is crucial to set the suitable MPD for

  19. Accelerated partial-breast irradiation with interstitial implants. The clinical relevance of the calculation of skin doses

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2007-08-15

    Purpose: To describe relative skin dose estimations and their impact on cosmetic outcome in interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 105 consecutive patients with early breast cancer were recruited in Erlangen, Germany, for this substudy of the German-Austrian APBI phase II trial. 51% (54/105) received pulsed-dose-rate (PDR), and 49% (51/105) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy every hour. Total treatment time was 3-4 days. With a wire cross on the skin surface during the brachytherapy-planning procedure the minimal, mean and maximal relative skin doses (SD{sub min%}, SD{sub max%}, SD{sub mean%}) were recorded. Endpoint of this evaluation was the cosmetic outcome in relation to the relative skin doses. Results: Median follow-up time was 38 months (range, 19-65 months). Cosmetic results for all patients were excellent in 57% (60/105), good in 36% (38/105), and fair in 7% (7/105). The SD{sub min%} (27.0% vs. 31.7%; p = 0.032), SD{sub mean%} (34.2% vs. 38.1%; p = 0.008), and SD{sub max%} (38.2% vs. 46.4%; p = 0.003) were significantly lower for patients with excellent cosmetic outcome compared to patients with a suboptimal outcome. SD{sub mean%} (37.6% vs. 34.2%; p = 0.026) and SD{sub max%} (45.4% vs. 38.2%; p = 0.008) were significantly higher for patients with good cosmetic outcome compared with the patients with excellent results. Conclusion: The appraisal of skin doses has been shown to be relevant to the achievement of excellent cosmetic outcome. Further investigations are necessary, especially on the basis of CT-based brachytherapy planning, to further improve the treatment results of multicatheter APBI. (orig.)

  20. Breast reconstruction: State of the arts

    International Nuclear Information System (INIS)

    Radical mastectomy is still required in many cases, such as inflammatory breast cancer, multicentric breast cancer, large tumour volume and small breast size. In this setting, immediate breast reconstruction is more and more offered for breast cancer patients. But such plastic surgery is still debated, owing to risks of implant complications when postoperative radiotherapy of chest wall is mandatory in locoregional breast cancer management. Here, the review is focused on different type of immediate breast reconstruction and on risk of implants complications with or without postoperative radiotherapy. (authors)

  1. The effect of latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer%早期乳腺癌术后背阔肌肌瓣联合即刻假体植入乳房重建的疗效

    Institute of Scientific and Technical Information of China (English)

    王昌亮

    2015-01-01

    Objective:To explore the feasibility,therapeutic effect,safety and postoperative cosmetic effect of latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer.Methods:20 patients with early breast cancer from April 2013 to August 2013 were treated with breast cancer modified radical mastectomy and the latissimus dorsi muscle flap transfer combined with immediate silicone prosthesis implanted between pectoris major and minor for breast reconstruction.Results:20 patients received adjuvant chemotherapy and there was no local recurrence or distant metastasis during the follow-up period,and the patients were satisfied with the appearance and texture of the reconstructive breast.16 cases(80%) was optimal,3 cases(15%) was good,1 case(5%) was common in postoperative cosmetic effect evaluation. Conclusion:Latissimus dorsi muscle flap combined with immediate prosthesis implanted for breast reconstruction postoperative early breast cancer had short time,simple operation,good effect and patient satisfaction,which was safe and reliable operation and worthy of popularizing.%目的:探讨早期乳腺癌行改良根治术后,取背阔肌部分肌瓣转移联合硅胶假体一期植入即时乳房重建的可行性、治疗效果、安全性和术后美容效果。方法:2013年4月-2013年8月收治早期乳腺癌患者20例,均行乳腺癌改良根治术,带状背阔肌肌瓣转移联合硅胶假体植入胸大、小肌之间行乳房再造。结果:20例患者均接受辅助化疗,随访期间均未发现局部复发或远处转移,再造乳房外形、质地满意。术后美容效果评价优16例(80%),良3例(15%),一般1例(5%)。结论:早期乳腺癌术后背阔肌肌瓣联合即刻假体植入乳房重建时间短、操作简便、效果良好,患者满意,是安全可靠值得推广的手术方法。

  2. Preparation and in vitro characterization of poly (epsilon-caprolactone-based tamoxifen citrate-loaded cylindrical subdermal implant for breast cancer

    Directory of Open Access Journals (Sweden)

    Hiremath Jagadeesh

    2011-01-01

    Full Text Available In the present study cylindrical poly(epsilon-caprolactone (PCL-based biodegradable polymeric tamoxifen citrate-loaded subdermal implants were prepared by laboratory-based modified melt extrusion technique. The prepared implants were evaluated for their physicochemical parameters. Drug content in implants by high-performance liquid chromatographic (HPLC method, differential scanning calorimetry (DSC, X-ray diffraction (XRD and scanning electron microscope (SEM studies of tamoxifen citrate-loaded implants. Determination of in vitro hydrolytic degradation of polymeric and tamoxifen citrate-loaded implants and in vitro drug release was carried out by using indigenously developed dissolution apparatus. DSC and XRD studies proved that the drug is entrapped in the implant. The highest rate of hydrolytic degradation (weight loss was observed in blank implants when compared to tamoxifen citrate-loaded implants. The studies proved that the developed method have potential in terms of industrial feasibility.

  3. Improvement of registration accuracy in accelerated partial breast irradiation using the point-based rigid-body registration algorithm for patients with implanted fiducial markers

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Minoru; Yoshimura, Michio, E-mail: myossy@kuhp.kyoto-u.ac.jp; Sato, Sayaka; Nakamura, Mitsuhiro; Yamada, Masahiro; Hirata, Kimiko; Ogura, Masakazu; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto 606-8507 (Japan); Sasaki, Makoto; Fujimoto, Takahiro [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507 (Japan)

    2015-04-15

    Purpose: To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations. Methods: Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods. Results: In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration. Conclusions: For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

  4. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  5. Breast reconstruction after mastectomy

    Directory of Open Access Journals (Sweden)

    Daniel eSchmauss

    2016-01-01

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  6. 假体隆乳术后严重包膜挛缩处理结合假体置入%Breast Prosthesis Implantation Combining with Correction for Capsular Contracture after Augmentation Mammoplasty

    Institute of Scientific and Technical Information of China (English)

    陈光平; 罗盛康

    2015-01-01

    Objective To explore the correction for serious capsular contracture after augmentation mammoplasty and the indication of breast prosthesis implantation. Methods From June 2006 to March 2014, 45 cases with serious capsular contracture after breast augmentation (Bilateral, level Ⅳ of Baker classification method) were treated and received breast prosthesis implantation at the same period or at stage Ⅱ. Via breast areola approach, the capsular tissue was kept or removed based on the circumstances, retro-mammary space or posterior pectoralis major space was stripped for prosthesis placing. Results Among all the cases, 38 cases received breast prosthesis at stage I, other 7 cases proceeded the second period of breast prosthesis 6 months later. Postoperative incisions were healed by first intension. Thirty-nine cases were followed up for 6-58 months (mean 13.5 months) successfully and the follow-up rate was 87.9%. Level Ⅳ of capsular contracture was still observed in 7 cases 4 months after the surgery, then the breast prosthesis was removed with no implantation again. The breast shape of remaining cases was good with soft handfeel. Conclusion For serious breast capsular contracture after augmentation mammoplasty, effective processing of the envelope with prosthesis imbedding according to the situation could obtain a better postoperative breast appearance and feel.%目的:探讨假体隆乳术后严重包膜挛缩的处理方法及乳房假体置入的适应征。方法2006年6月至2014年3月,对45例假体隆乳术后严重包膜挛缩(双侧乳房均为Baker分类法Ⅳ级)进行治疗,并进行同期或二期乳房假体置入。手术均采用乳晕切口入路,并根据情况保留或去除包膜组织,在乳腺后间隙或胸大肌后间隙置入假体。结果38例患者均一期置入乳房假体,7例于术后6个月行二期乳房假体置入。术后切口均一期愈合,39例获门诊随访,随访率86.7%,随访时间6~58

  7. Clinical effects of breast implant on congenital mammary dysplasia with mild pigeon chest deformity%先天乳腺不发育伴轻度鸡胸行隆乳术治疗的临床效果评价

    Institute of Scientific and Technical Information of China (English)

    许柯; 刘飞; 郭正东; 林海波; 杨卫国; 洪浩; 梁智

    2010-01-01

    Objective To evaluate the clinical effect of breast implant on congenital mammary dysplasia with mild pigeon chest deformity. Methods From January 2003 to July 2009,10 cases of female mammary dysplasia (between 20 to 31 years of age) underwent breast implant surgery. Subpectoral placement and transaxillary incision were selected. The surgeon marked the range of the operation on the skin, made a 3-4 cm incision in the armpit, separated the tissue until the pectoral lateral margin, cut the pecto-ralis fascia and bluntly created a suitable pocket under the pectoralis major for the implant. After the implant was placed in the pocket, the incision was closed. Results Ten cases of breast implant surgery did not pose the complications of local skin necrosis, infection, implant shift, heart and lungs dysfunction after one year follow-up. The appearance of anterior chest wall deformity was markedly improved. Conclusions The application of breast implant surgery in the treatment of congenital mammary dysplasia with mild pigeon chest deformity should be promoted, because of the double surgical effect of easy performing, minimal surgical damage, perfect breast shape and concealed deformity.%目的 评价隆乳术治疗先天乳腺不发育、乳腺发育不良及胸大肌发育不良伴轻度鸡胸畸形临床效果.方法 对10例先天乳腺不发育、乳腺发育不良及胸大肌发育不良伴轻度鸡胸的女性行隆乳术.先在体表标出剥离范围及畸形部位,经双腋窝切口,直达皮下组织,向内分离至胸大肌外侧缘,于胸大肌后间隙,置入硅凝胶乳房假体.结果 10例于隆乳术后,随访1年,均未见发生局部感染、假体移位、心肺功能异常等并发症,前胸壁鸡胸畸形外观有明显改善.结论 应用隆乳术治疗先天性乳腺不发育、乳腺发育不良及胸大肌发育不良并伴有轻度鸡胸,操作方便、手术损伤小、效果满意.既美化乳房外观又掩饰了鸡胸畸形,具有双重手术效果,值得推广.

  8. 乳腺癌术中植入氟尿嘧啶植入剂的安全性研究%The safety of the clinical application of fluorouracil implants hi patients with breast cancer

    Institute of Scientific and Technical Information of China (English)

    覃怀成; 孔勇; 钟先荣; 汪祖来; 陈希纲

    2011-01-01

    目的:探索进展期乳腺癌术中手术部位植入氟尿嘧啶植入剂化疗的安全性,寻找预防乳腺癌局部复发的新途径.方法:63例Ⅱ期乳腺癌患者随机分为术中植入氟尿嘧啶植入剂组(实验组)和对照组,实验组在胸大肌及腋窝植入氟尿嘧啶植入剂.观察植药后白细胞及丙氨酸氨基转移酶(ALT)、胆红素和肌酐变化.切口引流液的量.皮下积液,局部溃疡及有无淋巴漏等.结果:实验组与对照组的白细胞及ALT、胆红素和肌酐变化,皮下积液,局部溃疡及有无淋巴漏的发生率以及切口引流量差异无显著性;两组术后第l天血白细胞计数、ALT、胆红素和肌酐较治疗前有明显升高(P0.05).结论:乳腺癌术中植入氟尿嘧啶植入剂安全可靠.是术后局部区域性化疗的有效途径.%Objective To investigate the safety of local chemotherapy with fluorouracil implants in patients with breast cancer who were receiving modified radical mastectomy.Methods Sixty-three patients with breast cancer who were to receive modified radical mastectomy were divided into fluoromacil group and control group.Patients in control group received routine therapy, and patients in fluorouracil group received fluorouracil implants implanted in major pectoral muscle and axillary fossa.The counting of leucocyte, bilirubin, ALT, Cr, the drainage of the incision, the incidence of subcutaneous fluid, local ulceration were observed.Results There were no significant differences in the counting of leucocyte, bilirubin, ALT, Cr, the drainage of the incision, the incidence of subcutaneous fluid, and local ulceration between the two groups (P > 0.05), but there existed significant changes after the surgery in the two groups (P < 0.05).Conclusion The application of fluorouracil implants in patients with breast cancer is safe, effective, and convenient, and might become a new promising method to prevent postoperative local recurrence of breast cancer.

  9. Development of stereotactic seed implantation treatment planning system and its key technologies%立体定向粒子植入治疗计划系统的开发及其关键技术研究

    Institute of Scientific and Technical Information of China (English)

    刘博; 于新; 周付根

    2012-01-01

    Objective To design an original treatment planning system(TPS) suitable for stereotactic radioactive seed implantation treatment. Methods The linear source arrangement principle was adopted, and seed implantation planning module was designed according to stereotactic surgery operation. A fast dose calculation method based on graphics processing unit(GPU) was employed to achieve real -time calculation and update of dose distribution. Automated registration and fusion of pre -operative magnetic resonance imaging(MRI) and post -operative CT images was investigated to achieve the quantitative post -operative dose verification, and a new dose comparison method based on volume overlap ratio was presented. Results A well-designed, full-featured stereotactic seed implantation TPS was implemented, and the clinical trials showed that the system fully met the clinic needs. Conclusion It is demonstrated that the proposed system could effectively aid in pre-operative planning and postoperative dose verification, and has high clinical virtue and wide application prospect.%目的 设计一套适用于立体定向放射性粒子植入肿瘤治疗手术的计划系统.方法 采用线性布源原则,设计结合立体定向手术方式的粒子植入治疗计划设计模块;采用基于图形处理单元的粒子剂量快速计算方法,进行放射剂量场的实时计算和更新;研究术前MRI图像和术后CT图像的自动配准和融合方法,实现术后剂量的定量验证,并提出一种基于体积重合率的剂量比较方法.结果 实现了一套设计合理、功能完善的神经外科放射性粒子植入治疗计划系统软件.经临床试用,完全满足临床需求.结论 该系统能够有效地辅助医生进行放射性粒子植入手术的术前治疗计划设计、优化和术后的放射剂量验证,具有重要的临床价值和广泛的应用前景.

  10. 离子注入线辣椒F2代表型观察及变异分析%Phenotype Observation and Variation Analysis of Chili Pepper F2 Derived from the Seeds by Ion Implantation

    Institute of Scientific and Technical Information of China (English)

    汪宁; 许峥; 张丰收; 张涛; 苏颖; 连慕兰; 周云龙

    2011-01-01

    [OBJECTIVE] The genetic characteristics of Chili pepper F2 generation, which from F1 generation with ion implantation were observed. [METHOD] Five groups of chili pepper seeds were selected to sow in the field, which biological mutation occurred in F1 generation. Then the major phenotype changes in F2 were observed. The biochemical changes caused by ion implantation were analyzed by determination of peroxidase isozyme. [RESULT] Implanting one side of the seeds with 9× 1011 P2+/cm2 the other side with 1 × 1012 Cu2+/cm2 contributed to the continued superiority in yield per plant while the other 4 control groups failed to stably inherit the superior qualities of F1 generation. [CONCLUSION] The prominent biological characters induced in the seeds of group No.21 were relatively stably inherited, indicating the value of continuing breeding and further selection.%[研究目的]观察离子注入线辣椒种子在F1代诱变产生的生物学效应在F2代的遗传特征.[方法]选取经离子注入后发生生物学诱变的5组F1代线辣椒种子继续在田间播种实验,观察F2代主要表型变化,并通过过氧化物同工酶的测定对离子注入引起生物化学变化进行分析.[结果]种子双面分别注入9×1011 P2+/cm2和1×1012 Cu2+/cm2组(No.21)单株产量在F2代继续保持明显优势,而其他4组F1代的一些生物学优良性状未能在F2代中继续遗传显现.[结论]F1代No.21处理组种子诱变的优良生物学性状在F2代继续得到了遗传,具有进一步选育的价值.

  11. Augmentation Mammaplasty Using Implants: A Review

    Directory of Open Access Journals (Sweden)

    Susumu Takayanagi

    2012-09-01

    Full Text Available One of the techniques for augmentation mammaplasty is the procedure using implants. Eventhough this technique has been used for many years, there are still several controversial issuesto be discussed and overcome for patient safety. In this review article, capsular contracture,leak or rupture of the implants, possible systemic disease, relation with breast cancer, andrecent problems with Poly Implant Prothese implants are described and discussed.

  12. Comparison of margin status and lesional size between radioactive seed localized vs conventional wire localized breast lumpectomy specimens.

    Science.gov (United States)

    Rarick, Jason; Kimler, Bruce F; Tawfik, Ossama

    2016-04-01

    Despite the known benefits of the use of radioactive seed localization (RSL), few studies have looked at the resultant pathologic marginal status of these lumpectomy specimens, especially in regard to different definitions of close/positive margins. We compared the marginal status of lumpectomy specimens removed by either RSL or conventional wire localization (CWL) techniques. A total of 106 lumpectomy specimens including 62 by CWL and 44 by RSL for invasive ductal and lobular carcinomas were compared. Data on gross and microscopic surgical margin status, tumor type and grade, and demographic information were retrospectively collected. There was no difference between the techniques in terms of tumor characteristics including size, histologic grade, lymph node positivity, or age. Although the distributions are very similar between CWL and RSL specimens for final marginal assessments (P=.69), there is a (modest) statistically significant difference in the distribution for margin classifications based on gross assessments (P=.040), specifically more RSL specimens exhibiting tumor within 1mm of the closest margin. Concordance between gross and microscopic lesion measurements is highest for invasive ductal carcinoma grade 3 for both CWL and RSL lumpectomies (78.6% and 80.0%). This study shows that there were no significant marginal status differences between RSL and CWL lumpectomy specimens with invasive carcinoma. Rather, what was relevant is whether the entire specimen could be classified as having negative/close margins. Significant workflow challenges in surgical pathology laboratories are expected with the adoption of the RSL process.

  13. Breast reconstruction with silicone implants and acellular dermal matrix in women with Poland syndrome%硅胶假体及脱细胞真皮辅助女性Poland综合征患者的乳房再造

    Institute of Scientific and Technical Information of China (English)

    张琼阁; 王喜梅; 郭丽丽; 万程; 董海江

    2014-01-01

    BACKGROUND:Women with Poland syndrome are often accompanied by breast dysplasia and even agenesis, absence of breast and breast deformity. For such patients, we can implement different operations according to the degree of deformity, for remodeling the breast and improving chest shape. OBJECTIVE:To explore the clinical effects of breast reconstruction with silicone implants and acellular dermal matrix in Poland patients with breast deformity. METHODS:A retrospective analysis of six female cases of Poland syndrome was conducted, including four patients with unilateral (bilateral) breast agenesis, hypoplasia of the ipsilateral (bilateral) pectoralis major muscle, less tissue volume than the healthy side who were subjected to implantation of silicone breast prostheses, and two patients with unilateral breast agenesis, agenesis of the pectoralis major muscle and ribs, poor and adhered chest wal soft tissue who were subjected to implantation of silicone breast prosthesis and acellular dermal matrix combined with latissimus dorsi myocutaneous flap. RESULTS AND CONCLUSION:Six patients at day 4 after operation presented with edema, among whom, one appeared to have wound exudate. But al the six patients were healed. Then, the patients were fol owed up for 1-12 months. Outline of breast prosthesis could be touched in three cases, and one case presented with moderate hardness of the breast. However, there were no breast nodules and pain, no scar hyperplasia of the breast. Breast was uniform in appearance, with no wrinkle. These findings confirm that the silicone breast prosthesis with acellular dermal matrix is easy to operate, can reduce intraoperative injury, decrease the difficulty of the operation and al eviate the suffering of patients, which can obtain better clinical effects in the strict grasp of indications.%背景:女性Poland综合征患者同时伴有乳房发育不全甚至不发育,乳房缺失及乳房畸形等,可根据畸形程度实施背阔肌肌瓣

  14. Doses to internal organs for various breast radiation techniques - implications on the risk of secondary cancers and cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Keller Brian M

    2011-01-01

    Full Text Available Abstract Background Breast cancers are more frequently diagnosed at an early stage and currently have improved long term outcomes. Late normal tissue complications induced by adjuvant radiotherapy like secondary cancers or cardiomyopathy must now be avoided at all cost. Several new breast radiotherapy techniques have been developed and this work aims at comparing the scatter doses of internal organs for those techniques. Methods A CT-scan of a typical early stage left breast cancer patient was used to describe a realistic anthropomorphic phantom in the MCNP Monte Carlo code. Dose tally detectors were placed in breasts, the heart, the ipsilateral lung, and the spleen. Five irradiation techniques were simulated: whole breast radiotherapy 50 Gy in 25 fractions using physical wedge or breast IMRT, 3D-CRT partial breast radiotherapy 38.5 Gy in 10 fractions, HDR brachytherapy delivering 34 Gy in 10 treatments, or Permanent Breast 103Pd Seed Implant delivering 90 Gy. Results For external beam radiotherapy the wedge compensation technique yielded the largest doses to internal organs like the spleen or the heart, respectively 2,300 mSv and 2.7 Gy. Smaller scatter dose are induced using breast IMRT, respectively 810 mSv and 1.1 Gy, or 3D-CRT partial breast irradiation, respectively 130 mSv and 0.7 Gy. Dose to the lung is also smaller for IMRT and 3D-CRT compared to the wedge technique. For multicatheter HDR brachytherapy a large dose is delivered to the heart, 3.6 Gy, the spleen receives 1,171 mSv and the lung receives 2,471 mSv. These values are 44% higher in case of a balloon catheter. In contrast, breast seeds implant is associated with low dose to most internal organs. Conclusions The present data support the use of breast IMRT or virtual wedge technique instead of physical wedges for whole breast radiotherapy. Regarding partial breast irradiation techniques, low energy source brachytherapy and external beam 3D-CRT appear safer than 192Ir HDR

  15. Tissue modeling schemes in low energy breast brachytherapy.

    Science.gov (United States)

    Afsharpour, Hossein; Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-11-21

    Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this

  16. Gossypiboma after Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Kira Lundin

    2013-01-01

    Full Text Available A 39-year-old woman was referred for removal of cosmetic breast implants and related siliconoma. After an exchange of breast implants at a private clinic a year previously, she had asymmetry of the right breast, persistent pain, and a generally unacceptable cosmetic result. An MRI had shown a well-defined area with spots of silicone-like material at the upper pole of the right breast. Surgical removal of presumed silicone-imbibed breast tissue was undertaken, and surprisingly a gossypiboma was found in its place, which had not been identified on the MRI. Gossypiboma is the condition of an accidentally retained surgical sponge. This complication is also known as a textiloma, gauzoma, or muslinoma and is well described in other surgical specialties. However, it is extremely rare after plastic surgery, and this case illustrates the need for continued attention to the surgical count of sponges and instruments.

  17. Breast Imaging after Breast Augmentation with Autologous Tissues

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Kyu Won; Seo, Bo Kyung; Shim, Eddeum; Song, Sung Eun; Cho, Kyu Ran [Dept. of Radiology, Korea University Anam Hospital, Seoul (Korea, Republic of); Yoon, Eul Sik [Korea University Ansan Hospital, Ansan (Korea, Republic of); Woo, Ok Hee [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2012-06-15

    The use of autologous tissue transfer for breast augmentation is an alternative to using foreign implant materials. The benefits of this method are the removal of unwanted fat from other body parts, no risk of implant rupture, and the same feel as real breast tissue. However, sometimes there is a dilemma about whether or not to biopsy for calcifications or masses detected after the procedure is completed. The purpose of this study is to illustrate the procedures of breast augmentation with autologous tissues, the imaging features of various complications, and the role of imaging in the diagnosis and management of complications and hidden breast diseases.

  18. Symmetrization Management in Breast Reconstruction with Implant after Tissue Expansion%组织扩张后行假体乳房再造的对称性处理

    Institute of Scientific and Technical Information of China (English)

    李比; 夏有辰; 张洁; 潘柏林; 马建勋

    2015-01-01

    Objective To explore different techniques for bilateral symmetry in breast reconstruction with implant after tissue expansion. Methods From June 2006 to June 2014, 48 patients received breast reconstruction with implant after tissue expansion. The following symmetrization procedures were used during breast reconstruction. (1) Expander was chosen according to controlateral size and was placed 2 to 3 cm lower than controlateral IMF and then over-expand. (2) The implant was chosen according to the expander, the sizer or the data from 3D photography. (3) Ipsolateral fat transfer, latissimus dorsi muscle flap transplantation, NAC transposition, and contralateral breast reduction, mastopexy, augmentation were used for symmetrization. Results All the patients were followed up for 6 to 48 months, mean 11.9 months. Bilateral symmetry were achieved through these procedures and all patients were satisfied with the results. Conclusion Accurate measurement of the breast, the appropriate choice of the expander and implant, and symmetrization procedures of both side are necessary for better symmetry in breast reconstruction.%目的:探讨组织扩张后使用假体进行乳房再造过程中,可使两侧乳房对称的方法。方法2006年6月至2014年6月,对48例患者行组织扩张后假体乳房再造,在再造过程中采用对称性处理,方法包括:①选择直径与健侧乳房基底直径相近的扩张器,对称位置埋置,下极位置低于对称下皱襞2~3 cm,超量注水扩张;②依据扩张器注水容积,模拟假体容量及健侧乳房的三维摄像数据选择大小、形态适合的假体;③采用包括患侧的自体颗粒脂肪注射移植、背阔肌肌瓣移植、乳头乳晕移位,健侧乳房缩小、假体置入增大、上提固定等对称性修整手术。结果本组患者术后随访6~48个月,平均11.9个月。术后双侧乳房均达到基本对称,患者对再造效果满意。结论对乳

  19. Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

    International Nuclear Information System (INIS)

    Objectives: To assess the incidence and clinical parameters that could influence migration of seeds in localized prostate cancer patients treated by stranded versus loose sources by Iodine-125 brachytherapy. Materials and Methods: 100 patients were treated from January/1998 until December/2006. Age, PSA, clinical stage, Gleason, prostate volume, number of seeds, activity of radioactive seeds, and dosimetric parameters, such as V100, V150 and D90 were evaluated. Results: Mean follow-up was 79 months (18 - 120. CI 95%: 72 - 85). Overall, 6 of 100 patients experienced seed migration. Seed migration was found in 4/50 (8%) patients using loose seeds and in 2/50 (4%) treated by stranded seeds. Mean value dosimetric parameters for stranded seeds were greater than those for loose seeds (V100(%): 88.7/82, D90(Gy): 149.2/140.3, D90(%): 104.2/93.8, V150 (%): 53.8/47, respectively). No significant difference in migration of seeds was detected between loose and stranded seeds considering age (p = 0.33), PSA (p = 0.391), prostate volume (p 0.397), activity of radioactive seeds (p = 0.109), number of seeds (p 0.338), V100 (p = 0.332), although significant differences were measured in the values of D90 (% and Gy) (p = 0.022 and 0.011) and V150 (p = 0.023). Conclusions: Seed migration after brachytherapy might occur and it does affect post-implant dosimetry. (author)

  20. Application of CD-4 theory in determining the width of implant in breast augmentation%CD-4理论在隆乳术中确定乳房假体宽度中的应用

    Institute of Scientific and Technical Information of China (English)

    才杰; 周洋; 孙诚

    2016-01-01

    目的 探讨CD-4理论在隆乳术中确定乳房假体宽度的应用价值.方法 对630例经腋窝切口或乳晕切口行双平面Ⅰ型或Ⅱ型隆乳的患者,成功应用CD-4理论来确定乳房假体的宽度(W).曲线距离(CD)为经乳房下皱襞水平测得的从胸骨中线到腋前线的水平曲线距离.W=CD-4.0 cm或3.5 cm.结果 630例的圆形或水滴形乳房假体的W为10.5~12.5 cm不等,CD为14.5~17.0 cm不等.78.09%的隆乳患者获得了术后1个月到6年的随访,除了5例发生单侧包膜挛缩外,其余隆乳者对新乳房的形态大小都感满意.新乳房内侧的乳房间距为1~2.5 cm,乳房外侧缘均在腋前线区域.结论 在行双平面Ⅰ型或Ⅱ型隆乳术中乳房假体W=CD-4.0 cm,而对于非常消瘦的隆乳者应改为W=CD-3.5 cm.%Objective To introduce a new method ("CD-4"theory) to determine the width (W) of the implant and to explain the reasons why to do so in details.Methods From January 2006 to August 2015,the authors have found and applied "CD-4" theory to determine the width (W) of breast implant in dual plane Ⅰ or Ⅱ breast augmentation cases through transaxillary or periareolar incision for 630 patients."CD" was defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold (IMF).W =CD-4.0 cm or 3.5 cm.Results The 630 patients were treated by using both round and anatomic implants with width from 10.5 cm to 12.5 cm.Their CDs were from 14.5 cm to 17 cm.78% of the patients were followed up from 1 month to 5 years.Except for 5 patients were unilateral capsular contractions,all the other patients were satisfied with their nature new breast shapes and volumes.Their new intermammary cleavages without bras were between 1-2.5 cm and lateral borders of breast were on the area of the anterior axillary line (AAL).Conclusions Width of the implant is equal to CD-4.0 cm

  1. Rab25基因对乳腺癌裸鼠移植瘤生长的影响%Effects of Rab25 gene on the growth of implanted tumor of breast cancer in nude mice

    Institute of Scientific and Technical Information of China (English)

    张小彬; 陆云飞; 沈桂鑫; 吴非

    2014-01-01

    目的:建立一系列Rab25表达水平不同的乳腺癌细胞裸鼠移植瘤模型,观察不同水平Rab25表达对乳腺癌裸鼠移植瘤的影响。方法:通过分别上调及沉默Rab25基因在乳腺癌细胞中的表达,建立Rab25表达水平不同的乳腺癌细胞的裸鼠移植瘤模型,测量肿瘤体积,绘制肿瘤生长曲线,检测肿瘤组织中Rab25表达差异。结果:Rab25转染组较干扰组、原株细胞组及空质粒组对裸鼠细胞致瘤能力明显增强。转染组裸鼠瘤体中Rab25 mRNA表达明显增强,而干扰组瘤体Rab25 mRNA表达明显减弱。结论:Rab25为促癌基因,其高表达可直接增强乳腺癌细胞的增殖侵袭能力,而RNA干扰技术有可能为乳腺癌的肿瘤靶向和基因治疗提供新的思路。%Objective To establish nude mice models with implanted tumor of breast cancer cells with different expressing levels of Rab25 gene , and to observe the effects of Rab25 gene on the growth of implanted tumor. Methods Nude mice models with implanted tumor of breast cancer cells with different expressing levels of Rab25 gene were constructed through up-regulating or silencing the expression of Rab25 gene in breast cancer cells. The size of implanted tumor was measured, the growth curve of tumor was portrayed, and the expression of Rab25 gene in tumor tissues was detected. Results The tumorigenic effect on nude mice was the strongest and the highest in Rab25 up-regulating group , as compared to those in Rab25 interference group , original cells group, and Rab25 empty plasmid group. The expression of Rab25 mRNA in interference group was significantly reduced. Conclusions Rab25 is a cancer-promoting gene , its high expression could directly enhance the proliferation of breast cancer cells. RNA interference technology had the potential to provide new ideas for tumor targeting and gene therapy for breast cancer.

  2. Experimental model of capsular contracture in silicone implants

    Directory of Open Access Journals (Sweden)

    Bastos Érika Malheiros

    2003-01-01

    Full Text Available The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.

  3. Is a Loose-Seed Nomogram Still Valid for Prostate Brachytherapy in a Stranded-Seed Era?

    International Nuclear Information System (INIS)

    Purpose: To characterize the amount of activity required to treat the prostate with stranded 125I radioactive seeds and compare our stranded data with the amount of activity recommended when individual seeds are implanted using a Mick applicator. Methods and Materials: Data from two groups of patients at University of Texas M. D. Anderson Cancer Center who were treated with prostate brachytherapy as monotherapy were analyzed. The first group included 100 patients implanted with individual seeds in 2000 and 2001. The second group comprised 81 patients for whom stranded seeds were implanted in 2006 and 2007. Seeds in both groups were 125I seeds with an air kerma strength of 0.497 U per seed (0.391 mCi per seed). The prescribed dose to planning target volume was 145 Gy. Results: The total implanted activity and the number of seeds used were significantly lower in the second group (p 3 prostate and approximately 15% for a 60-cm3 prostate. With equivalent activity between the two groups, the stranded-seed treatment covered a larger treatment volume with the prescribed dose. Conclusions: The amount of activity required to effectively treat a prostate of a given volume was lower with stranded seeds than with loose seeds. Our experience suggests that prostate brachytherapy that uses stranded seeds leads to a more efficient implant with fewer seeds and lower overall activity, resulting in improved homogeneity

  4. 保留乳头乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的临床分析%Clinical analysis of breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer

    Institute of Scientific and Technical Information of China (English)

    崔世恩; 凌飞海; 黄志华; 马士辉; 郑书楷; 李晓薇

    2014-01-01

    Objective To investigate clinical efficacy of breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer. Methods 16 patients with breast cancer were selected as observation group, who received treatment in our hospital from December 2011 to October 2013. Breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer was taken to treat the cases. 16 patients with breast cancer treated in the same period was selected as control group, who taked traditional modified radical mastectomy without breast reconstruction. Survival, recurrence, morbidity and quality of life of both groups were compared by follow-up. And cosmetic effect of observation group was also investigated. Results The surgery of both groups were all successful,without serious complications. The survival rate of observation group was 100%, and there were no local recurrence and distant metastasis. Compared with the control group, recurrence and survival rate had no significant difference(P > 0.05). Quality of life scores of observation group was (77.2±4.3)points,and the indicator was significantly better than the control group(P<0.05).Cosmetic effect of observation group was 93.75%. Conclusion Breast reconstruction with latissimus dorsi flap plus prosthesis implantation surgery after nipple-sparingmodified radicalmastectomy of breast cancer has a good clinical efficacy. Patients affirm its safety and cosmetic effect, so it is worthy of promotion.%目的:探讨保留乳头、乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的临床效果。方法选择2011年12月~2013年10月我院16例乳腺癌患者作为观察组,该组病例采取保留乳头、乳晕乳腺癌术后背阔肌皮瓣加假体一期置入乳房再造的方案治疗,选择同期收治的16例乳腺癌患者作对照,该组病例

  5. Simvastatin Reduces Capsular Fibrosis around Silicone Implants.

    Science.gov (United States)

    Chung, Kyu Jin; Park, Ki Rin; Lee, Jun Ho; Kim, Tae Gon; Kim, Yong-Ha

    2016-08-01

    Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 μm in the simvastatin group and 491.2 μm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction. PMID:27478339

  6. Practical Use of the Extended No Action Level (eNAL) Correction Protocol for Breast Cancer Patients With Implanted Surgical Clips

    International Nuclear Information System (INIS)

    Purpose: To describe the practical use of the extended No Action Level (eNAL) setup correction protocol for breast cancer patients with surgical clips and evaluate its impact on the setup accuracy of both tumor bed and whole breast during simultaneously integrated boost treatments. Methods and Materials: For 80 patients, two orthogonal planar kilovoltage images and one megavoltage image (for the mediolateral beam) were acquired per fraction throughout the radiotherapy course. For setup correction, the eNAL protocol was applied, based on registration of surgical clips in the lumpectomy cavity. Differences with respect to application of a No Action Level (NAL) protocol or no protocol were quantified for tumor bed and whole breast. The correlation between clip migration during the fractionated treatment and either the method of surgery or the time elapsed from last surgery was investigated. Results: The distance of the clips to their center of mass (COM), averaged over all clips and patients, was reduced by 0.9 ± 1.2 mm (mean ± 1 SD). Clip migration was similar between the group of patients starting treatment within 100 days after surgery (median, 53 days) and the group starting afterward (median, 163 days) (p = 0.20). Clip migration after conventional breast surgery (closing the breast superficially) or after lumpectomy with partial breast reconstructive techniques (sutured cavity). was not significantly different either (p = 0.22). Application of eNAL on clips resulted in residual systematic errors for the clips’ COM of less than 1 mm in each direction, whereas the setup of the breast was within about 2 mm of accuracy. Conclusions: Surgical clips can be safely used for high-accuracy position verification and correction. Given compensation for time trends in the clips’ COM throughout the treatment course, eNAL resulted in better setup accuracies for both tumor bed and whole breast than NAL.

  7. Bilateral Poly Implant Prothèse Implant Rupture: An Uncommon Presentation

    Directory of Open Access Journals (Sweden)

    Peter Mallon

    2013-07-01

    Full Text Available Summary: A woman in her 50s underwent delayed bilateral Poly Implant Prothèse implant reconstruction following mastectomy for breast cancer. Symptoms of implant rupture developed 43 months after surgery with an erythematous rash on her trunk. The rash then spread to her reconstructed breast mounds. Initial ultrasound scan and magnetic resonance imaging were normal; however, subsequent magnetic resonance imaging demonstrated left implant rupture only. In theater, following removal of both implants, both were found to be ruptured. The rash on her trunk resolved within 3 weeks in the postoperative period. Chemical analyses of silicone in both implants confirmed a nonauthorized silicone source; in addition, the chemical structure was significantly different between the left and right implant, perhaps explaining the variation in presentation.

  8. A dosimetric research on radioactive 125I seed plane implantation%125I 放射性粒子单平面布源剂量学研究

    Institute of Scientific and Technical Information of China (English)

    唐富龙; 任菊娜; 吴娟; 张宏涛; 高贞; 于慧敏; 王娟

    2014-01-01

    Objective To explore the dosimetric effects of the same number and activity of radioactive 125I seeds in different plane arrangements. Methods Simulated 9 distribution modes using 9 125I seeds were designed by three- dimensional treatment planning system (3D- TPS), and the isodose curves of 60 Gy, 80Gy, 130 Gy, 145 Gy and 200 Gy were obtained. The areas enclosed by the isodose curves, the longer and shorter radius of these isodose curves and the medical cost per unit area were calculated with the professional image analysis software. Results Obvious differences in areas enclosed by the isodose curves, the longer and shorter radius of these isodose curves and the medical cost per unit area existed between each other among the nine different distribution modes of 9 125I seeds. The distribution modes that had the maximum areas enclosed by 60 Gy, 80 Gy, 130 Gy, 145 Gy and 200 Gy isodose curves were x1.5y1.5, x1y1.5, x1y1, x1y1 and x0.5y1, respectively, with the corresponding areas of 1 583.86 mm2, 1 146.03 mm2, 768.30 mm2, 621.85 mm2 and 480.97 mm2, respectively. Conclusion The peripheral dose and the therapeutic efficacy are significantly influenced by the arrangement of 125I seeds when the same number and activity of the seeds are used. The dose distributions are more homogeneous when the maximum areas enclosed by the isodose curves are obtained.%目的:探讨同数量、同活度125I 粒子单平面不同排列的剂量分布及其效应。方法利用计算机三维治疗计划系统(3D- TPS)模拟9颗2.59×107 Bq 125I 粒子的9种排列方式,得出60 Gy、80 Gy、130 Gy、145 Gy 和200 Gy 等剂量分布曲线并计算曲线包含的面积、长径、短径及单位面积的医疗费用。结果粒子排列方式不同时相同等剂量曲线包含的面积、长径、短径和单位面积的医疗费用存在差异。60 Gy、80 Gy、130 Gy、145 Gy 和200 Gy 等剂量曲线内面积最大的粒子排列方式分别为:x1.5y1.5、x1y1.5、x1y1

  9. 125I粒子植入治疗非小细胞肺癌的护理及辐射防护%Radiation protective nursing intervene of 125I seed implantation in non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    刘莉; 杨景魁

    2012-01-01

    Lung cancer is the most common primary malignant tumor.Because most sufferers have already been in later stage in their first diagnosis,the lump body infringing upon the important organs often influences the excision of tumor.125I seeds permanent implantation is a new method for tumor brachytherapy,which contributes to kill the tumor completely,ensures the normal physiological functions of organs,reduces tissue injuries and treatment of complications,and raises the survival rate of sufferers.The rapid promotion of this technique is also followed by radiation risks in the treatment.Currently,the researches of 125I seeds implantation is limited to the aspects of treatment means and effects,with no detailed study in intraoperative usage,disinfection and protection.Although a satisfactory curative effect is the key in the treatment,the studies in protection principles,means and technological upgradation are also too important to be ignored.%肺癌是最常见的肺部原发性恶性肿瘤,由于多数患者就诊时已处于中晚期,瘤体侵犯重要脏器后常影响肿瘤的切除.125I粒子永久性组织间植入治疗是肿瘤近距离放疗的一种新兴方法,有助于肿瘤的整体杀灭,同时保证了脏器的正常生理功能,减少了组织创伤及治疗并发症,提高了患者的生存率.随着放射性粒子植入治疗技术的迅速推广,治疗过程中的辐射威胁也随之而至.目前,对125I粒子的研究局限于治疗手段和效果方面,尚未在术中使用、消毒及防护等方面进行详细研究.虽然能达到疗效是治疗的关键,但是防护的基本原则、具体方式和更新防护技术的研究也不容忽视,其研究结果势必对肿瘤的放射性粒子植入治疗有着重要意义.

  10. Injury of ~(125)Ⅰ seeds implants to trachea and esophagus of rabbits%放射性~(125)Ⅰ粒子植入对家兔正常气管、食管损伤初探

    Institute of Scientific and Technical Information of China (English)

    李运; 李剑锋; 杨帆; 周足力; 王俊

    2010-01-01

    Objective To evaluate the impact of 1125 seeds para-tracheal braehytherapy on regional tissue injury in rab-bit models. Methods 42 rabbits were randomized into 7 groups. Group 1 to 6 belong to study groups (in which 1,4,5 and 6 belong to "dose gradient" subgroup, while 2,3 and 4 to "chronologic" subgroup) , while the last group acts as negative con-trol. The activity of seeds in study group were 0.3 mCi in group 1, 0.5 mCi in group 2 to 5, 0.7 mCi in group 5, and 0.9mCi in group 6. False seeds (0 mCi) were used for the negative control. 4 seeds with equal dosage were implanted between trachea and esophagus in each rabbit under general anesthesia. Seeds arrangement was made according to Paris principle. For the tissue injury evaluation, group 2 was sacrificed by the end of first month post-operatively, group 3 at the end of the second month, and group 4 end of the third month. The rest of rabbits were also sacrificed at the end of the third month. Pieces of adjacent e-sophagus and trachea were sampled from each rabbit. Tissue injury features such as inflammation, edema, congestion or fibrosis as evaluated histologically. Results All rabbits were healthy during study period except 5. Histological analysis revealed that trachea samples from all groups had lymphocytas and plasma cells infiltration as signs of chronic inflammation, hut fibrosis was nut clearly visible. There were no differences between study and control groups with respect to inflammation, edema and con-gestion scores. But in groups which received the highest doses of radiation or sacrificed at 60 d showed more eosinophil infiltra-tion and epithelum degeneration, and statistical significance was reached between these groups and control. Esophageal samples had less histological changes compared with trachea. Conclusion Para-tracheal implantation of ~(125)Ⅰ seeds with therapeutic or higher dosage only induce minor and reversible damage to the regional tissue. This implies that ~(125)Ⅰ implants

  11. Immediate breast reconstruction with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy for young patients with early breast cancer%双侧乳腺切除加假体植入一期乳房重建治疗青年早期乳腺癌患者

    Institute of Scientific and Technical Information of China (English)

    唐欣; 张艳君; 李捷; 郑一琼; 刘蕾; 高影; 李席如

    2012-01-01

    目的 探讨保留皮肤和乳头乳晕复合体的双侧乳腺切除及假体植入一期乳房重建在青年早期乳腺癌治疗中的临床应用.方法 回顾性分析2006年1月至2011年3月接受保留皮肤及乳头乳晕复合体双侧乳腺切除加假体植入一期乳房重建术的21例青年早期乳腺癌患者临床资料.结果 21例患者手术成功,术后美容效果优良.随访12~72个月(中位随访期为34个月),无局部复发和远处转移.结论 对青年早期乳腺癌患者,在切除患乳同时预防性切除对侧乳房,即行保留皮肤和乳头乳晕复合体的双侧乳腺切除加一期假体植入重建乳房,美容效果好,临床疗效满意.%Objective To evaluate the application of immediate breast reconstruction (1BR) with silicon prosthetic implants following bilateral nipple preserving subcutaneous mastectomy in treatment of young patients with early breast cancer. Methods We retrospectively analyzed the clinical data of 21 patients with breast cancer who underwent IBR with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy from January 2006 to March 2011. Results The operations were successful and excellent cosmetic results were obtained in all cases. No local recurrence or remote metastasis was found during the follow-up of 12-72 months (median 34 months). Conclusion For the young patients with breast cancer, the mastectomy on the affected side together with prophylactic excision of the contralateral side, i. e. IBR with prosthetic implants following bilateral nipple preserving subcutaneous mastectomy can obtain satisfactory cosmetic and clinical results.

  12. The Role of Cancer Stem Cells in the Organ Tropism of Breast Cancer Metastasis: A Mechanistic Balance between the Seed and the Soil?

    International Nuclear Information System (INIS)

    Breast cancer is a prevalent disease worldwide, and the majority of deaths occur due to metastatic disease. Clinical studies have identified a specific pattern for the metastatic spread of breast cancer, termed organ tropism; where preferential secondary sites include lymph node, bone, brain, lung, and liver. A rare subpopulation of tumor cells, the cancer stem cells (CSCs), has been hypothesized to be responsible for metastatic disease and therapy resistance. Current treatments are highly ineffective against metastatic breast cancer, likely due to the innate therapy resistance of CSCs and the complex interactions that occur between cancer cells and their metastatic micro environments. A better understanding of these interactions is essential for the development of novel therapeutic targets for metastatic disease. This paper summarizes the characteristics of breast CSCs and their potential metastatic micro environments. Furthermore, it raises the question of the existence of a CSC niche and highlights areas for future investigation.

  13. Seed quality in informal seed systems

    NARCIS (Netherlands)

    Biemond, P.C.

    2013-01-01

    Keywords:     informal seed systems, seed recycling, seed quality, germination, seed pathology, seed health, seed-borne diseases, mycotoxigenic fungi, Fusarium verticillioides, mycotoxins, Vigna unguiculata, Zea mays, Nigeria.   Seed is a crucial input for agricultural producti

  14. Radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds; Exposition radiologique de l'equipe operatoire au cours de curietherapies de prostate par implants permanents d'iode-125

    Energy Technology Data Exchange (ETDEWEB)

    Gagna, G.; Amabile, J.C.; Laroche, P. [Service de protection radiologique des armees (SPRA), 1 bis rue du Lieutenant Raoul Batany, 92141 Clamart Cedex (France); Gauron, C. [Institut national de recherche et de securite (INRS), Departement Etudes et Assistance Medicales, 30 rue Olivier Noyer, 75680 Paris Cedex 14 (France)

    2011-04-15

    The French defense radiation protection service (SPRA) and the French national institute for research and safety (INRS) conducted a joint study to assess the radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds at the Val-de-Grace military hospital. The purpose of the study was the assessment of the effective doses, the equivalent doses to the extremities and lens received by a novice team, the different ambient dose equivalent rates measurements and the delineation of areas. After six brachy-therapies, all the recorded doses with whole-body InLight{sup R} OSL and nanoDot{sup R} dosimeters remained below the detection limit for the whole staff. The dose rate measured at the end of implantation by an AT1123{sup R} survey meter is about 170 {mu}Sv/h at the perineum of the patient. The controlled area limit is estimated to be about 20 cm from the patient perineum. From these results, the authors propose recommendations for the categorization of workers, the delineation of areas and the dose monitoring procedures. This study demonstrates that real-time ultrasound-guided trans-perineal prostate brachytherapy delivers low dose to the operators because of the radioactive source characteristics and the instrumentation providing an effective radiation protection for the surgical team. (authors)

  15. CT引导下125Ⅰ放射性粒子组织间植入治疗复发性卵巢癌%Interstitial implantation of 125Ⅰ seed therapy for recurrent ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    李常仑; 刘继红; 黄金华; 顾仰葵; 高飞; 黄绮丹; 胡莹莹; 江雄鹰; 黄英杰

    2012-01-01

    Objective To explore the feasibility,short-term efficacies and complications of computed tomography (CT)-guided 125Ⅰ interstitial implant therapy for recurrent ovarian cancer.Methods From October 2009 to November 2010,a total of 25 lesions for 12 patients were diagnosed as recurrent ovarian cancer by positron emission tomography/computed tomography (PET/CT).Among 25 lesions,21 underwent 125Ⅰ seed implantation.And 4 lesions of liver and spleen in one patient were treated with microwave ablation.Nine patients underwent 2-6 cycles of chemotherapy after seeding.There were 11 lesions with diameter > 2 cm and 10 ≤2 cm.According to the area of physiologic 18FDG uptake in lesions,the treatment plans were formulated by computerized treatment planning system (TPS) and Memorial Sloan-Ketterin nomograph.The matched peripheral dose (MPD) was 145 Gy in target mass.A median of 20.5 seeds per patient (range:9-45) were implanted.The efficacies were evaluated by CT and 18F-FDG PET/CT findings.Results One patient died of renal failure while the other patients survived during a median followup of 15 mouths (range:9-19).Ten lesions showed complete remission,6 partial remission and 5 progressive disease.The effective rate was 76.2% (16/21).Compared with those > 2 cm,the lesions ≤2 cm in diameter had a better local control rate by Fisher's exact test (P =0.035).The hepatic and renallesions treated by microwave ablation showed inactivation on PET/CT.Only one patient suffered from sciatic nerve injury caused by punctuation and numbness and pain of right lower extremity were persistent.There was no onset of the complications of radiation injury,such as intestinal fistula and proctitis.Conclusion The CT-guided 125Ⅰ interstitial implant therapy for recurrent ovarian cancer yields excellent short-term efficacies with fewer complications.The combined modality of 125I interstitial implant and chemotherapy may further improve the patient outcomes.%目的

  16. Influencia de las cargas triboeléctricas y de la contaminación sintomática de los implantes Triboelectric charges and breast implant symptomatic contamination

    OpenAIRE

    G. Peña Cabús

    2007-01-01

    El hallazgo ocasional de energía estática importante en un implante mamario, generó una revisión sistemática de la información disponible al respecto que restableció una secuencia de eventos y conceptos de importancia, a nuestro juicio, en la práctica clínica Los implantes mamarios son elastómeros resultantes de la polimerización industrial que pueden generar cargas electrostáticas en su superficie. El efecto triboeléctrico puede mantener suficiente energía estática como para atraer partícula...

  17. 125I粒子植入对面神经超微结构影响的动物实验%Ultrastructural study on the facial nerve of rabbit after 125I seed implantation

    Institute of Scientific and Technical Information of China (English)

    左健; 宋铁砾; 鞠向群; 郑磊; 蔡志刚; 张建国

    2011-01-01

    目的 探讨 125I放射性粒子不同处方剂量近距离照射对家兔面神经超微结构的影响,旨为临床提供参考.方法 将大耳白兔54只随机分为3个实验组:40 Gy组、80 Gy组、120 Gy组,每组18只动物;每只动物自身对照,将 125I粒子植入一侧腮腺区面神经周围,另一侧作为对照植入粒子空壳.每组分别于2、4、6个月时取面神经干做透射电镜观察.结果 对照组:术后2、4、6个月均可见面神经轴膜连续、轴膜下轻度水肿,髓鞘局部松散.实验组:术后2个月均可见面神经轴膜下水肿、髓鞘松散,其中80 Gy组可见巨噬细胞和新生神经纤维,120 Gy组可见板层分离及新生神经纤维;4个月均可见面神经板层分离、髓鞘松散,其中40、80 Gy组可见胶原增生及轴膜下水肿; 6个月均可见新生神经纤维、髓鞘松散,其中80、120 Gy组可见板层分离、轴膜下水肿.结论 家兔面神经在接受40、80及120 Gy 125I照射后,面神经超微结构存在一定的损伤,面神经受照射剂量越大损伤程度越重;但在120 Gy 125I照射6个月后,髓鞘与轴突的完整性和连续性仍基本保持.%Objective To investigate the ultrastructural variation of the facial nerve of rabbit with different dosage of 125I seed brachytherapy. Methods Fifty-four big ear rabbits were divided into 3 groups randomly and given 40 Gy, 80 Gy, 120 Gy respectively. Radioactive seeds were implanted in one side of parotid gland, the other side was implanted with vacant shell as a control group. The facial nerves were obtained 2, 4, 6 months respectively after operation and the histological ultrastructural changes observed by electromicroscope. Results In the control group,epineurium was continuous, there was slight pitting edema under the epineurium, and axonal myelin was loose. In the test groups, there was slight pitting edema under the epineurium, and axonal myelin sheath was loose at 4th month. Macrophage and regenerated fibers were

  18. Carmustine Implant

    Science.gov (United States)

    Carmustine implant is used along with surgery and sometimes radiation therapy to treat malignant glioma (a certain type of ... Carmustine implant comes as a small wafer that is placed in the brain by a doctor during surgery to ...

  19. Goserelin Implant

    Science.gov (United States)

    Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is ... treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin- ...

  20. The comparison of modified Lejour method and the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis%改良Lejour法与传统双环法联合假体矫正乳房下垂方法比较

    Institute of Scientific and Technical Information of China (English)

    吴振; 贺洁; 周蔚; 付莹莹; 徐岩; 王大勇

    2015-01-01

    目的:对乳房提升术改良Lejour法的效果予以评价,并与传统双环法联合假体矫正乳房下垂的效果进行比较.方法:对1例乳房下垂患者,先用传统双环法联合假体进行矫正,效果改善不明显而瘢痕明显,术后半年采用改良Lejour法,重塑乳房外观.结果:术后随访3个月,采用改良Lejour法后切口瘢痕不明显,满意度高.结论:本例乳房松弛明显,就本例而言,采用改良Lejour法比传统双环法联合假体矫正乳房下垂效果要好,术后乳房形态好、瘢痕轻.%Objective To evaluate the effect of modified Lejour method for breast lift,and to compare with the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis. Methods The patient had received treatment with the traditional double-ring periareolar incisions joint breast implants technique for the correction of mastoptosis six months ago, the effects are not ideal and the scar of incision are obvious.Now we reshaped the breast appearance by modified Lejour method. Results The patient was followed up for 3 months,we found that the scar were not obvious,and the patient was high satisfied. Conclusion In this case,the patient with severe mastoptosis received better effects by modified Lejour method compared with the traditional double-ring periareolar incisions joint breast implants technique,the appearance of breast are ideal and there are less scar.

  1. A rare case of silicone mammary implant infection by Streptomyces spp. in a patient with breast reconstruction after mastectomy: taxonomic characterization using molecular techniques

    DEFF Research Database (Denmark)

    Manteca, Angel; Pelaez, Ana Isabel; del Mar Garcia-Suarez, Maria;

    2009-01-01

    A Streptomyces sp. isolated from a patient who had had breast reconstruction after a mastectomy was identified at the species level by comparative sequence analysis of 16S ribosomal DNA (rDNA) and the hypervariable alpha-region of the 16S rDNA....

  2. Surgical intervention and capsular contracture after breast augmentation

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R;

    2005-01-01

    Epidemiologic data on local complications after breast augmentation are scarce. In particular, few prospectively collected data are available on modern breast implants on this issue. Using data from the Danish Registry for Plastic Surgery of the Breast, the authors examined determinants of surgery......-requiring complications and capsular contracture grades III to IV among 2277 women who underwent cosmetic breast implantation from June 1999 through April 2003. During an average follow-up period of 1.6 years after implantation, 4.3% of these women (3% of implants) required secondary surgery as a result of short...... surgical practices and modern implants used for breast augmentation produce fewer short-term complications than procedures and devices of the past. This prospective study indicates that surgical procedures are more important predictors for local (short-term) complications than implant or patient...

  3. Induction of apoptosis and oxidative stress in estrogen receptor-negative breast cancer, MDA-MB231 cells, by ethanolic mango seed extract

    OpenAIRE

    Abdullah, Al-Shwyeh Hussah; Mohammed, Abdulkarim Sabo; Rasedee, Abdullah; Mirghani, Mohamed Elwathig Saeed; Al-Qubaisi, Mothanna Sadiq

    2015-01-01

    Background In this study, the effect of mango kernel extract in the induction of apoptosis of the breast cancer (MDA-MB-231) cell line was examined. This is an attempt to discover alternatives to current therapeutic regimes in the treatment of breast cancers. Methods The pro-apoptotic markers, Bax, cytochrome c, caspases-. -8 and −9, and anti-apoptotic markers, Bcl-2, p53 and glutathione were determined in MDA-MB231 cells treated for 12 and 24 h with mango kernel extract. Results The results ...

  4. Sterile Acellular Dermal Collagen as a Treatment for Rippling Deformity of Breast

    OpenAIRE

    Brittany Busse; Hakan Orbay; Sahar, David E.

    2014-01-01

    Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal...

  5. Un nuevo tratamiento de la prótesis de mama expuesta A new way to treat the exposed breast implant

    Directory of Open Access Journals (Sweden)

    P. Benito Duque

    2011-03-01

    Full Text Available Presentamos el caso de una paciente tratada mediante mastectomía subcutánea bilateral y sometida a reconstrucción mediante la implantación de prótesis mamarias subpectorales. A los 15 días de la intervención, la paciente se presentó con una prótesis expuesta. Fue posible cubrirla mediante cierre directo con los tejidos locales, y en el espacio de implantación de la prótesis, colocamos una lámina de colágeno reabsorbible con gentamicina. No hemos encontrado descrita la utilización de estas láminas en el manejo de prótesis o expansores mamarios expuestos o infectados. La aplicación local de estas láminas permite concentraciones locales elevadas de antibiótico que pueden ser eficaces sobre bacterias habitualmente resistentes, al tiempo que permiten una administración del antibiótico sin molestias para la paciente.We report the case of a patient who underwent a bilateral subcutaneous mastectomy and was reconstructed with mammary implants. Fifteen days after surgery, the patient presented an implant exposition. It was possible to close the wound with local tissues, and placing a gentamicin-collagen sponge in the same pocket of the implant. We have found no references concerning the use of absorbable gentamicin-collagen sponges for the management of implants or expanders when they have become exposed or infected. The local application of gentamicincollagen sponge affords elevated regional concentrations of antibiotic that may act on bacteria usually considered to be resistant with less discomfort for the patient.

  6. Combination of acellular allogenic dermis with silicone prosthesis implant to correct secondary deformities of the breast after operation%脱细胞异体真皮联合硅凝胶假体植入矫正乳房术后继发畸形

    Institute of Scientific and Technical Information of China (English)

    白明; 曾昂; 张海林; 赵茹; 刘志飞; 王智; 龙笑; 崔雅宁; 乔群

    2011-01-01

    Objective To evaluate the early clinical outcome and efficacy of combination of acellular allogenic dermal matrix with silicone gel implant to correct secondary deformities following removal of polyacrylamide hydrogel ( PAHG) for breast augmentation.Methods A total of 10 patients (20 breasts) who had had breast augmentation by PAHG injection were admitted in our hospital from January 2008 to May 2010. The injected PAHG was removed. then the silicone gel implant was placed for breast reconstruction . the acellular allogenic dermal matrix was inserted to replenish the insufficient pectoralis major muscle and mammary tissue, and the inframammary fold was created by encapsulation of the lower third of the implant. Results The follow-up of 12 months showed all the 10 patients were satisfied with the breast appearance and no infection. seroma. implant malposition or other complications happened. Conclusions Acellular allogenic dermal matrix combined with silicone gel implant can avoid severe breast deformity from removal of injected PAHG. Ideal outcome can be achieved with stringent adherence to the indications for this procedure.%目的 探讨利用脱细胞异体真皮联合硅凝胶假体植入矫正乳房因聚丙烯酰胺水凝胶取出术造成的继发畸形,并对其早期临床效果做出评价.方法 2008年1月至2010年5月期间,共有10例注射式隆乳术后患者在本院进行了脱细胞异体真皮联合硅凝胶假体植入术.脱细胞异体真皮被用于修补和填充胸大肌及乳腺腺体组织缺损,包裹硅凝胶假体的下1/3,以重建乳房下皱襞.结果 术后随访12个月,乳房外形满意,无感染、积液等并发症.结论 应用脱细胞异体真皮联合硅凝胶假体植入可避免取出乳房内聚丙烯酰胺水凝胶后造成的严重乳房畸形.在严格把握适应证的前提下,可以取得较好的临床效果.

  7. Analysis of the National Surgical Quality Improvement Program Database in 19,100 Patients Undergoing Implant-Based Breast Reconstruction: Complication Rates With Acellular Dermal Matrix

    OpenAIRE

    Shuster, Marina

    2015-01-01

    Background: The use of acellular dermal matrices has become increasingly popular in immediate and delayed tissue expander/implant–based breast reconstruction. However, it is unclear whether their use is associated with increased postoperative complication rates. Using the American College of Surgeons National Surgical Quality Improvement Program database, the authors assessed baseline differences in demographics and comorbidities with and without acellular dermal matrix and determined whether...

  8. Ectopic bone formation in bone marrow stem cell seeded calcium phosphate scaffolds as compared to autograft and (cell seeded allograft

    Directory of Open Access Journals (Sweden)

    J O Eniwumide

    2007-08-01

    Full Text Available Improvements to current therapeutic strategies are needed for the treatment of skeletal defects. Bone tissue engineering offers potential advantages to these strategies. In this study, ectopic bone formation in a range of scaffolds was assessed. Vital autograft and devitalised allograft served as controls and the experimental groups comprised autologous bone marrow derived stem cell seeded allograft, biphasic calcium phosphate (BCP and tricalcium phosphate (TCP, respectively. All implants were implanted in the back muscle of adult Dutch milk goats for 12 weeks. Micro-computed tomography (µCT analysis and histomorphometry was performed to evaluate and quantify ectopic bone formation. In good agreement, both µCT and histomorphometric analysis demonstrated a significant increase in bone formation by cell-seeded calcium phosphate scaffolds as compared to the autograft, allograft and cell-seeded allograft implants. An extensive resorption of the autograft, allograft and cell-seeded allograft implants was observed by histology and confirmed by histomorphometry. Cell-seeded TCP implants also showed distinct signs of degradation with histomorphometry and µCT, while the degradation of the cell-seeded BCP implants was negligible. These results indicate that cell-seeded calcium phosphate scaffolds are superior to autograft, allograft or cell-seeded allograft in terms of bone formation at ectopic implantation sites. In addition, the usefulness of µCT for the efficient and non-destructive analysis of mineralised bone and calcium phosphate scaffold was demonstrated.

  9. 乳腺癌保留皮肤改良根治并即刻假体再造与传统改良根治术的疗效比较%Comparison of therapeutic effects of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy on breast cancer

    Institute of Scientific and Technical Information of China (English)

    全红; 李杰; 刘军; 李发成; 蒋宏传

    2011-01-01

    Objective To compare the therapy efficiency of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy in breast cancer. Methods The data of 530 female patients with early of stage 0 to Ⅲ a breast cancer was retrospectively analyzed, from January 2004 to Decembet 2008. Among the patients,91 patients operated with skin sparing mastectomy and immediate implanting breast reconstruction ( Group of immediate implanting reconstruction), and 439 patients were with modified radical mastectomy (Group of modified radical mastectomy ). By comparing complications, local recurrence, distant metastases and mortality rates between the two groups, the research was done to evaluate the therapy efficiency. Results In the group of immediate implanting reconstruction,84 patients completed follow-up with the median follow-up time of 35 months ( 14-72 months) while the local recurring rate was 2. 4%, distant metastasis rate was 8. 3% and mortality rate was 6. 0%. In the group of modified radical mastectomy, 398 patients completed follow-up with the median follow-up time of 36 months ( 12-74 months) while the local recurring rate was 3.3%, distant metastasis rate was 9. 5% and mortality rate was 6. 5%. Therefore there was no obvious statistic difference between the two groups in local recurring rate, distant metastasis rate and mortality rate (P > 0. 05 ). Evaluation of aesthetic results was done in the 84 patients after immediate implanting reconstruction for 12 months which was 93% as good or excellent by surgeons while 87% by patients. Surgeons and patients were both satisfied with the breast appearance. Conclusions For patients with early stage breast cancer, combining standard postoperative therapy, skin sparing mastectomy and immediate implanting reconstruction could achieve the same effect as the traditional modified radical mastectomy, while reconstruction would bring about better appearance and higher quality of life.%目的

  10. Breast reconstruction with an expander prosthesis following mastectomy does not cause additional persistent pain

    DEFF Research Database (Denmark)

    Klit, Anders; Mejdahl, Mathias Kvist; Gärtner, Rune;

    2013-01-01

    Few studies have examined the prevalence of persistent pain after breast reconstruction with an implant after tissue expansion in comparison to mastectomy without breast reconstruction. Our primary objective was to evaluate the prevalence of persistent pain after breast reconstruction...... with a subpectoral implant after tissue expansion in a population-based study. Secondary objectives were to evaluate sensory disturbances, lymphoedema and functional impairment....

  11. ALK1-Negative Anaplastic Large Cell Lymphoma of the Breast from a Nonprosthesis Cyst

    Directory of Open Access Journals (Sweden)

    Christopher Mulligan, MBBS

    2014-10-01

    Full Text Available Summary: Anaplastic large cell lymphoma of the breast is a rare malignancy associated with prosthetic breast implants. We present a case of a woman with no prior history of breast implants who developed anaplastic lymphoma kinase-1 negative anaplastic large cell lymphoma on a background of a previous benign cyst aspiration.

  12. Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

    International Nuclear Information System (INIS)

    The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds. We reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration. A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration. We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90

  13. Recombinant AAV-mediated HSVtk gene transfer with direct intratumoral injections and Tet-On regulation for implanted human breast cancer

    International Nuclear Information System (INIS)

    HSVtk/ganciclovir (GCV) gene therapy has been extensively studied in tumors and relies largely on the gene expression of HSVtk. Most studies, however, have failed to demonstrate any significant benefit of a controlled gene expression strategy in cancer treatment. The Tet-On system is commonly used to regulate gene expression following Dox induction. We have evaluated the antitumor effect of HSVtk/ganciclovir gene therapy under Tet-On regulation by means of adeno-associated virus-2 (AAV-2)-mediated HSVtk gene transfer with direct intratumoral injections in mice bearing breast cancer tumors. Recombinant adeno-associated virus-2 (rAAV) was constructed and transduced into MCF-7 cell line. GCV treatment to the rAAV infected MCF-7 cells was performed by MTT assay under the doxycycline (Dox) induction or without Dox induction at a vp (viral particle) number of ≥104 /cell. The virus was administered intratumorally to nude mice that had also received GCV intraperitoneally. The antitumor effects were evaluated by measuring tumor regression and histological analysis. We have demonstrated that GCV treatment to the infected MCF-7 cells under the Dox induction was of more inhibited effects than those without Dox induction at ≥104 vp/cell. In ex vivo experiments, tumor growth of BALB/C nude mice breast cancer was retarded after rAAV-2/HSVtk/Tet-On was injected into the tumors under the Dox induction. Infiltrating cells were also observed in tumors after Dox induction followed by GCV treatment and cells were profoundly damaged. The expression of HSVtk gene in MCF-7 cells and BALB/C nude mice tumors was up-regulated by Tet-On under Dox induction with reverse transcription-PCR (RT-PCR) analysis. The antitumor effect of rAAV-mediated HSVtk/GCV gene therapy under the Dox induction with direct intratumoral injections may be a useful treatment for breast cancer and other solid tumors

  14. A new rat model of bone cancer pain produced by rat breast cancer cells implantation of the shaft of femur at the third trochanter level

    OpenAIRE

    GUI, QI; Chengcheng XU; Liang ZHUANG; Xia, Shu; Chen, Yu; Peng, Ping; Shiying YU

    2013-01-01

    Bone cancer pain remains one of the most challenging cancer pains to fully control. In order to clarify bone cancer pain mechanisms and examine treatments, animal models mimicking the human condition are required. In our model of Walker 256 tumor cells implantation of the shaft of femur at the third trochanter level, the anatomical structure is relatively simple and the drilled hole is vertical and in the cortical bone only 1–2 mm in depth without injury of the distal femur. Pain behaviors an...

  15. Iodine-125 seeds for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Rostelato, Maria E.C.M.; Zeituni, Carlos A.; Feher, Anselmo; Moura, Joao A.; Moura, Eduardo S.; Nagatomi, Helio R.; Manzoli, Jose E.; Souza, Carla D., E-mail: elisaros@ipen.b, E-mail: czeituni@pobox.co, E-mail: afeher@ipen.b, E-mail: jmoura31@yahoo.com.b, E-mail: esmoura@ipen.b, E-mail: hrnagato@ipen.b, E-mail: jemanzoli@ipen.b, E-mail: cdsouza@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Karam, Dib, E-mail: dib.karan@usp.b [Universidade de Sao Paulo (USP), SP (Brazil). Escola de Artes, Ciencias e Humanidades

    2009-07-01

    In Brazil, cancer has become one of the major public health problems. An estimate by the Health Ministry showed that 466,430 people had the disease in the country in 2008. The prostate cancer is the second largest death cause among men. The National Institute of Cancer estimated the occurrence of 50,000 new cases for 2009. Some of these patients are treated with Brachytherapy, using Iodine-125 seeds. By this technique, small seeds with Iodine-125, a radioactive material, are implanted in the prostate. The advantages of radioactive seed implants are the preservation of healthy tissues and organs near the prostate, besides the low rate of impotence and urinary incontinence. The Energy and Nuclear Research Institute - IPEN, which belongs to the Nuclear Energy National Commission - CNEN, established a program for the development of the technique and production of Iodine-125 seeds in Brazil. The estimate for the 125-Iodine seeds demand is of 8,000 seeds/month and the laboratory to be implanted will need this production capacity. The purpose of this paper is to explain the project status and show some data about the seeds used in the country. The project will be divided in two phases: technological development of a prototype and a laboratory implementation for the seeds production. (author)

  16. Seed proteomics

    Science.gov (United States)

    Seeds comprise a protective covering, a small embryonic plant, and a nutrient-storage organ. Seeds are protein-rich, and have been the subject of many mass spectrometry-based analyses. Seed storage proteins (SSP), which are transient depots for reduced nitrogen, have been studied for decades by cel...

  17. 硅胶假体置入及注射丰胸患者全数字化乳腺X射线摄影技术探讨%Discussion on full-field digital mammography technique in patients with silicone prosthesis implantation and injection breast augmentation

    Institute of Scientific and Technical Information of China (English)

    徐炜伟; 付丽媛; 董丽锋; 黄淑贞; 钟群; 杨熙章; 陈自谦

    2015-01-01

    目的:探讨硅胶假体置入及注射丰胸患者全数字化乳腺X射线摄影技术与方法。方法硅胶假体置入患者32例,女性,年龄25~49岁,平均年龄37.94岁。注射丰胸患者21例,女性,年龄30~45岁,平均年龄39.38岁。400例正常乳腺患者作为对照,女性,年龄18~72岁,平均年龄43.58岁。收集数字化乳腺X射线影像资料,对图像质量进行分析,并归纳总结其摄影参数。结果3组乳腺摄影图像甲级片率分别为84.38%、85.71%及91.00%。假体置入和注射丰胸摄影参数采用的kV值与正常乳腺摄影基本接近,但要得到与正常乳腺摄影相当的影像质量,需要加大mAs。在相同的压迫厚度下,假体置入与注射丰胸患者摄影mAs约是正常患者的2~3倍。结论掌握假体置入及注射丰胸患者乳腺X射线摄影的方法、技术及摄影参数能够获得高质量的影像,为正确诊断提供可靠的影像学依据。%Objective To investigate the full-field digital mammography technique and method in patients with silicone prosthesis implantation and injection breast augmentation. Methods A total of 32 patients (females) with silicone prosthesis implantation were enrolled, which aged 25-49 years old with mean age of 37.94 years old. Twenty-one patients(females) were performed by injection breast augmentation, which aged 30-45 years old with age of 39.38 years old. The 400 patients(females) with normal breast were set as control, which aged 18-72 years old with mean age of 43.58 years old. Retrospective analysis of full-field digital mammography breast data of all patients was collected and image quality was analyzed. The mammography parameters were summarized. Results The image quality ratios of class A were 84.38 %, 85.71 % and 91.00 % in silicone prosthesis implantation group, injection breast augmentation group and normal group respectively. The mammography parameter of kV in patients with

  18. Mutation breeding by ion implantation

    Science.gov (United States)

    Yu, Zengliang; Deng, Jianguo; He, Jianjun; Huo, Yuping; Wu, Yuejin; Wang, Xuedong; Lui, Guifu

    1991-07-01

    Ion implantation as a new mutagenic method has been used in the rice breeding program since 1986, and for mutation breeding of other crops later. It has been shown, in principle and in practice, that this method has many outstanding advantages: lower damage rate; higher mutation rate and wider mutational spectrum. Many new lines of rice with higher yield rate; broader disease resistance; shorter growing period but higher quality have been bred from ion beam induced mutants. Some of these lines have been utilized for the intersubspecies hybridization. Several new lines of cotton, wheat and other crops are now in breeding. Some biophysical effects of ion implantation for crop seeds have been studied.

  19. 术后即刻硅胶假体乳房再造在保留乳头乳晕的乳腺癌改良根治术中的应用%Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipplesparing mastectomy

    Institute of Scientific and Technical Information of China (English)

    杜稼苓; 王颖; 路选; 孙鹤庆

    2011-01-01

    目的 探讨术后即刻胸大肌包裹硅胶假体行乳房再造在早期乳腺癌保留乳头乳晕的改良根治术中应用的可行性.方法 自2006年1月至2009年11月,扬州市第一人民医院对28例早期乳腺癌行保留乳头乳晕改良根治术后即刻采用胸大肌包裹硅胶假体的乳房再造,观察术后并发症及患者满意度.结果 术后随访13~58个月,出现假体渗漏1例,乳头感觉减退2例,包膜挛缩1例,骨转移1例,28例均存活.27例对术后乳房外形满意,满意率96.43%.结论 保留乳头乳晕的乳腺癌改良根治术后即刻硅胶乳房假体再造,在保证肿瘤治疗的前提下,同时满足了患者对保持乳房外形美观的要求.手术简便、创伤小、恢复快,在术后并发症、局部复发率及死亡率等方面与单纯乳腺癌手术相比并无差异.%Objective To investigate the feasibility of immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy in early stage breast cancer.Methods From Jan.2006 to Nov.2009,28 breast cancer patients underwent immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy.Results Among the 28 patients,27 were satisfied with the apperance of their breast after operation.Conclusions Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy not only ensures the curative effects but also beautifies the apperance of the breast.The operation has the advantages of simplity,less trauma and quick recovery.There is no difference compared with mastectomy in terms of complication,recurrence rate and mortality etc.

  20. A comparison of postimplant dosimetry for {sup 103}Pd versus {sup 131}Cs seeds on a retrospective series of PBSI patients

    Energy Technology Data Exchange (ETDEWEB)

    Ravi, Ananth; Keller, Brian M.; Pignol, Jean-Philippe [Department of Medical Physics, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada); Departments of Medical Physics and Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada)

    2011-11-15

    Purpose: Permanent breast seed implantation (PBSI) is an accelerated partial breast irradiation technique performed using stranded {sup 103}Pd radioactive seeds (average energy of 21 keV, 16.97 day half-life). Since 2004, {sup 131}Cs brachytherapy sources have become clinically available. The {sup 131}Cs radionuclide has a higher energy (average energy of 30 keV) and a shorter half-life (9.7 days) than {sup 103}Pd. The purpose of this study was to determine whether or not there are dosimetric benefits to using {sup 131}Cs brachytherapy seeds for PBSI. Methods: The prescribed dose for PBSI using {sup 103}Pd is 90 Gy, which was adjusted for {sup 131}Cs implants to account for the shorter half-life. A retrospective cohort of 30 patients, who have already undergone a {sup 103}Pd implant, was used for this study. The treatments were planned using the Variseed treatment planning system. The air kerma strength of the {sup 131}Cs seeds was adjusted in all preimplantation treatment plans so that the V{sub 100} (the volume within the target that receives 100% or more of the prescribed dose) were equivalent at time of implantation. Two month follow-up CT scans were available for all 30 patients and each patient was reevaluated using {sup 131}Cs seeds. The postimplant dosimetric parameters were compared using a two tailed t-test. Results: The prescribed dose for {sup 131}Cs was calculated to be 77 Gy; this dose would have the same biological effect as a PBSI implant with {sup 103}Pd of 90 Gy. The activities of the {sup 131}Cs sources were adjusted to an average of 2.2 {+-} 0.8 U for {sup 131}Cs compared to 2.5 {+-} 1.1 U for {sup 103}Pd in order to get an equivalent V{sub 100} as the {sup 103}Pd preimplants. While the use of {sup 131}Cs significantly reduces the preimplant V{sub 200} (the volume within the target that receives 200% or more of the prescribed dose) compared to {sup 103}Pd by 13.5 {+-} 9.0%, the reduction observed on the 2 month postimplant plan was 12.4 {+-} 5

  1. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  2. Seed quality in informal seed systems

    OpenAIRE

    Biemond, P.C.

    2013-01-01

    Keywords:     informal seed systems, seed recycling, seed quality, germination, seed pathology, seed health, seed-borne diseases, mycotoxigenic fungi, Fusarium verticillioides, mycotoxins, Vigna unguiculata, Zea mays, Nigeria.   Seed is a crucial input for agricultural production. Approximately 80% of the smallholder farmers in Africa depend for their seed on the informal seed system, consisting of farmers involved in selection, production and dissemination of seed. The la...

  3. Breast reconstruction - methods and imaging; Brustaugmentation - Methoden und Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Pfleiderer, B.; Weigel, S.; Hurtienne, B.; Heindel, W. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie

    2007-12-15

    Silicon implants are used for breast reconstruction or for cosmetic operations. The contribution outlines the role of mammography, sonography and MR for defect assessment, tumour detection and monitoring after prosthesis implantation. Instrument adjustment for mammographic screening of patients with implants is gone into. Autologic reconstruction techniques and protocols of secondary and tertiary early detection are presented. (orig.)

  4. Dual-Energy CT for Evaluation of Intra- and Extracapsular Silicone Implant Rupture

    Directory of Open Access Journals (Sweden)

    Katrina N. Glazebrook

    2016-01-01

    Full Text Available Silicone implants are commonly used for both breast augmentation and breast reconstruction. With aging of the implant, the silicone envelope may become weak or may rupture. The technique of choice for evaluation of implant integrity is breast MRI; however this may be contraindicated in some patients or the cost may be prohibitive. Dual-energy CT allows determination of density and atomic number of tissue and can provide material composition information. We present a case of extracapsular implant rupture with MRI and dual-energy CT imaging and surgical correlation.

  5. X线钼靶、高频超声及MRI对硅胶假体隆乳术后破裂的诊断价值%The Diagnosis of Mammography, High-frequency Ultrasound and MRI in Silicone Breast Implant Rupture

    Institute of Scientific and Technical Information of China (English)

    杜牧; 曹满瑞; 谢肇峰; 刘涛

    2014-01-01

    目的:探讨X线钼靶、高频超声及MRI对硅胶假体隆乳术后破裂的诊断价值。方法对28例56只乳腺硅胶假体隆乳术后患者的X线钼靶、高频超声及MRI资料进行回顾性研究,分析其影像表现及对假体囊内破裂及囊外破裂的诊断价值。结果 X线不能完整显示假体(0%),高频超声及MRI都能够完整显示假体(均为100%);对囊外破裂,X线钼靶、高频超声及MRI都能显示(均为7.1%,4/56); X线不能显示囊内破裂(0%), MRI(32.1%,18/56)对囊内破裂的检出率高于超声(21.4%,12/56)(P=0.031)。结论对硅胶假体破裂的诊断,X线钼靶并不是令人满意的方法,超声是经济高效的检查方法,而MRI是最理想的检查方法,如经济允许,MRI可列为首选。%Objective To investigate the diagnostic value of mammography, high-frequency ultrasound and MRI in silicone breast implant rupture. Methods 28 cases with 56 breasts were included in this study, and the mammography, high-frequency ultrasound and MRI findings and its diagnostic value for silicone breast implant rupture were analyzed. Results The mammography can't show the integrity of the silicone breast implant(0%,0/56), and ultrasound and MRI can show it(100%,56/56). Both mammography, ultrasound and MRI can diagnose extracapsular rupture(7.1%,4/56). Mammography can't detect intracapsular rupture (0%,0/56),and MRI(32.1%,18/56)is better than ultrasound(21.4%,12/56)in detection of intracapsular rupture(P=0.031). Conclusion In detecting silicone breast implant rupture, mammography is a satisfied way, ultrasound is an economic and efficient way, and MRI is the most ideal way and it should be the first choice if the economy allowed.

  6. Incidence and severity of short-term complications after breast augmentation

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Hölmich, Lisbet R; Fryzek, Jon P;

    2003-01-01

    The frequency and severity of local complications remain the primary safety issues with silicone breast implants. The Danish Registry for Plastic Surgery of the Breast (DPB), established in 1999, prospectively collects pre-, peri- and postoperative information regarding Danish women undergoing...

  7. 解剖型假体隆乳治疗重度乳腺发育不良%Treatment of severe mammary dysplasia by anatomic implants breast augmentation

    Institute of Scientific and Technical Information of China (English)

    李健; 贾亮亮

    2012-01-01

    Objective To evaluate the methods and results of breast augmentation with anatomic prosthesis on the treatment of severe mammary dysplasia. Methods Through axillary or areolae incision, 19 cases with severe mammary dysplasia were treated by augmentation mammoplasty with anatomic prosthesis under pec-toralis major muscle. The size, prominence, height of the anatomic prosthesis were chosen, based on data of height, chest circumference, distances of SN-N, N-N, A-IMF and individual requirements. The postoperative results were evaluated according to postoperative patients' satisfaction. Results All patients were satisfied with the dropwise-shaped breast and upward nipple. Conclusion Augmentation mammoplasty with anatomic prosthesis under pectoralis major muscle is an ideal choice for patients with severe mammary dysplasia.%目的 探讨应用解剖型假体隆乳治疗重度乳腺发育不良的方法 及效果.方法 经乳晕切口或腋窝切口,对19例重度乳腺发育不良者应用解剖型假体行胸大肌下隆乳术,依据身高、胸围、胸骨上切迹-乳头(SN-N)间距离、乳头- 乳头(N-N)间距离、乳晕-乳房下皱襞(A-IMF)间距离等测量参数,并结合求美者的要求选择假体体积、突度、高度,术后根据求美者满意度判断手术治疗效果.结果 所有求美者获随访6个月至4年,19例重度乳腺发育不良者术后乳房呈现水滴状,乳头上翘,形态逼真,求美者均满意.结论 应用解剖型假体行胸大肌下隆乳术,是治疗乳腺组织发育不良者较理想的选择.

  8. A tissue-engineered humanized xenograft model of human breast cancer metastasis to bone

    Directory of Open Access Journals (Sweden)

    Laure Thibaudeau

    2014-02-01

    Full Text Available The skeleton is a preferred homing site for breast cancer metastasis. To date, treatment options for patients with bone metastases are mostly palliative and the disease is still incurable. Indeed, key mechanisms involved in breast cancer osteotropism are still only partially understood due to the lack of suitable animal models to mimic metastasis of human tumor cells to a human bone microenvironment. In the presented study, we investigate the use of a human tissue-engineered bone construct to develop a humanized xenograft model of breast cancer-induced bone metastasis in a murine host. Primary human osteoblastic cell-seeded melt electrospun scaffolds in combination with recombinant human bone morphogenetic protein 7 were implanted subcutaneously in non-obese diabetic/severe combined immunodeficient mice. The tissue-engineered constructs led to the formation of a morphologically intact ‘organ’ bone incorporating a high amount of mineralized tissue, live osteocytes and bone marrow spaces. The newly formed bone was largely humanized, as indicated by the incorporation of human bone cells and human-derived matrix proteins. After intracardiac injection, the dissemination of luciferase-expressing human breast cancer cell lines to the humanized bone ossicles was detected by bioluminescent imaging. Histological analysis revealed the presence of metastases with clear osteolysis in the newly formed bone. Thus, human tissue-engineered bone constructs can be applied efficiently as a target tissue for human breast cancer cells injected into the blood circulation and replicate the osteolytic phenotype associated with breast cancer-induced bone lesions. In conclusion, we have developed an appropriate model for investigation of species-specific mechanisms of human breast cancer-related bone metastasis in vivo.

  9. Cochlear Implants

    Science.gov (United States)

    ... on this topic can be found in our Audiology Information Series [PDF]. How does a cochlear implant ... speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. ...

  10. What Is Breast Cancer?

    Science.gov (United States)

    ... Next Topic Types of breast cancers What is breast cancer? Breast cancer starts when cells in the breast ... breast cancer? ” and Non-cancerous Breast Conditions . How Breast Cancer Spreads Breast cancer can spread through the lymph ...

  11. Iodine-125 thin seeds decrease prostate swelling during transperineal interstitial permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Prostate swelling following seed implantation is a well-recognised phenomenon. The purpose of this intervention was to assess whether using thinner seeds reduces post-implant swelling with permanent prostate brachytherapy. Eighteen consecutive patients eligible for prostate seed brachytherapy underwent seed implantation using iodine-125 (I-125) thin seeds. Operative time, dosimetry, prostate swelling and toxicity were assessed and compared with standard I-125 stranded seed controls, sourced from the department's brachytherapy database. A learning curve was noted with the thin seeds in terms of greater bending and deviation of needles from their intended path. This translated into significantly longer total operative time (88 vs 103 minutes; P=0.009, 95% confidence interval (CI) 4.1-24.3) and time per needle insertion (2.6 vs 3.7 minutes; P<0.001, 95% CI 0.5-1.3) for the thin seeds. Day 30 prostate volumes were significantly smaller in the thin seed group compared with standard seeds (40.9cc vs 46.8cc; P=0.001, 95% CI 1.5-5.6). The ratio of preoperative transrectal ultrasound to day 30 post-implant CT volume was also smaller in the thin seed group (1.2±0.1 for standard seeds vs 1.1±0.1 for thin seeds). Post-implant dosimetric parameters were comparable for both groups. No significant differences were seen in acute urinary morbidity or quality of life between the two groups. I-125 thin seeds are associated with an initial learning curve, with longer operative time, even for experienced brachytherapists. The significant reduction in day 30 prostate volumes with the thin seeds has useful implications in terms of optimising dose coverage to the prostate in the early period post-implantation, as well as improving the accuracy of post-implant dosimetric assessments.

  12. Study on factors influencing survival in patients with radioactive 125Ⅰ seeds implantation combined with surgery therapy on advanced esophageal squamous cell carcinoma by COX model%COX模型对术中125Ⅰ粒子植入治疗中晚期食管鳞癌预后因素的分析

    Institute of Scientific and Technical Information of China (English)

    李义生; 周国志

    2012-01-01

    Objective: To evaluate the safety, efficacy, survival rate and the factors influencing survival in united intraoperative 125I seed implantation in the treatment of advanced esophageal squamous cell carcinoma. Methods: The clinical data were collected from 100 cases of surgical treatment of combined Ⅰ seed implantation in patients with esophageal squamous cell carcinoma (based on preoperative CT staging: Ⅱ -Ⅲ phase) between 2001 -2006 in our hospital, excluding 5 patients performed on palliative resection and bypass surgery, the final 95 patients with e-sophageal cancer radical resection combined with I seed implantation, and their data were analysized. Patients were developed based on TPS dose, surgery under direct vision interstitial implantation of 125I seeds; using 0. 3 -0. 7mCi 10 -40 I25I seeds, total activity in the 7 -28mCi, matching peripheral tumor dose40 -80Gy. The factors influencing postoperative survival in patients were analysized by univariate and multivariate analysis. Results: On the close date of June 30,2011, 95 patients all had been followed up, the survival was observed in 40 patients. The satisfied quality assessment of I seeds was observed. There were no surgery or seeds implantation -related deaths, the local recur-rence rate was 11. 6% and the distant metastasis rate was 41. 1 % . The 1 - year, 3 - year and 5 - year overall surviv-al rates were 90. 5% , 58. 9% and 42. 1% , respectively. The median survival was 38 months (95% CI; 25 -51 months). Univariate survival analysis showed that the factors influencing long - term survival included the age group (P =0.0006) , tumor location (P =0.0013), preoperative CT staging (P =0.0003), particle activity (P = 0. 0026) , tumor matched peripheral dose (P = 0. 0021 ) and pathological stage (P =0. 0001) . Then the prognostic factors including particle activity (P =0. 017) and tumor matched peripheral dose (P = 0. 000) and pathological stage (P =0. 0000) were shown by COX regression analysis

  13. Transaxillary endoscopic silicone gel breast augmentation.

    Science.gov (United States)

    Strock, Louis L

    2010-09-01

    Following the return of silicone gel breast implants to the US market in 2006, augmentation with these implants has become increasingly popular. Surgeons have an array of refined techniques from which to choose when performing these procedures, many of which offer the advantage of reduced or less-obvious postoperative scarring. For obvious reasons, many patients are requesting placement of the implants through incisions that are removed from the breast area (and thereby hidden). The challenge of these approaches is to provide a level of technical control that matches what is afforded with the traditional inframammary approach. The addition of endoscopic assistance has provided a level of tissue visualization and technical control not previously possible with the transaxillary approach, with results that rival those of an inframammary procedure. In this article, the author presents his current operative technique, which has allowed for the routine placement of silicone gel breast implants through a transaxillary incision using endoscopic assistance.

  14. Growth Inhibition of Breast Cancer in Rat by AAV Mediated Angiostatin Gene

    Institute of Scientific and Technical Information of China (English)

    LI Ran; CHEN Hong; REN Chang-shan

    2007-01-01

    Objective: To observe growth inhibition effect of adeno-associated viral vectors (AAV) mediated angiostatin (ANG) gene on implanted breast cancer in rat and its mechanism. Methods: Gene transfer technique was used to transfer AAV-ANG to the tumor. Growth curves were drawn to observe the growth of breast cancer implanted in rat, and immunohistochemical method was used to detect the effects of angiostatin on microvesel density (MVD) of breast cancer implanted in rat. Results: Angiostatin inhibited the growth of breast cancer implanted in rat and decreased the microvessel density of tumor. Conclusion: Expression of an angiostatin transgene can suppress the growth of breast cancer implanted in rat through the inhibition of the growth of microvessels, surggesting that angiostatin gene transfer technique may be effective against breast cancer.

  15. Transperineal percutaneous I-125 implant of prostate

    International Nuclear Information System (INIS)

    Although iodine-125 seeds for interstitial radiation of prostatic cancer via the retropubic route is an established method of treatment, the retropubic implant technique has disadvantages: inadequate space for proper placement of the needles, possible bleeding from the prostatic venous plexus by the insertion of needles through these veins, and possible wound infection due to inadvertent puncturing of the bladder and/or rectum by the needles. A technique is described whereby Iodine-125 seeds for interstitial radiation are placed into the prostate through the perineum allowing more accurate placement of the seeds, assuring homogenous dose distribution, and decreasing the risk of bleeding and of bacterial contamination

  16. Transperineal percutaneous I-125 implant of prostate

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, P.P.; Bartone, F.F.

    1981-03-01

    Although iodine-125 seeds for interstitial radiation of prostatic cancer via the retropubic route is an established method of treatment, the retropubic implant technique has disadvantages: inadequate space for proper placement of the needles, possible bleeding from the prostatic venous plexus by the insertion of needles through these veins, and possible wound infection due to inadvertent puncturing of the bladder and/or rectum by the needles. A technique is described whereby Iodine-125 seeds for interstitial radiation are placed into the prostate through the perineum allowing more accurate placement of the seeds, assuring homogenous dose distribution, and decreasing the risk of bleeding and of bacterial contamination.

  17. Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery

    OpenAIRE

    Macadam, Sheina A; Lennox, Peter A

    2012-01-01

    Acellular dermal matrices (ADMs) were first described for use in breast surgery in 2001. Since this initial report, ADMs have become an increasingly common component of implant-based breast procedures. ADMs have shown promise for use in both aesthetic and reconstructive breast surgery; however, concerns about their use remain because of the significant costs associated with these products. The present article reviews the history of ADM use in breast surgery and the outcomes reported to date. ...

  18. Inhibitory effect of isoamericanol A from Jatropha curcas seeds on the growth of MCF-7 human breast cancer cell line by G2/M cell cycle arrest.

    Science.gov (United States)

    Katagi, Ayako; Sui, Li; Kamitori, Kazuyo; Suzuki, Toshisada; Katayama, Takeshi; Hossain, Akram; Noguchi, Chisato; Dong, Youyi; Yamaguchi, Fuminori; Tokuda, Masaaki

    2016-01-01

    Although various parts of J. curcas (Jatropha curcas L., Euphorbiaceae) have long been used as traditional folk medicines for their antiviral, analgesic, and/or antidotal efficacies, we are the first to investigate the role of anti-carcinogenicity of isoamericanol A (IAA) from the seed extract. Our results showed that IAA is capable of inhibiting cell proliferation in a dose-dependent manner on the human cancer cell lines of MCF-7, MDA-MB231, HuH-7, and HeLa. Flow cytometry analysis showed IAA significantly induces cell cycle arrest at G2/M on MCF-7 cells. At both protein and mRNA levels examined by western blot and real-time PCR, the results revealed increased expression of BTG2 (B-cell translocation gene 2), p21 (p21(WAF1/CIPI) ), and GADD45A (growth arrest and DNA-damage-inducible, alpha) after IAA treatment, but inversed expression in CDK1 (cyclin-dependent kinase 1) and cyclins B1 and B2. All these effects contribute to G2/M cell cycle arrest. Furthermore, these results coincide with the changes in molecular expressions determined by DNA-microarray analysis. Our findings indicate that IAA has an inhibitory effect on cell proliferation of MCF-7 through cell cycle arrest, giving it great potential as a future therapeutic reagent for cancers. PMID:27441238

  19. Nipple-areola complex sparing mastectomy with immediate breast reconstruction using subpectoral prosthesis implantation%保留乳头乳晕复合体乳腺癌根治即刻胸大肌包裹假体植入乳房重建

    Institute of Scientific and Technical Information of China (English)

    任敏; 汪英; 王本忠; 王劲; 裴静; 徐晓军; 颜蕴文

    2010-01-01

    目的 探讨保留乳头乳晕复合体(NAC)的乳腺癌改良根治术即刻胸大肌包裹假体植入乳房重建的可行性.方法 对28例0、I、II期乳腺癌行保留皮肤的乳腺癌改良根治术后,即刻于胸大肌后方植入硅胶假体重建乳房,并根据冰冻切片结果决定是否保留NAC.结果 28例早期乳腺癌均保留了NAC,术后随访2~18个月(中位随访期:15个月),外观良好,双侧乳房对称,优良率达96.5%;均无局部复发或远处转移,无明显术后并发症.结论 保留NAC的乳腺癌改良根治术后用硅胶假体行即刻乳房重建,能达到满意的乳房美容效果,是治疗早期乳腺癌安全可行的方法.%Objective To explore the feasibility of immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after nipple-areola complex (NAC) sparing modified radical mastectomy. Methods A total of 28 patients of 0,I,II stage breast cancer were implanted with silicon gel prosthesis immediately after they underwent skin-sparing modified radical mastectomy. NAC conservation depended on frozen section result. Results NAC of all the 28 patients were conserved. During 2-18 months (median15 months) follow-up, bilateral breasts were symmetrical and in good appearance with a 96.5% excellent rate. No local recurrence, distant metastasis or obvious complications occurred. Conclusions Immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after NAC sparing modified radical mastectomy is proven to be an effective and safe method with the advantage of good appearance and shorter recovery time in early-stage breast cancer.

  20. Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this text, the authors recall the main principles and data ruling cochlear implants. Then, a first circle of technical equipment for assistance is presented. This circle includes: device setting (DS), Electrically evoked Auditory Brainstem Responses (EABR), Neural Response Telemetry (NRT), Stapedial Reflex (SR) and Electrodogram Acquisition (EA). This first cycle becomes more and more important as children are implanted younger and younger; the amount of data available with this assistance makes necessary the use of models (implicit or explicit) to handle this information. Consequently, this field is more open than ever.

  1. Breast lump

    Science.gov (United States)

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  2. Breast Diseases

    Science.gov (United States)

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  3. Cochlear Implants

    Science.gov (United States)

    ... an optimal period to develop speech and language skills. Research has shown that when these children receive a cochlear implant followed by intensive therapy before they are 18 months ... age develop language skills at a rate comparable to children with normal ...

  4. Dental Implants

    Medline Plus

    Full Text Available ... suffer from social consequences and poor nutrition. Rebuilding Bone When the supporting alveolar bone melts away , it’s gone for good, but through grafting, a skilled dental professional can recreate bone to fuse with and support an implant. This ...

  5. Cochlear implant

    Science.gov (United States)

    ... are sent along the auditory nerve to the brain. A deaf person does not have a functioning inner ear. A cochlear implant tries to replace the function of the inner ear by ... signals to the brain. Sound is picked up by a microphone worn ...

  6. Dental Implants

    Medline Plus

    Full Text Available Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide helpful facts so you ... found in nature. What Happens When You Lose a Tooth? When you lose a tooth, especially a ...

  7. Dental Implants

    Medline Plus

    Full Text Available ... an implant connects directly to the jaw bone. It’s obviously not the same as the original connection , ... may feel you don’t need to replace it, since no one can see that it’s missing ...

  8. Linguine sign in musculoskeletal imaging: calf silicone implant rupture

    Energy Technology Data Exchange (ETDEWEB)

    Duryea, Dennis; Petscavage-Thomas, Jonelle [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Frauenhoffer, Elizabeth E. [Milton S. Hershey Medical Center, Department of Pathology, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD, 20814 (United States)

    2015-08-15

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition. (orig.)

  9. Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy

    OpenAIRE

    Andree, Christoph; Munder, Beatrix; Seidenstuecker, Katrin; Richrath, Philipp; Behrendt, Philipp; Köppe, Tobias; Hagouan, Mazen; Audretsch, Werner; Nestle-Krämling, Carolin; Witzel, Christian

    2012-01-01

    Summary Background Currently about 70% of women who suffer from breast cancer undergo breast-conserving therapy (BCT) without removing the entire breast. Thus, this surgical approach is the standard therapy for primary breast cancer. If corrections are necessary, the breast surgeon is faced with irritated skin and higher risks of complications in wound healing. After radiation, an implant-based reconstruction is only recommended in selected cases. Correction of a poor BCT outcome is often onl...

  10. Tomosynthesis-based localization of radioactive seeds in prostate brachytherapy

    International Nuclear Information System (INIS)

    Accurately assessing the quality of prostate brachytherapy intraoperatively would be valuable for improved clinical outcome by ensuring the delivery of a prescribed tumoricidal radiation dose to the entire prostate gland. One necessary step towards this goal is the robust and rapid localization of implanted seeds. Several methods have been developed to locate seeds from x-ray projection images, but they fail to detect completely-overlapping seeds, thus necessitating manual intervention. To overcome this limitation, we have developed a new method where (1) a three-dimensional volume is reconstructed from x-ray projection images using a brachytherapy-specific tomosynthesis reconstruction algorithm with built-in blur compensation and (2) the seeds are located in this reconstructed volume. In contrast to other projection-based methods, our method can detect completely overlapping seeds. Our simulation results indicate that we can locate all implanted seeds in the prostate using a tomosynthesis angle of 30 deg. and seven projection images. The mean localization error is 1.27 mm for a case with 100 seeds. We have also tested our method using a prostate phantom with 61 implanted seeds and succeeded in locating all seeds automatically. We believe this new method can be useful for the intraoperative quality assessment of prostate brachytherapy in the future

  11. Computer calculations in interstitial seed therapy: I. Radiation treatment planning

    International Nuclear Information System (INIS)

    Interstitial seed therapy computers can be used for radiation treatment planning and for dose control after implantation. In interstitial therapy with radioactive seeds there are much greater differences between planning and carrying out radiation treatment than in teletherapy with cobalt-60 or X-rays. Because of the short distance between radioactive sources and tumour tissue, even slight deviations from the planned implantation geometry cause considerable dose deviations. Furthermore, the distribution of seeds in an actual implant is inhomogeneous. During implantation the spatial distribution of seeds cannot be examined exactly, though X-rays are used to control the operation. The afterloading technique of Henschke allows a more exact implantation geometry, but I have no experience of this method. In spite of the technical difficulty of achieving optimum geometry, interstitial therapy still has certain advantages when compared with teletherapy: the dose in the treated volume can be kept smaller than in teletherapy, the radiation can be better concentrated in the tumour volume, the treatment can be restricted to one or two operations, and localized inoperable tumours may be cured more easily. The latter may depend on an optimal treatment time, a relatively high tumour dose and a continuous exponentially decreasing dose rate during the treatment time. A disadvantage of interstitial therapy is the high personnel dose, which may be reduced by the afterloading technique of Henschke (1956). However, the afterloading method requires much greater personnel and instrumental expense than free implantation of radiogold seeds and causes greater trauma for the patient

  12. Cochlear implants

    OpenAIRE

    Despotović, Adrijana

    2011-01-01

    The aim of the thesis is to analyze the performance of the child with cochlear implant (CI) at language, math and movement activities. For the purpose of research exercises from all three above mentioned activities are prepared. Results of the exercises constitute the ground for the comparison of a child with CI and children with no hearing disability. Testing language skills was performed with exercises that included understanding, diction and identifying syllables. Mathematic skills...

  13. Breast Cancer

    Science.gov (United States)

    ... I found something when I did my breast self-exam. What should I do now? How often should I have mammograms? I have breast cancer. What are my treatment options? How often should I do breast self-exams? I have breast cancer. Is my daughter ...

  14. Localization of brachytherapy seeds in ultrasound by registration to fluoroscopy

    Science.gov (United States)

    Fallavollita, P.; KarimAghaloo, Z.; Burdette, E. C.; Song, D. Y.; Abolmaesumi, P.; Fichtinger, G.

    2010-02-01

    Motivation: In prostate brachytherapy, transrectal ultrasound (TRUS) is used to visualize the anatomy, while implanted seeds can be seen in C-arm fluoroscopy or CT. Intra-operative dosimetry optimization requires localization of the implants in TRUS relative to the anatomy. This could be achieved by registration of TRUS images and the implants reconstructed from fluoroscopy or CT. Methods: TRUS images are filtered, compounded, and registered on the reconstructed implants by using an intensity-based metric based on a 3D point-to-volume registration scheme. A phantom was implanted with 48 seeds, imaged with TRUS and CT/X-ray. Ground-truth registration was established between the two. Seeds were reconstructed from CT/X-ray. Seven TRUS filtering techniques and two image similarity metrics were analyzed as well. Results: For point-to-volume registration, noise reduction combined with beam profile filter and mean squares metrics yielded the best result: an average of 0.38 +/- 0.19 mm seed localization error relative to the ground-truth. In human patient data C-arm fluoroscopy images showed 81 radioactive seeds implanted inside the prostate. A qualitative analysis showed clinically correct agreement between the seeds visible in TRUS and reconstructed from intra-operative fluoroscopy imaging. The measured registration error compared to the manually selected seed locations by the clinician was 2.86 +/- 1.26 mm. Conclusion: Fully automated seed localization in TRUS performed excellently on ground-truth phantom, adequate in clinical data and was time efficient having an average runtime of 90 seconds.

  15. The clinical utility of image-guided iodine-125 seed in patients with unresectable pancreatic cancer.

    Science.gov (United States)

    Niu, Hongxin; Zhang, Xikun; Wang, Bin; Zhou, Zhao; Wang, Jian; Xu, Zhongfa

    2016-02-01

    In the present study, we investigated the clinical effects of image-guided iodine-125 ((125)I) seed on unresectable pancreatic cancer. Twenty-five patients with unresectable pancreatic cancer were enrolled in this study, including 13 patients with seed implantation and 12 patients as control. The survival status, clinical benefits, objective curative effects, and relevant tumor markers were analyzed to assess the feasibility and safety of interstitial (125)I seed implantation. We found that the clinical benefit rate of the seed implantation group is 92.3 % (12/13), compared with 41.7 % (5/12) in the control, and the difference was statistically significant (p  0.05). In conclusion, (125)I seed implantation provides a safe and effective method to inhibit the tumor development, relieve pain, and improve quality of life for unresectable pancreatic cancer. These findings need to be validated by conducting further studies with larger cohorts. PMID:26353858

  16. 32P-磷酸铬-聚L乳酸粒子植入肝癌H22移植瘤模型治疗淋巴道转移的潜能%Therapeutic potential of lymph metastasis after 32P-chromicphosphate-poly L-lactic acid seeds implanted into hepatoma H22 xenograft model

    Institute of Scientific and Technical Information of China (English)

    高海林; 刘璐; 黄培林; 吴清华; 杨泽萱; 聂琦

    2010-01-01

    Objective To compare the therapeutic potential of 32P-chromicphosphate-poly L-lactic acid (32P-CP-PLLA) seeds on regional lymph nodes in the KM mice model of hepatoma H22 lymph metastasis after intratumoral implantation. Methods Ascitic hepatoma cells (H22) were injected into right fat pad to establish lymph metastasis model in KM mice. Fifty-five KM mouse models were randomly divided into different groups (n=5 each) through 32P-CP-PLLA implantion or colloid 32 P-chromicphosphate ( 32P-CP) intravenous injection. Different doses at 18. 5, 37. 0 or 74. 0 MBq per mouse were used immediately after establishing the tumor models. Different injection time points of 3, 7, 10 or 13 days were used as well at the dose of 37 MBq per mouse. Dynamic imaging was performed by γ camera. Thereafter, all of KM mice were sacririced to separate popliteal lymph node (PLN) and inguinal lymph nodes (ILN). The dose- and time-effect relation was observed by lymph node weight, light microscopy and electron microscopy. Results γ camera imaging demonstrated that the implantation points in 32P-CP-PLLA group had a limited and lasting radioactive uptake while the quality was the contrary, better than that in 32P-CP group. At the same dose the colloidal group had a higher radioactivity than the seed group. At the same dose, the PLN quality of seed group and colloidal group was not significantly different ( P > 0. 05 ) ; The ILN quality of colloidal group is less than seed group (P < 0.05 ). Seeds implanted at different times, PLN quality is significantly different ( F=31. 268 ,P <0. 01 ). Conclusion 32P-CP-PLLA seeds implanted into tumor targeting position is better than 32P-CP. There is a therapeutic effect to the lymph node metastasis as well as the treatment of tumor.%目的 观察32P-磷酸铬-聚L乳酸(32P-CP-PILA)粒子瘤体植入后对KM小鼠肝癌H22淋巴转移模型区域淋巴结(LN)治疗的潜能.方法 KM小鼠55只,建立右爪垫移植瘤淋巴道转移模型,随机分11

  17. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  18. Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... NHLBI on Twitter. What Is an Implantable Cardioverter Defibrillator? An implantable cardioverter defibrillator (ICD) is a small ... pacemakers and defibrillators. Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker The image compares an ICD ...

  19. Plasma immersion ion implantation for silicon processing

    Science.gov (United States)

    Yankov, Rossen A.; Mändl, Stephan

    2001-04-01

    Plasma Immersion Ion Implantation (PIII) is a technology which is currently widely investigated as an alternative to conventional beam line implantation for ultrashallow doping beyond the 0.15 m technology. However, there are several other application areas in modern semiconductor processing. In this paper a detailed discussion of the PIII process for semiconductors and of actual as well as future applications is given. Besides the well known advantages of PIII - fast process, implantation of the whole surface, low cost of ownership - several peculiarities - like spread of the implantation energy due to finite rise time or collisions, no mass separation, high secondary electron emission - must be mentioned. However, they can be overcome by adjusting the system and the process parameters. Considering the applications, ultrashallow junction formation by PIII is an established industrial process, whereas SIMOX and Smart-Cut by oxygen and hydrogen implantation are current topics between research and introduction into industry. Further applications of PIII, of which some already are research topics and some are only investigated by conventional ion implantation, include seeding for metal deposition, gettering of metal impurities, etch stop layers and helium implantation for localized lifetime control.

  20. Distortions induced by radioactive seeds into interstitial brachytherapy dose distributions.

    Science.gov (United States)

    Zhou, Chuanyu; Inanc, Feyzi; Modrick, Joseph M

    2004-12-01

    In a previous article, we presented development and verification of an integral transport equation-based deterministic algorithm for computing three-dimensional brachytherapy dose distributions. Recently, we have included fluorescence radiation physics and parallel computation to the standing algorithms so that we can compute dose distributions for a large set of seeds without resorting to the superposition methods. The introduction of parallel computing capability provided a means to compute the dose distribution for multiple seeds in a simultaneous manner. This provided a way to study strong heterogeneity and shadow effects induced by the presence of multiple seeds in an interstitial brachytherapy implant. This article presents the algorithm for computing fluorescence radiation, algorithm for parallel computing, and display results for an 81-seed implant that has a perfect and imperfect lattice. The dosimetry data for a single model 6711 seeds is presented for verification and heterogeneity factor computations using simultaneous and superposition techniques are presented.

  1. I-125 seed dose estimates in heterogeneous phantom

    Energy Technology Data Exchange (ETDEWEB)

    Branco, Isabela S.L.; Antunes, Paula C.G.; Cavalieri, Tassio A.; Moura, Eduardo S.; Zeituni, Carlos A.; Yoriyaz, Helio, E-mail: isabela.slbranco@gmail.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Brachytherapy plays an important role in the healing process involving tumors in a variety of diseases. Several studies are currently conducted to examine the heterogeneity effects of different tissues and organs in brachytherapy clinical situations and a great effort has been made to incorporate new methodologies to estimate doses with greater accuracy. The objective of this study is to contribute to the assessment of heterogeneous effects on dose due to I-125 brachytherapy source in the presence of different materials with different densities and chemical compositions. The study was performed in heterogeneous phantoms using materials that simulate human tissues. Among these is quoted: breast, fat, muscle, lungs (exhaled and inhaled) and bones with different densities. Monte Carlo simulations for dose calculation in these phantoms were held and subsequently validated. The model 6711 I-125 seed was considered because it is widely used as a brachytherapy permanent implant and the one used in clinics and hospitals in Brazil. Thermoluminescent dosimeters TLD-700 (LiF: Mg, Ti) were simulated for dose assess. Several tissue configurations and positioning of I-125 sources were studied by simulations for future dose measurements. The methodology of this study so far shall be suitable for accurate dosimetric evaluation for different types of brachytherapy treatments, contributing to brachytherapy planning systems complementation allowing a better assessment of the dose actually delivered to the patient. (author)

  2. Nanotechnology and Dental Implants

    OpenAIRE

    Sandrine Lavenus; Guy Louarn; Pierre Layrolle

    2010-01-01

    The long-term clinical success of dental implants is related to their early osseointegration. This paper reviews the different steps of the interactions between biological fluids, cells, tissues, and surfaces of implants. Immediately following implantation, implants are in contact with proteins and platelets from blood. The differentiation of mesenchymal stem cells will then condition the peri-implant tissue healing. Direct bone-to-implant contact is desired for a biomechanical anchoring of i...

  3. Immediate implanting breast reconstruction with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle%应用背阔肌与胸大肌联合肌瓣及假体置入即刻乳房再造

    Institute of Scientific and Technical Information of China (English)

    牛兆河; 曹明智

    2011-01-01

    Objective To explore immediate implanting breast reconstruction after subcutaneous mastectomy by through breast lateral curved incision with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle covering the breast prosthesis. Methods 30 patients were selected in clinical stage Ⅰ or Ⅱ , and without involvement of skin and pectoral muscle. After subcutaneous mastectomy through breast lateral curved incision, by the same incision the latissimus dorsi muscle flap was removed and transferred, and the submuscular interspace was dissected, and the inferior border of the pectoralis major muscle was cut off. The pedicled latissimus dorsi and pectoralis major muscle flap were sutured and the combined muscle flap was formed to cover the breast prothesis.Results The shape and feeling were satisfactory in 30 reconstructive breasts, and 22 cases were excellent (73.3 %), and 8 cases were good (26.7 %). All the patients survived without tumor recurrence after following-up more than half a year. Conclusions The method has advantages of good cosmetic breast shape, without appendant incision, and larger breast prosthesis could be insertted. It is a good method of immediate breast reconstruction for the young women with early stage breast cancer without axillary lymph node metastasis.%目的 探讨经乳房外侧弧形切口皮下乳腺切除术后,带蒂转移背阔肌肌瓣,与胸大肌肌瓣形成联合肌瓣覆盖乳房假体,进行即刻乳房再造术的治疗效果.方法 选择临床分期为Ⅰ期或Ⅱ期,肿瘤未侵及皮肤和胸肌的乳腺癌患者共30例,经乳房外侧弧形切口皮下切除乳腺腺体并清扫腋窝淋巴结,利用同一切口,切取背阔肌肌瓣带蒂转移,分离胸大肌下间隙,切断胸大肌下缘与胸壁附着处直至胸骨边缘,将转移的背阔肌肌瓣与胸大肌断缘缝合,组成联合肌瓣,形成宽大的包裹假体的腔隙,置入假体.结果 30例再造乳房外形及手感良好,其中优22

  4. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  5. Dose determination in breast tumor in brachytherapy using Iridium-192

    International Nuclear Information System (INIS)

    Thermoluminescent dosimetry studies in vivo and in vitro aiming to determing radiation dose in the breast tumor, in brachytherapy using Iridium-192 was done. The correlation between radiation doses in tumor and external surface of the breast was investigated for correcting the time interval of radiation source implantation. (author)

  6. Chronic breast abscess due to Mycobacterium fortuitum: a case report

    Directory of Open Access Journals (Sweden)

    MacNeill Fiona A

    2011-05-01

    Full Text Available Abstract Introduction Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery. Case presentation We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with Mycobacterium fortuitum and treated with antibiotic therapy and surgical debridement. Conclusion This is a rare case of a spontaneous breast abscess secondary to Mycobacterium fortuitum infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.

  7. Method of electroplating a conversion electron emitting source on implant

    Science.gov (United States)

    Srivastava, Suresh C.; Gonzales, Gilbert R.; Adzic, Radoslav; Meinken, George E.

    2012-02-14

    Methods for preparing an implant coated with a conversion electron emitting source (CEES) are disclosed. The typical method includes cleaning the surface of the implant; placing the implant in an activating solution comprising hydrochloric acid to activate the surface; reducing the surface by H.sub.2 evolution in H.sub.2SO.sub.4 solution; and placing the implant in an electroplating solution that includes ions of the CEES, HCl, H.sub.2SO.sub.4, and resorcinol, gelatin, or a combination thereof. Alternatively, before tin plating, a seed layer is formed on the surface. The electroplated CEES coating can be further protected and stabilized by annealing in a heated oven, by passivation, or by being covered with a protective film. The invention also relates to a holding device for holding an implant, wherein the device selectively prevents electrodeposition on the portions of the implant contacting the device.

  8. Breast Gangrene

    Directory of Open Access Journals (Sweden)

    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  9. Which Breast Is the Best? Successful Autologous or Alloplastic Breast Reconstruction : Patient-Reported Quality-of-Life Outcomes

    NARCIS (Netherlands)

    Eltahir, Yassir; Werners, Lisanne L. C. H.; Dreise, Marieke M.; Zeiffmans van Emmichoven, Ingeborg A.; Werker, Paul M. N.; de Bock, Geertruida H.

    2015-01-01

    Background: Breast reconstruction is an appropriate option offered to women who are diagnosed with breast cancer or gene mutations. It may be accomplished with implants or autologous procedures. This cross-sectional study evaluated the satisfaction and quality of life in addition to complications an

  10. Assessment of microseeds biodegradability of Sm and Sm:Ba splenic implants in rabbits

    International Nuclear Information System (INIS)

    The radioactive interstitial implants have applications in controlling neoplasm in several regions of the human body. Currently the permanent brachytherapy seeds implanted in the spleen and other organs are made of I-125 seeds. After the total emission of radiation, the metal encapsulated seed remains inert in the implanted area. Seeds of bioactive ceramics have been prepared with Sm-152 incorporation to be activated in Sm-153. This study aimed to develop surgical technique for implanting biodegradable micro-seeds in the spleen of the rabbit. Three micro-seeds were introduced by hypodermic needle in the spleen in eight rabbits by median laparotomy. Subsequently, there were clinical and functional reactions of the animal to the implanted foreign body. The other objective was to perform the animal monitoring by radiography, produced in time sequence, and pathological studies of a fragment of the spleens of rabbits. The results show the effectiveness of surgery, the identification of the implanted material by radiography in vivo, and the biocompatibility of micro-seeds most of Sm and Sm:Ba. These seeds of reduced volume, 0.3x 1.6 mm, could be monitored for radiological studies in 2 periods: early and later implant. On the later studies, radiography was taken at 60d post-implant. Biopsies were taken and radiographs of the samples were also performed for evidencing the degradation state of the seeds. The results of the two groups of four rabbits are presented. They show partial degradation of the seed verified by radiographic contrast which is related to the atomic number of the elements and mass density in the seed. The biopsy showed that the ceramic is clearly absorbed by the spleen tissue and form tissue-implant interface. The histological slides showed an inflammatory reaction with presence of fibrosis of the giant cell foreign body. In conclusion, the radiograph shows a suitable noninvasive technique for monitoring the degradation of micro-seed ceramics in vivo

  11. Therapeutic Lymphangiogenesis With Implantation of Adipose‐Derived Regenerative Cells

    OpenAIRE

    Shimizu, Yuuki; Shibata, Rei; Shintani, Satoshi; Ishii, Masakazu; Murohara, Toyoaki

    2012-01-01

    Background Lymphedema is one of the serious clinical problems that can occur after surgical resection of malignant tumors such as breast cancer or intra‐pelvic cancers. However, no effective treatment options exist at present. Here, we report that implantation of adipose‐derived regenerative cells (ADRCs) can induce lymphangiogenesis in a mouse model of reparative lymphedema. Methods and Results ADRCs were isolated from C57BL/6J mice. To examine the therapeutic efficacy of ADRC implantation i...

  12. Study of dose deposition for different configurations of seeds OncoSeed 6711

    International Nuclear Information System (INIS)

    Prostate cancer is the second most common cancer among men. lodine-125 brachytherapy seeds are presented as a form of treatment. In prostate cancer therapy 80-120 iodine-125 seeds are implanted in the organ following a previous planning. During positioning and after it, the implanted seeds can undergo slight displacements relative to the original position. These deviations may cause changes in dose distribution in the tumor volume. This work has made a dosimetry study for iodine-125 seeds used in low dose rate brachytherapy. In the first stage, we performed a one seed dosimetric parameters study following the TG-43 protocol recommendations with the objective of validating our methodology. Then a quantitative study of the variation in dose distribution for three configurations of four seeds OncoSeed 6711 was conducted with two configurations using the seeds in symmetrical positions and the other presenting small displacements. A soft tissue phantom and TLD dosimeters were used. Then a qualitative study of isodose curves of the configurations was performed using radiochromic film, Gafchromic model. This method was used to complement the study of the crystals. The seed's dosimetric parameters obtained in this work showed excellent agreement with the TG-43 consensual values, thus validating the methodology used in this work. The results obtained with radiochromic film and thermoluminescent dosimeters have shown that there is a significant difference in dose distribution when there is a change in the positioning of the seeds. The use of these two methods simultaneously is efficient since the crystals bring a point view and the film has a global view of the dose distribution. (author)

  13. Breast lift

    Science.gov (United States)

    ... One breast that is larger than the other (asymmetry of the breasts) Uneven position of the nipples ... to achieve this important distinction for online health information and services. Learn more about A.D.A. ...

  14. Breast cancer

    Science.gov (United States)

    ... perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  15. Breast; Sein

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, C.; Garbay, J.R.; Pichenot, C.; Uzan, C.; Delaloge, S.; Andre, F.; Spielmann, M.; Arriagada, R.; Lefkopoulos, D.; Marsigli, H.; Bondiau, P.Y.; Courdi, A.; Lallemand, M.; Peyrotte, I.; Chapellier, C.; Ferrero, J.M.; Chiovati, P.; Baldissera, A.; Frezza, G.; Vicenzi, L.; Palombarini, M.; Martelli, O.; Degli Esposti, C.; Donini, E.; Romagna CDR, E.; Romagna CDF, E.; Benmensour, M.; Bouchbika, Z.; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Benider, A.; Gilliot, O.; Achard, J.L.; Auvray, H.; Toledano, I.; Bourry, N.; Kwiatkowski, F.; Verrelle, P.; Lapeyre, M.; Tebra Mrad, S.; Braham, I.; Chaouache, K.; Bouaouin, N.; Ghorbel, L.; Siala, W.; Sallemi, T.; Guermazi, M.; Frikha, M.; Daou, J.; El Omrani, A.; Chekrine, T.; Mangoni, M.; Castaing, M.; Folino, E.; Livi, L.; Dunant, A.; Mathieu, M.C.; Bitib, G.P.; Arriagada, R.; Marsigli, H

    2007-11-15

    Nine articles treat the question of breast cancer. Three-dimensional conformal accelerated partial breast irradiation: dosimetric feasibility study; test of dose escalation neo-adjuvant radiotherapy focused by Cyberknife in breast cancer; Three dimensional conformal partial irradiation with the technique by the Irma protocol ( dummy run multi centers of the Emilie Romagne area Italy); Contribution of the neo-adjuvant chemotherapy in the treatment of locally evolved cancers of the uterine cervix; Post operative radiotherapy of breast cancers (N0, pN) after neo-adjuvant chemotherapy. Radiotherapy of one or two mammary glands and ganglions areas,The breast cancer at man; breast conservative treatment; breast cancers without histological ganglions invasion; the breast cancer at 70 years old and more women; borderline mammary phyllod tumors and malignant. (N.C.)

  16. Breast reconstruction: current and future options

    Directory of Open Access Journals (Sweden)

    Paul Jr H

    2011-08-01

    Full Text Available Henry Paul Jr1, Tahira I Prendergast2, Bryson Nicholson2, Shenita White2, Wayne AI Frederick2,31Departments of Plastic Surgery, 2General Surgery, Howard University Hospital, 3Cancer Center, Howard University, Washington, DC, USAAbstract: When initiated by the devastating diagnosis of cancer, post ablative breast restoration has at its core the goal of restoring anatomic normalcy. The concepts of body image, wholeness, and overall well-being have been introduced to explain the paramount psychological influence the breast has on both individuals and society as a whole. Hence, a growing subspecialty has been established to recreate or simulate the lost breast. At least one third of breast cancer victims consider breast reconstruction. Breast reconstruction post mastectomy may be offered at the time of mastectomy or delayed post mastectomy after adjuvant therapy. This may be utilizing autologous tissues or implants and each has risks and benefits, especially when considering adjuvant therapy. In addition, there has been a move away from a traditional mastectomy to less invasive, but still curative procedures, such as skin-sparing and nipple-sparing mastectomy. These procedures provide the breast envelope to facilitate reconstruction. This paper reviews the primary issues in breast reconstruction, as well as their psychologic, oncologic, and social impact.Keywords: breast restoration, body image, breast reconstruction, mastectomy

  17. Endocurietherapy of breast cancer III

    International Nuclear Information System (INIS)

    We recently introduced the implantation of Iridium192 as a method of local treatment of breast cancer in Austria. The afterloading technique is described. This modality should be used as a boost to the 'high-risk' areas following conservative breast surgery and combined with megavoltage external irradiation. Interstitial implantation may also be used as a primary form of treatment. A report on 35 patients is presented, 25 of whom underwent a curative schedule for T1-2, N0-1 tumors. 10 patients were treated individually. The aesthetic results are very pleasing. There were no severe complications and no early local recurrences. The interpretation of the results can be only in the form of trends because of the short follow-up time of 1 year. (Author)

  18. Experimental study on microSPECT-CT bremsstrahlung imaging in solid tumor mesenchymal implantation of 32 P-chromic phosphate-paclitaxel-poly-L-lactic acid sustained-release seeds%32 P-磷酸铬-紫杉醇-聚L乳酸缓释粒子实体瘤间质植入microSPECT-CT韧致辐射显像的实验研究

    Institute of Scientific and Technical Information of China (English)

    刘伟; 邵国强; 孟庆乐; 杨瑞; 王峰; 王自正

    2016-01-01

    Objective To investigate the value of single photon emission computed tomography (CT) imaging and transmis‐sion CT imaging (microSPECT‐CT ) bremsstrahlung imaging for the solid tumor mesenchymal implantaion of 32 P‐chromic phos‐phate‐paclitaxel‐poly‐L‐lactic acid (32 P‐CP‐PSP‐PLLA) sustained release seeds and to investigate the 32 P in vivo biodistribution and degradation sustained release churacteristics .Methods The animal model of prostate cancer subcutaneously transplanted tumor was established .32 P‐CP‐PSP‐PLLA sustained‐release seeds were intratumorally implanted by the mediation of microSPECT‐CT brems‐strahlung imaging and the 32 P distribution in bearing tumor mouse was verified by the imaging and biological distrubtion tests .The ultrastructural changes of 32 P seeds were observed by the scanning electron microscope .Results The MicroSPECT/CT brems‐strahlung imaging could effectively guide the intratumoral implantation operation of the 32 P sustained‐release seeds with clear visu‐alization .Partial sustained‐release 32 P was remained in the tumor tissues with little distribution in important organs of spleen and liver ,which was proved by the biodistribution results .The particle surface and inside micropores and tunnels formation ,their pro‐gressive increase ,fusion and connection were found by the electronic microscope after the 32 P sustained‐release seeds intratumoral implantation .Conclusion The MicroSPECT/CT bremsstrahlung imaging can effectively monitor the 32 P sustained‐release seeds and their in vivo biodistribution and lays a foundation for the sustained‐release seeds prostatic targeted implantation .%目的:以32 P‐磷酸铬‐紫杉醇微球‐聚L乳酸(32 P‐CP‐PSP‐PLLA)缓释粒子实体瘤间质靶向植入后,行小动物单光子发射计算机断层成像‐透射断层成像(microSPECT‐CT )韧致辐射显像,探讨其32 P体内生物学分布及其降解缓释特

  19. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks ... the risk. Women who have family members with breast or ovarian cancer may wish to be tested ...

  20. Ultrasound - Breast

    Science.gov (United States)

    ... Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. In breasts that are dense, meaning there is a lot ... and less fat, many cancers can be hard to see on mammography. Many ...

  1. Long-term effects of radical resectin plus interstitial implantation of 125Ⅰ radioactive seeds in the treatment of cancer of the cardia%125Ⅰ粒子组织间插置治疗贲门癌的远期疗效

    Institute of Scientific and Technical Information of China (English)

    张继军; 梁彦; 高翔; 程晓斌; 莫晓潮

    2009-01-01

    Objective To evaluate the long-term effect of interstitial implantation of radioactive iadine-125 (125Ⅰ) seeds as an adjunctive technique to the radical resection in the treatment of cancer of the cardia. Methods From March 2001 to Match 2003, one hundred and eighteen patients with cancer of the cardia underwent radical resection in our department. Fifty-seven patients (group A) were treated with radical resection plus interstitial implantation of radioactive 125Ⅰ seeds during surgery, and 61 patients (group B) were treated with radical resection along. The rate of 3-year and 5-year survival, postoperative complications and mortality were compared between the two groups. Results The demographic data of the two groups were comparable, as well as metastatic status of the lymph nodes, cancer staging, and the type of operation. One hundred and thirteen patients were followed for 5 years. The overall rate of follow up was 95.8%, 96.5% in group A and 95.1% in group B. The differences in the rates of 3-year and 5-year survival between group A (59.6% and49.1%) and group B (41.0% and 31.1%) were statistically significant (X2 =4.072, P0.05, for the rate of postoperative complications; X2 =0.333, P>0.05, for the mortality rate). There were 26 and 37 deaths in group A and B respectively. Six deaths in group A and 13 deaths in group B were attributed to local recurrence, and 17 deaths in group A and 21 deaths in group B were attributed to remote metastasis. Non-neoplasma diseases such as vascular events, diabetes mellitus, pulmonary infection and severe malnutrition were the causes of 3 deaths in each group. Conclusion As a safe and effective method, interstitial implantation of radioactive 125 seeds should be recommended in combination with radical resection to improve the long-term outcomes of patients with cancer of the cardia.%目的 探讨贲门癌根治术中组织间插置125Ⅰ粒子治疗贲门癌的临床价值.方法 118例贲门癌病人施行根治性

  2. Implant success!!!.....simplified

    OpenAIRE

    Luthra Kaushal

    2009-01-01

    The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of “restoration-driven implant placement” ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant t...

  3. Seed Treatment. Bulletin 760.

    Science.gov (United States)

    Lowery, Harvey C.

    This manual gives a definition of seed treatment, the types of seeds normally treated, diseases and insects commonly associated with seeds, fungicides and insecticides used, types of equipment used for seed treatment, and information on labeling and coloring of treated seed, pesticide carriers, binders, stickers, and safety precautions. (BB)

  4. Mammography and breast sonography in transsexual women.

    Science.gov (United States)

    Weyers, S; Villeirs, G; Vanherreweghe, E; Verstraelen, H; Monstrey, S; Van den Broecke, R; Gerris, J

    2010-06-01

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  5. Mammography and breast sonography in transsexual women

    Energy Technology Data Exchange (ETDEWEB)

    Weyers, S., E-mail: steven.weyers@ugent.b [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2010-06-15

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  6. Non-microsurgical breast reconstruction

    Directory of Open Access Journals (Sweden)

    Sharma Sheel

    2007-12-01

    Full Text Available Breast reconstruction after mastectomy should aim at resulting in an aesthetic outcome that matches the patient′s expectations and without interfering in the oncologic treatment. Whether the reconstruction is performed immediately or in a delayed fashion depends on various factors, which needs detailed attention. Autologous tissue, implants or both are used in the reconstruction. This article reviews the current concepts in these, with emphasis on non-microsurgical methods of using the autologous tissue for reconstruction. Breast conservation has become an accepted practice of treatment. Reconstruction in these situations as well as in an occasion when the surgery is done for failed breast conservation is discussed in detail. The article also reviews the various methods for nipple reconstruction available.

  7. Padrão de aleitamento materno no primeiro mês de vida em mulheres submetidas a cirurgia de redução de mamas e implantes Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation

    Directory of Open Access Journals (Sweden)

    Regina Aparecida de Andrade

    2010-06-01

    Full Text Available OBJETIVO: Descrever o padrão de aleitamento materno no primeiro mês de vida da criança em mulheres que se submeteram a dois tipos de cirurgias mamárias - redução e implante - e comparar com o padrão praticado por mulheres que não se submeteram às cirurgias. MÉTODOS: Coorte prospectiva controlada com 25 mulheres submetidas a cirurgia redutora, 24 a cirurgia de implante e 25 sem cirurgia de mama, que tiveram seus filhos no Hospital Israelita Albert Einstein, São Paulo (SP. Os dados foram coletados por meio de avaliações realizadas entre 48 e 72 horas, entre os quinto e sétimo dias e 30 dias após o parto. Para análise dos dados, usaram-se os testes qui-quadrado, exato de Fisher, curva de Kaplan-Meier e regressão de Cox. RESULTADOS: A probabilidade de uma criança estar em aleitamento exclusivo no final do primeiro mês de vida foi de 29% em mulheres com cirurgia redutora e 54% nas com cirurgia de implante, e 80% nas mulheres sem cirurgia. A probabilidade do aleitamento misto estar presente neste mesmo período foi de 68% entre mães com cirurgia de redução, 32% com cirurgia de implante e apenas 16% entre as mulheres sem cirurgia mamária. O risco de uma criança estar em aleitamento não exclusivo foi cinco vezes maior entre mães do grupo submetido a redução, quando comparado àquelas do grupo sem cirurgia (p = 0,002. Para o grupo de mulheres com implante, o risco de uma criança estar em aleitamento não exclusivo foi 2,6 vezes aquele observado entre crianças cujas mães fazem parte do grupo sem cirurgia (p = 0,075. CONCLUSÃO: A cirurgia redutora de mama e de implante refletiu em menor taxa de aleitamento materno exclusivo no primeiro mês de vida da criança.OBJECTIVE: To describe the breastfeeding pattern in the first month of life in women submitted to two types of surgery - breast reduction and augmentation - and to compare it with the pattern exhibited by women who had no surgery. METHODS: Controlled prospective cohort

  8. 小切口、持续负压引流与传统切开引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的比较%The comparison betweenthe outcomes of using small cuts and continuous negative pressure drainage and the traditional incision and drainage to treat mammary abscess caused by HPG breast implants

    Institute of Scientific and Technical Information of China (English)

    郑轲; 何山; 刘兵; 刘美宏; 冯佳

    2012-01-01

    Objective To discuss the outcomes of using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants. Methods Small cuts and continuous negative pressure drainage were per-formeded in 20 cases of mammary abscess caused by HPG breast implants and the traditional incision and drainage was performed-ed in another 20 cases to evaluate the outcomes. Results Using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants has obvious advantages over the group of using incision and drainage in healing time, the frequency of changing dressings, the degree of pain and the bigrosmall of scar. Conclusion Using small cuts and continuous negative pressure drainage can obviously shorten the healing time, reduce the the frequency of changing dressings, reduce patients pain and reduce scar formation. It is the idealest way to treat mammary abscess caused by HPG breast implants.%目的 探讨小切口、持续负压引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的效果.方法 20例患者采用小切口、持续负压引流和20例患者采用传统切开油纱填塞引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿,观察治疗效果.结果 小切口、持续负压引流组在愈合时间、换药次数、疼痛程度、瘢痕大小等方面均明显优于传统切开引流组.结论 持续负压引流组可以明显缩短愈合时间,减少换药次数,减轻换药痛苦,减少瘢痕形成.是治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿最理想方法.

  9. RAPD analysis of alfalfa DNA mutation via N+ implantation

    Institute of Scientific and Technical Information of China (English)

    LI Yu-Feng; HUANG Qun-Ce; LIANG Yun-Zhang; YU Zeng-Liang

    2003-01-01

    Germination capacity of alfalfa seeds under low energy N+ implantation manifests oscillations goingdown with dose strength. From analyzing alfalfa genome DNA under low energy N+ implantation by RAPD (RandomAmplified Polymorphous DNA), it is recommended that 30 polymorphic DNA fragments be amplified with 8 primersin total 100 primers, and fluorescence intensity of the identical DNA fragments amplified by RAPD is different be-tween CK and treatments. Number of different polymorphic DNA fragments between treatment and CK via N+ im-plantation manifests going up with dose strength.

  10. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... your stomach on a narrow table with your breasts hanging down into cushioned openings. The table slides ...

  11. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  12. Stages of Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  13. Congenital Abnormalities of the Breast. A Case Report

    Directory of Open Access Journals (Sweden)

    Elvira María Martínez Barreto

    2015-12-01

    Full Text Available Normal breasts have a wide range of shapes and sizes varying according to cultural, racial, or other conditions, but it is clear that there are abnormalities related to the shape, size, number, location, and so on. Management of these defects requires prior clinical and imaging assessment in addition to plastic surgery. The case of a 14-year-old mestizo girl of rural origin treated at the Paquito González Cueto University Pediatric Hospital due to multiple breast abnormalities and significant asymmetry is presented. Reconstructive surgery of both breasts was performed, placing a breast implant in one of them. The asymmetry and the rest of the malformations were corrected to the patient and her family’s satisfaction. This is the first case of breast implants in the province, hence the interest in presenting it.

  14. Implant success!!!.....simplified

    Directory of Open Access Journals (Sweden)

    Luthra Kaushal

    2009-01-01

    Full Text Available The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of "restoration-driven implant placement" ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant treatment. By applying the harmony of artistic skill, scientific knowledge and clinical expertise, we can simply master the outstanding implant success in requisites of aesthetics, phonetics and function.

  15. Hybrid adipogenic implants from adipose stem cells for soft tissue reconstruction in vivo.

    Science.gov (United States)

    Moioli, Eduardo K; Chen, Mo; Yang, Rujing; Shah, Bhranti; Wu, June; Mao, Jeremy J

    2010-11-01

    A critical barrier in tissue regeneration is scale-up. Bioengineered adipose tissue implants have been limited to ∼10  mm in diameter. Here, we devised a 40-mm hybrid implant with a cellular layer encapsulating an acellular core. Human adipose-derived stem cells (ASCs) were seeded in alginate. Poly(ethylene)glycol-diacrylate (PEGDA) was photopolymerized into 40-mm-diameter dome-shaped gel. Alginate-ASC suspension was painted onto PEGDA surface. Cultivation of hybrid constructs ex vivo in adipogenic medium for 28 days showed no delamination. Upon 4-week in vivo implantation in athymic rats, hybrid implants well integrated with host subcutaneous tissue and could only be surgically separated. Vascularized adipose tissue regenerated in the thin, painted alginate layer only if ASC-derived adipogenic cells were delivered. Contrastingly, abundant fibrous tissue filled ASC-free alginate layer encapsulating the acellular PEGDA core in control implants. Human-specific peroxisome proliferator-activated receptor-γ (PPAR-γ) was detected in human ASC-seeded implants. Interestingly, rat-specific PPAR-γ was absent in either human ASC-seeded or ASC-free implants. Glycerol content in ASC-delivered implants was significantly greater than that in ASC-free implants. Remarkably, rat-specific platelet/endothelial cell adhesion molecule (PECAM) was detected in both ASC-seeded and ASC-free implants, suggesting anastomosis of vasculature in bioengineered tissue with host blood vessels. Human nuclear staining revealed that a substantial number of adipocytes were of human origin, whereas endothelial cells of vascular wall were of chemaric human and nonhuman (rat host) origins. Together, hybrid implant appears to be a viable scale-up approach with volumetric retention attributable primarily to the acellular biomaterial core, and yet has a biologically viable cellular interface with the host. The present 40-mm soft tissue implant may serve as a biomaterial tissue expander for

  16. Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2004-01-01

    Full Text Available Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.

  17. Conservative treatment for breast cancer. Complications requiring reconstructive surgery

    International Nuclear Information System (INIS)

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects

  18. Conservative treatment for breast cancer. Complications requiring reconstructive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bostwick, J. 3d.; Paletta, C.; Hartrampf, C.R.

    1986-05-01

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthe