The difficult problem of automatically welding nipples onto the header is first analyzed in this paper, and then the overall structure and operating principle of the robot working unit are introduced. The robot and th...The difficult problem of automatically welding nipples onto the header is first analyzed in this paper, and then the overall structure and operating principle of the robot working unit are introduced. The robot and the measuring device are located by employing the traveling lorry, and this unit enables the robot to adjust the tracks according to the errors received from the measuring device, and then the nipples are welded properly. This paper emphases on the development of the master-slave control system, in which the prograrmmable Logic Controller (PLC) is used as the master computer.展开更多
Introduction Hyperkeratosis of nipples and areola (HNA) is a benign skin disease with unknown etiology, and is sporadic and clinically rare. It was first described by Tauber in 1923, and characterized by verrucous hyp...Introduction Hyperkeratosis of nipples and areola (HNA) is a benign skin disease with unknown etiology, and is sporadic and clinically rare. It was first described by Tauber in 1923, and characterized by verrucous hyper-keratosis and dark brown pigmentation of nipples and/or areola(1)Currently, the classification proposed by Levy-Franckel in 1938 is widely used[2], which divides HNA into three types accoding to its clinical mani-festations:TypeⅠis characterized by the extension of epidermis nevus, involving only unilateral nipple and/or areola. TypeⅡis mostly bilateral, involving nipples and areolae, and usually accompanied by other skin diseases, for example ichthyosis, acanthosis nigricans, Darier's disease, chronic eczema, allergic dermatitis, and skin T cell lymphoma. TypeⅢ is congenital or nevus-shaped, and mostly occurrs among 20 to 30 years old females, with involvement of bilateral nipples and/or areolae. Herein, we reported a female patient with hyper-keratosis of bilateral giant nipples and areolae, who was successfully treated by surgery in the Hospital for Dermatology.展开更多
The term“nipple confusion”accurately describes the confusion newborns experience between their mother’s nipple and an artificial nipple during feeding.Specifically,it refers to the feeding habits infants develop ba...The term“nipple confusion”accurately describes the confusion newborns experience between their mother’s nipple and an artificial nipple during feeding.Specifically,it refers to the feeding habits infants develop based on their initial feeding experiences after birth.Infants accustomed to the maternal nipple often resist bottle-feeding;conversely,those accustomed to bottle-feeding may reject the maternal nipple.This confusion is particularly common among infants receiving mixed feeding.展开更多
Nipple confusion,a term that accurately describes the confusion that occurs between the mother’s nipple and the artificial teat during feeding in newborns.Specifically,it refers to the fact that babies develop specif...Nipple confusion,a term that accurately describes the confusion that occurs between the mother’s nipple and the artificial teat during feeding in newborns.Specifically,it refers to the fact that babies develop specific breastfeeding habits after birth,based on their initial feeding experience.For babies who are accustomed to their mother’s nipple,they tend to show resistance to bottle feeding;on the contrary,those who have adapted to bottle feeding may refuse to accept their mother’s nipple.This confusion is particularly common among mixed-feeding babies.展开更多
BACKGROUND Compared to earlier,there has been an increase in the tattoo procedures for cosmetic purposes;and there has also been an increase in the tattoo procedures performed by non-medical personnel.In South Korea,o...BACKGROUND Compared to earlier,there has been an increase in the tattoo procedures for cosmetic purposes;and there has also been an increase in the tattoo procedures performed by non-medical personnel.In South Korea,only tattoos performed by a doctor are considered legal;however,there is still some debate over whether tattoo procedures performed by non-healthcare providers should be considered legal.CASE SUMMARY A 28-year-old woman visited our hospital with pain in both nipples and heat sensation over the last 4 d.She had a history of a nipple tattoo performed by an unlicensed person.Pinpoint bleeding was noted in both areolar areas,and the exudate mixed with pus and orange color ink was discharged.Oral medication and tulle with foam dressing were performed under the impression of cellulitis and allergic reaction.After 4 wk,nipples remained dark brown in color,resulting in a color mismatch between the nipple and orange-colored areola.The size of the areola was also found to be distinctly asymmetrical after healing.This complication may have been caused by the use of illegal ink or unsanitary procedures,or a problem may have occurred in the post-tattoo management stage.CONCLUSION Doctors use approved ink,aseptic procedure and appropriate postoperative care,and appropriate management can be performed in case of complications.展开更多
Accessory breast tissue development frequently occurs in addition to physiologic breast development and is a common congenital condition with an occurrence of 0.4% to 6% in women and 1% - 3% in men. A 31-year-old G1P0...Accessory breast tissue development frequently occurs in addition to physiologic breast development and is a common congenital condition with an occurrence of 0.4% to 6% in women and 1% - 3% in men. A 31-year-old G1P0 female presented to our triage at 20 + 4 weeks gestation with a one-week history of painful bilateral axillary lumps. Her last menstrual period was consistent with an estimated gestational age of 39 + 3 weeks by LMP. She had emigrated from Bengal three years earlier with no other gynecological complaints and knew of no abnormalities on physical exam. The painful axillary lumps were found to be accessory breast tissue. This entity is presented as a palpable thickening that is most prevalent along the milk line in the region immediately below the breasts, along the abdomen, in the axilla and in the groin region adjacent to the vulva. Affected individuals may undergo premenstrual changes such as tenderness, swelling, and difficulty with shoulder range of motion and irritation. The onset of pregnancy stimulates the tissue and makes it more evident as it did with our patient.展开更多
Objective： The purpose of this study was to study the clinical and pathological characteristics of breast intraductal proliferative lesions （IDPLs） and associated with invasive breast cancer. Methods： We reviewed ...Objective： The purpose of this study was to study the clinical and pathological characteristics of breast intraductal proliferative lesions （IDPLs） and associated with invasive breast cancer. Methods： We reviewed 327 cases of breast intra- ductal proliferative lesions including 53 cases of usual ductal hyperplasia, 57 cases of atypical ductal hyperplasia, 89 cases of ductal carcinoma in situ, and 128 cases coexist with invasive ductal carcinomas. Cases of pure invasive cancer without intraductal proliferative lesions were excluded. The mult IDPLs biological parameters including the express of ER, PR, HER2, HIF-lo and Ki-67 detected by immunohistochemistry S-P method （n = 327） and the levels of CA153, TSGF, CA125 and CEA both in nipple discharge and serum （n = 179） measured with Electrochemiluminescence method and their relationship were studied, and 30 cases of normal pregnant women were compared with. Results： A single histologic subtype was present in 49.85% （163/327） of the cases, two subtypes in 33.03% （108/327）, and three in 17.13% （56/327）. The most common subtypes present were cribriform （43.12%, 141/327） and solid （38.53%, 126/327）, while the comedo （16.35%, 54/327）, and micropapillary （12.84%, 42/327） subtypes were less common. Comedo and solid were frequently found together for coexpres- sion as were micropapillary and papillary subtypes. However, Comedo subtype was much less likely to be found with papillary, cribriform or micropapillary subtypes. Additionally, comedo subtypes tend to be hormone receptor negative, Her2 positive and high-grade while the cribriform and solid subtype tends to be hormone receptor positive, Her2 negative and low grade. Papil- lary subtype was least likely to be associated with an invasive cancer. Furthermore, the nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in coexist with invasive ductal carcinomas patients were significantly higher than those in the benign breast disease （pure intraductal proliferative lesions） and normal pregnant women （P 〈 0.01）. Additionally, the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than in the serum （P 〈 0.01）, and had a positive correlation with the Ki-67, grade, clinical stage, lymph node metastasis and tumor recurrence （P 〈 0.05）, and negative correla- tion with the level of ER and PR （P 〈 0.05）. The sensitivity of the four serum tumor markers in combination was only 69.77%, in contrast, the combined detection both in discharge and serum was 97.67%, and the negative predictive value was 99.03%. The sensitivity of combined detection both in nipple discharge and serum were significantly higher than other detection （P 〈 0.05）. Conclusion： IDPLs often present more than one histologic subtype and the most common subtypes are cribriform and solid, while comedo and micropapillary subtypes are less common. Our results suggest that the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than those in the serum, and is associated with HIF-le. The aberration of HIF-la may play a key role during oncogenesis and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. Nipple discharge can be the earliest presenting symptom of breast cancer. The dynamic combined detection of the four tumor markers both in nipple discharge and serum are helpful to the stratification of preoperative patients and benefit to better prewarning markers for monitoring their recurrence and metastasis and clinical staging of tumors in clinic, but cannot increase the sensitivity of judging the patients with early breast cancer.展开更多
Necrosis of nipple-areola complex is one of the major complications of breast reduction in gigatomastia.Wie present a case study of a 32-year-old patient with severe gigantomastia,who required an immediate nipple reco...Necrosis of nipple-areola complex is one of the major complications of breast reduction in gigatomastia.Wie present a case study of a 32-year-old patient with severe gigantomastia,who required an immediate nipple reconstruction during breast reduction.The final reconstruction was satisfactory.No complications were observed within three months postoperatively.展开更多
BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with ...BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.展开更多
Bloody discharge from the breasts in a lactating woman can be caused by various conditions like cracked nipples, mastitis, trauma or ductal papilloma [1]. A physiological condition called rusty pipe syndrome can also ...Bloody discharge from the breasts in a lactating woman can be caused by various conditions like cracked nipples, mastitis, trauma or ductal papilloma [1]. A physiological condition called rusty pipe syndrome can also cause bilateral bloody discharge in lactating mothers [2].展开更多
OBJECTIVE To explore the value of fiberoptic ductoscopy in diagnosing and treating bilateral and polyporous nipple discharge (ND).METHODS Fiberoptic ductoscopy was conducted in 29 patients with bilateral and polyporou...OBJECTIVE To explore the value of fiberoptic ductoscopy in diagnosing and treating bilateral and polyporous nipple discharge (ND).METHODS Fiberoptic ductoscopy was conducted in 29 patients with bilateral and polyporous ND.After the ductoscopy,the patients with intraductal papilloma (IDP) underwent a surgical procedure,and the others,identified with galactostasis,mammary duct ectasia (MDE) and obstructive galactophoritis (OG),received a ductoscopy-guided interventional therapy. RESULTS Among 29 cases,and with 79 galactophores examined,IDP was found in 11 cases (37.9% of the total cases),or 13.9% of the galactopores examined.IDP was found in 9 of 11 cases with a bloody nipple discharge,while IDP was seen in 2 of the 18 cases with a non-bloody nipple discharge.The excision accuracy achieved 100% in the cases,and postoperative pathological diagnosis accordance rate reached 88.9%. CONCLUSION Fiberoptic ductoscopy has many features such as ability to see the lesion,and accurate preoperative localization,thus eliminating excessive excision of tissue during surgery.For most patients with ND,especially those suffering galactostasis,OG or MDE,washout under fiberoptic ductoscopy and interventional therapy may achieve a thorough cure of the disease.展开更多
Objective: To evaluate the long term follow-up results of the direct nipple ureteroneocystostomy technique. Materials and Methods: We studied a total of 16 patients (19 renal units) who underwent direct nipple uretero...Objective: To evaluate the long term follow-up results of the direct nipple ureteroneocystostomy technique. Materials and Methods: We studied a total of 16 patients (19 renal units) who underwent direct nipple ureteroneocystostomy. The mean age was 43 years and 3 patients had bilateral disease. In five units the ureters had been ligated during gynecological surgery, 11 renal units were obstructive and three units were reflexive megaureters. The ureters were spatulated for about 2 cm and folded back. Nipples 2 to 2.5 cm long were prepared. In two cases the ureters were thin-walled (2 mm or less) and they were not spatulated but folded back onto themselves. In one case the ureter could not be everted since it had a thick and fibrotic wall. The distal 2 to 2.5 cm segment of this ureter was directly inserted in to the bladder. Postoperative follow-up was at 3 month intervals for the first year at 6 month intervals for 2 - 3 years and yearly thereafter. At the time of follow-up serum creatinine, urine culture, ultrasound, intravenous urography, voiding cystoureterography, nuclear renal scintigraphy and cystometric evaluations were performed. The functions of 11 and 15 renal units were evaluated scintigraphically and stereologically, respectively, in the both preoperative and postoperative first year follow-up. The Wilcoxon Signed Ranks test was used for statistical evaluation and p < 0.05 was considered statistically significant. Results: Mean follow-up was 49 months. Three renal units had Grade III reflux (two of them during voiding) and one unit had Grade IV reflux. At follow-up this patient developed in the ureteral stricture. No patients had urinary tract infection, pyelonephritis or ureteral stricture follow-up period. Between the preoperative and postoperative first year, there was an increase in postoperative split renal function based on renal scintigraphy but this difference was not statistically significant. The stereologically calculated decrease in pelvicaliceal dilatation was statistically significant. Conclusion: Ease of application and no need to taper or plicate the ureter or prepare a submucosal tunnel may be the reasons to consider the direct nipple ureteroneocystostomy technique for megaureters of different etiologies.展开更多
<strong>Objective:</strong> To evaluate the role of invasive imaging in the identification and pre-surgical localization of endoductal breast lesions. <strong>Methods:</strong> We retrospective...<strong>Objective:</strong> To evaluate the role of invasive imaging in the identification and pre-surgical localization of endoductal breast lesions. <strong>Methods:</strong> We retrospectively evaluated cytological outcomes, non-invasive/invasive breast imaging obtained between January 2016 and December 2019 in women with pathological nipple discharge (PND). We analysed sensitivity, specificity, positive predictive value and negative predictive value. We also evaluated the advantages of a pre-surgical radiological study using an endoductal contrast medium (with 3D-technique, in young women with dense breasts). <strong>Results:</strong> A total of 286 women with PND underwent cytological examination, mammography and/or breast ultrasound. When the cytological outcome was reported as “negative” (66.78%) in agreement with negative noninvasive imaging, patients were sent to follow up. Patients with cytological outcomes defined as “bloody with papillary clusters” (29.37%) “bloody not associated to cytological modifications” (2.44%), or “atypical/suspected” for malignant (1.39%) underwent an invasive procedure. Sensitivity, specificity, positive predictive value and negative predictive value were, respectively: 92.63%, 100%, 100% and 96.46% for cytological examination;64.28%, 96.95%, 60% and 97.44% for mammography;41.11%, 97.44%, 88.09% and 78.27% for ultrasound;93.68%, 100%, 100% and 96.95% for invasive procedures. Post-surgical histological outcomes confirmed the diagnosis. <strong>Conclusion:</strong> In absence of a standard diagnostic algorithm, we recommend invasive procedures to identify intraductal breast lesions and for preoperative planning. Digital imaging and new technologies such as 3D-tomosynthesis lead to a renaissance of breast invasive imaging;they are confirmed to be an essential diagnostic modality for preoperative planning, to define localization and extension of multiple coexisting endoductal lesions.展开更多
A possibility of the efficient use of rotary percussive drilling to provide drilling smaller diameter holes(40–70 mm) both in mining and prospecting is disclosed herein. A new construction designed for the nipple thr...A possibility of the efficient use of rotary percussive drilling to provide drilling smaller diameter holes(40–70 mm) both in mining and prospecting is disclosed herein. A new construction designed for the nipple thread connection is described. The relative amplitude variation, change of power pulse time and energy in their propagation throughout the drilling tool are determined. A possibility of the efficient power pulse transfer along the drill string to the rock destruction tools with new nipple connections which allow automating the make-up and breakout system of drill pipe was supported by experiments.展开更多
Behaviors,immunities and growth performances of suckling calves to either fed milk through barrel feeding or artificial nipple feeding were investigated in this study.Seventy-two newborn female suckling Holstein calve...Behaviors,immunities and growth performances of suckling calves to either fed milk through barrel feeding or artificial nipple feeding were investigated in this study.Seventy-two newborn female suckling Holstein calves were selected and divided into two treatments which fed regular milk through milk barrels or artificial nipples.The behaviors′parameters were measured on 14,29 and 44 days.Body weight and body size of the calves were recorded on 15,30 and 45 days.Immune indicators were collected in quiet situation on 15,30 and 45 days.Compared with the barrel feeding method,calves fed by artificial nipples had less non-nutritive behaviors,stronger growth performances and higher immune levels.Artificial nipples gave calves sucking conditions and reduced the motivation of calves to suck each other,which might promote the development of complex stomachs,allow food to be better digested and more effective.It also reduced cross-infection indirectly which increased the calves'immunities.展开更多
Objective: To probe the effect of mastoscopic in modified radical mastectomy operation for preserving nipple-areolar complex in the treatment of breast cancer. Methods: Thirty patients, with breast cancer of a diamete...Objective: To probe the effect of mastoscopic in modified radical mastectomy operation for preserving nipple-areolar complex in the treatment of breast cancer. Methods: Thirty patients, with breast cancer of a diameter≤3 cm and a distance≥3 cm from the mammary areola were treated by mastoscopic from November 2003 to August 2006. After the lipoly- sis and suction of axillary fat, mastoscopic axillary lymph node dissection was performed. Results: The average operation time was 128.9 min (120–156 min), the intraoperative blood loss was 56 mL (30–100 mL). The mean lymph nodes harvested by endoscopy were 16 (6–34). Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2–29 months (mean, 16.6 months) found no local recur-rence. Conclusion:This model of operation can protect the upper limb function and has value of aesthetics of the brisket. What’s more, improve the quality of survive of the patients.展开更多
Nipple adenoma is a rare benign condition that simulates malignancy. A 37-year-old woman presented with unilateral bloody nipple discharge for 1-year duration followed by severe nipple erosion. As biopsy revealed nipp...Nipple adenoma is a rare benign condition that simulates malignancy. A 37-year-old woman presented with unilateral bloody nipple discharge for 1-year duration followed by severe nipple erosion. As biopsy revealed nipple adenoma and therefore, complete local excision was done. The final histopathology showed florid papillomatosis which was adequately excised. Nipple adenoma although rare entity this should be included in the differential diagnosis of any nipple erosion such as carcinoma and Paget’s disease of the breast specially when associated with bloody discharge in premenopausal women.展开更多
BACKGROUND Male breast cancer(MBC)is an extremely rare condition and accounts for less than 1%of all breast cancers,and malignant tumors occur in less than 1%of the affected men.Mucinous breast cancer is extremely rar...BACKGROUND Male breast cancer(MBC)is an extremely rare condition and accounts for less than 1%of all breast cancers,and malignant tumors occur in less than 1%of the affected men.Mucinous breast cancer is extremely rare and accounts for 2%of all invasive breast cancers.Generally,MBC is accompanied by a retroareolar mass.CASE SUMMARY Herein,we report a case of male mucinous breast carcinoma(MMBC)without gynecomastia development and with mass localization outside the common retroareolar region,wherein the mass was a painless nodule in the right breast of a 64-year-old man.We also discuss the clinical and pathological characteristics of this unusual tumor.The excised breast specimen showed pure mucinous carcinoma.The patient had strong expression of estrogen and progesterone receptors,a low Ki-67 proliferation index of the tumor cells,and negative pathological axillary lymph nodes.The patient underwent modified radical mastectomy and axillary lymph node dissection,followed by tamoxifen hormone therapy.CONCLUSION To the best of our knowledge,this is the first case report of MMBC in the nonretroareolar region of the nipple without gynecomastia development.Mucinous tumors are easily missed during diagnosis,and the incidence of axillary lymph node metastases of chest mucinous tumors has increased.展开更多
Background: Recent advances in breast reconstruction and the introduction of oncoplastic techniques have resulted in significant improvement in quality of life and psychological well-being of most patients. Nipple spa...Background: Recent advances in breast reconstruction and the introduction of oncoplastic techniques have resulted in significant improvement in quality of life and psychological well-being of most patients. Nipple sparing mastectomy is a surgical technique that removes breast tissue while preserving the native skin envelope, infra-mammary fold and the NAC, which allows immediately reconstructed breasts to have an excellent cosmetic outcome. Aim: Our primary end point was for objective assessment of aesthetic outcome after NSM via more accurate new method and subsiding bias in that assessment and the secondary end point was for evaluating the influence of incision choice and recommending which incision is the best for each patient putting in mind cup size, degree of ptosis and body mass index of Egyptian patients. Methods: Starting January 2013 to November 2015, 74 patients with breast cancer underwent NSM with immediate reconstruction using LD flap with or without implant augmentation. Results: Incisions used are elliptical (37.8%), lateral (27%), peri-areolar (21.6%) and infra-mammary (13.5%). In 81.1% of the patients, the procedure was performed using extended LD flaps only, while in the remaining 18.9% the flaps were augmented using implant insertion. Axillary dissection was done in 68.9% of patients and SLN in 24.3% of patients. Overall aesthetic results were done by patient self-assessment, assessment by the surgeon, assessment by professional plastic breast surgeon and assessment by onco-plastic surgeon, and this was followed by statistical analysis of the agreement between the plastic surgeon and the onco-plastic surgeon. Conclusion: NSM is safe, feasible and offers adequate oncologic results along with excellent cosmetic outcome. Choice of incision and reconstruction should be tailored to suit each patient. Breast cancer patients can benefit from sound resection and enjoy a sense of wholeness.展开更多
文摘The difficult problem of automatically welding nipples onto the header is first analyzed in this paper, and then the overall structure and operating principle of the robot working unit are introduced. The robot and the measuring device are located by employing the traveling lorry, and this unit enables the robot to adjust the tracks according to the errors received from the measuring device, and then the nipples are welded properly. This paper emphases on the development of the master-slave control system, in which the prograrmmable Logic Controller (PLC) is used as the master computer.
文摘Introduction Hyperkeratosis of nipples and areola (HNA) is a benign skin disease with unknown etiology, and is sporadic and clinically rare. It was first described by Tauber in 1923, and characterized by verrucous hyper-keratosis and dark brown pigmentation of nipples and/or areola(1)Currently, the classification proposed by Levy-Franckel in 1938 is widely used[2], which divides HNA into three types accoding to its clinical mani-festations:TypeⅠis characterized by the extension of epidermis nevus, involving only unilateral nipple and/or areola. TypeⅡis mostly bilateral, involving nipples and areolae, and usually accompanied by other skin diseases, for example ichthyosis, acanthosis nigricans, Darier's disease, chronic eczema, allergic dermatitis, and skin T cell lymphoma. TypeⅢ is congenital or nevus-shaped, and mostly occurrs among 20 to 30 years old females, with involvement of bilateral nipples and/or areolae. Herein, we reported a female patient with hyper-keratosis of bilateral giant nipples and areolae, who was successfully treated by surgery in the Hospital for Dermatology.
文摘The term“nipple confusion”accurately describes the confusion newborns experience between their mother’s nipple and an artificial nipple during feeding.Specifically,it refers to the feeding habits infants develop based on their initial feeding experiences after birth.Infants accustomed to the maternal nipple often resist bottle-feeding;conversely,those accustomed to bottle-feeding may reject the maternal nipple.This confusion is particularly common among infants receiving mixed feeding.
文摘Nipple confusion,a term that accurately describes the confusion that occurs between the mother’s nipple and the artificial teat during feeding in newborns.Specifically,it refers to the fact that babies develop specific breastfeeding habits after birth,based on their initial feeding experience.For babies who are accustomed to their mother’s nipple,they tend to show resistance to bottle feeding;on the contrary,those who have adapted to bottle feeding may refuse to accept their mother’s nipple.This confusion is particularly common among mixed-feeding babies.
文摘BACKGROUND Compared to earlier,there has been an increase in the tattoo procedures for cosmetic purposes;and there has also been an increase in the tattoo procedures performed by non-medical personnel.In South Korea,only tattoos performed by a doctor are considered legal;however,there is still some debate over whether tattoo procedures performed by non-healthcare providers should be considered legal.CASE SUMMARY A 28-year-old woman visited our hospital with pain in both nipples and heat sensation over the last 4 d.She had a history of a nipple tattoo performed by an unlicensed person.Pinpoint bleeding was noted in both areolar areas,and the exudate mixed with pus and orange color ink was discharged.Oral medication and tulle with foam dressing were performed under the impression of cellulitis and allergic reaction.After 4 wk,nipples remained dark brown in color,resulting in a color mismatch between the nipple and orange-colored areola.The size of the areola was also found to be distinctly asymmetrical after healing.This complication may have been caused by the use of illegal ink or unsanitary procedures,or a problem may have occurred in the post-tattoo management stage.CONCLUSION Doctors use approved ink,aseptic procedure and appropriate postoperative care,and appropriate management can be performed in case of complications.
文摘Accessory breast tissue development frequently occurs in addition to physiologic breast development and is a common congenital condition with an occurrence of 0.4% to 6% in women and 1% - 3% in men. A 31-year-old G1P0 female presented to our triage at 20 + 4 weeks gestation with a one-week history of painful bilateral axillary lumps. Her last menstrual period was consistent with an estimated gestational age of 39 + 3 weeks by LMP. She had emigrated from Bengal three years earlier with no other gynecological complaints and knew of no abnormalities on physical exam. The painful axillary lumps were found to be accessory breast tissue. This entity is presented as a palpable thickening that is most prevalent along the milk line in the region immediately below the breasts, along the abdomen, in the axilla and in the groin region adjacent to the vulva. Affected individuals may undergo premenstrual changes such as tenderness, swelling, and difficulty with shoulder range of motion and irritation. The onset of pregnancy stimulates the tissue and makes it more evident as it did with our patient.
基金Supported by a grant from the Application Technology Research and Development Project Foundation in Rizhao City(No.2060402)
文摘Objective： The purpose of this study was to study the clinical and pathological characteristics of breast intraductal proliferative lesions （IDPLs） and associated with invasive breast cancer. Methods： We reviewed 327 cases of breast intra- ductal proliferative lesions including 53 cases of usual ductal hyperplasia, 57 cases of atypical ductal hyperplasia, 89 cases of ductal carcinoma in situ, and 128 cases coexist with invasive ductal carcinomas. Cases of pure invasive cancer without intraductal proliferative lesions were excluded. The mult IDPLs biological parameters including the express of ER, PR, HER2, HIF-lo and Ki-67 detected by immunohistochemistry S-P method （n = 327） and the levels of CA153, TSGF, CA125 and CEA both in nipple discharge and serum （n = 179） measured with Electrochemiluminescence method and their relationship were studied, and 30 cases of normal pregnant women were compared with. Results： A single histologic subtype was present in 49.85% （163/327） of the cases, two subtypes in 33.03% （108/327）, and three in 17.13% （56/327）. The most common subtypes present were cribriform （43.12%, 141/327） and solid （38.53%, 126/327）, while the comedo （16.35%, 54/327）, and micropapillary （12.84%, 42/327） subtypes were less common. Comedo and solid were frequently found together for coexpres- sion as were micropapillary and papillary subtypes. However, Comedo subtype was much less likely to be found with papillary, cribriform or micropapillary subtypes. Additionally, comedo subtypes tend to be hormone receptor negative, Her2 positive and high-grade while the cribriform and solid subtype tends to be hormone receptor positive, Her2 negative and low grade. Papil- lary subtype was least likely to be associated with an invasive cancer. Furthermore, the nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in coexist with invasive ductal carcinomas patients were significantly higher than those in the benign breast disease （pure intraductal proliferative lesions） and normal pregnant women （P 〈 0.01）. Additionally, the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than in the serum （P 〈 0.01）, and had a positive correlation with the Ki-67, grade, clinical stage, lymph node metastasis and tumor recurrence （P 〈 0.05）, and negative correla- tion with the level of ER and PR （P 〈 0.05）. The sensitivity of the four serum tumor markers in combination was only 69.77%, in contrast, the combined detection both in discharge and serum was 97.67%, and the negative predictive value was 99.03%. The sensitivity of combined detection both in nipple discharge and serum were significantly higher than other detection （P 〈 0.05）. Conclusion： IDPLs often present more than one histologic subtype and the most common subtypes are cribriform and solid, while comedo and micropapillary subtypes are less common. Our results suggest that the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than those in the serum, and is associated with HIF-le. The aberration of HIF-la may play a key role during oncogenesis and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. Nipple discharge can be the earliest presenting symptom of breast cancer. The dynamic combined detection of the four tumor markers both in nipple discharge and serum are helpful to the stratification of preoperative patients and benefit to better prewarning markers for monitoring their recurrence and metastasis and clinical staging of tumors in clinic, but cannot increase the sensitivity of judging the patients with early breast cancer.
文摘Necrosis of nipple-areola complex is one of the major complications of breast reduction in gigatomastia.Wie present a case study of a 32-year-old patient with severe gigantomastia,who required an immediate nipple reconstruction during breast reduction.The final reconstruction was satisfactory.No complications were observed within three months postoperatively.
文摘BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.
文摘Bloody discharge from the breasts in a lactating woman can be caused by various conditions like cracked nipples, mastitis, trauma or ductal papilloma [1]. A physiological condition called rusty pipe syndrome can also cause bilateral bloody discharge in lactating mothers [2].
文摘OBJECTIVE To explore the value of fiberoptic ductoscopy in diagnosing and treating bilateral and polyporous nipple discharge (ND).METHODS Fiberoptic ductoscopy was conducted in 29 patients with bilateral and polyporous ND.After the ductoscopy,the patients with intraductal papilloma (IDP) underwent a surgical procedure,and the others,identified with galactostasis,mammary duct ectasia (MDE) and obstructive galactophoritis (OG),received a ductoscopy-guided interventional therapy. RESULTS Among 29 cases,and with 79 galactophores examined,IDP was found in 11 cases (37.9% of the total cases),or 13.9% of the galactopores examined.IDP was found in 9 of 11 cases with a bloody nipple discharge,while IDP was seen in 2 of the 18 cases with a non-bloody nipple discharge.The excision accuracy achieved 100% in the cases,and postoperative pathological diagnosis accordance rate reached 88.9%. CONCLUSION Fiberoptic ductoscopy has many features such as ability to see the lesion,and accurate preoperative localization,thus eliminating excessive excision of tissue during surgery.For most patients with ND,especially those suffering galactostasis,OG or MDE,washout under fiberoptic ductoscopy and interventional therapy may achieve a thorough cure of the disease.
文摘Objective: To evaluate the long term follow-up results of the direct nipple ureteroneocystostomy technique. Materials and Methods: We studied a total of 16 patients (19 renal units) who underwent direct nipple ureteroneocystostomy. The mean age was 43 years and 3 patients had bilateral disease. In five units the ureters had been ligated during gynecological surgery, 11 renal units were obstructive and three units were reflexive megaureters. The ureters were spatulated for about 2 cm and folded back. Nipples 2 to 2.5 cm long were prepared. In two cases the ureters were thin-walled (2 mm or less) and they were not spatulated but folded back onto themselves. In one case the ureter could not be everted since it had a thick and fibrotic wall. The distal 2 to 2.5 cm segment of this ureter was directly inserted in to the bladder. Postoperative follow-up was at 3 month intervals for the first year at 6 month intervals for 2 - 3 years and yearly thereafter. At the time of follow-up serum creatinine, urine culture, ultrasound, intravenous urography, voiding cystoureterography, nuclear renal scintigraphy and cystometric evaluations were performed. The functions of 11 and 15 renal units were evaluated scintigraphically and stereologically, respectively, in the both preoperative and postoperative first year follow-up. The Wilcoxon Signed Ranks test was used for statistical evaluation and p < 0.05 was considered statistically significant. Results: Mean follow-up was 49 months. Three renal units had Grade III reflux (two of them during voiding) and one unit had Grade IV reflux. At follow-up this patient developed in the ureteral stricture. No patients had urinary tract infection, pyelonephritis or ureteral stricture follow-up period. Between the preoperative and postoperative first year, there was an increase in postoperative split renal function based on renal scintigraphy but this difference was not statistically significant. The stereologically calculated decrease in pelvicaliceal dilatation was statistically significant. Conclusion: Ease of application and no need to taper or plicate the ureter or prepare a submucosal tunnel may be the reasons to consider the direct nipple ureteroneocystostomy technique for megaureters of different etiologies.
文摘<strong>Objective:</strong> To evaluate the role of invasive imaging in the identification and pre-surgical localization of endoductal breast lesions. <strong>Methods:</strong> We retrospectively evaluated cytological outcomes, non-invasive/invasive breast imaging obtained between January 2016 and December 2019 in women with pathological nipple discharge (PND). We analysed sensitivity, specificity, positive predictive value and negative predictive value. We also evaluated the advantages of a pre-surgical radiological study using an endoductal contrast medium (with 3D-technique, in young women with dense breasts). <strong>Results:</strong> A total of 286 women with PND underwent cytological examination, mammography and/or breast ultrasound. When the cytological outcome was reported as “negative” (66.78%) in agreement with negative noninvasive imaging, patients were sent to follow up. Patients with cytological outcomes defined as “bloody with papillary clusters” (29.37%) “bloody not associated to cytological modifications” (2.44%), or “atypical/suspected” for malignant (1.39%) underwent an invasive procedure. Sensitivity, specificity, positive predictive value and negative predictive value were, respectively: 92.63%, 100%, 100% and 96.46% for cytological examination;64.28%, 96.95%, 60% and 97.44% for mammography;41.11%, 97.44%, 88.09% and 78.27% for ultrasound;93.68%, 100%, 100% and 96.95% for invasive procedures. Post-surgical histological outcomes confirmed the diagnosis. <strong>Conclusion:</strong> In absence of a standard diagnostic algorithm, we recommend invasive procedures to identify intraductal breast lesions and for preoperative planning. Digital imaging and new technologies such as 3D-tomosynthesis lead to a renaissance of breast invasive imaging;they are confirmed to be an essential diagnostic modality for preoperative planning, to define localization and extension of multiple coexisting endoductal lesions.
基金supported by the research Grant within the framework of the Federal Target Program ‘Scientific and Academic Staff of Innovative Russia’ during the years of 2009–2013competitive activity 1.3.1. ‘Research conducted by young researchers, Ph.D. holders’, the project theme ‘Research of power pulse interaction in a drilling tool and in rock mass in underground borehole drilling’
文摘A possibility of the efficient use of rotary percussive drilling to provide drilling smaller diameter holes(40–70 mm) both in mining and prospecting is disclosed herein. A new construction designed for the nipple thread connection is described. The relative amplitude variation, change of power pulse time and energy in their propagation throughout the drilling tool are determined. A possibility of the efficient power pulse transfer along the drill string to the rock destruction tools with new nipple connections which allow automating the make-up and breakout system of drill pipe was supported by experiments.
基金Supported by the National Science and Technology Support Project(2012BAD12B05)。
文摘Behaviors,immunities and growth performances of suckling calves to either fed milk through barrel feeding or artificial nipple feeding were investigated in this study.Seventy-two newborn female suckling Holstein calves were selected and divided into two treatments which fed regular milk through milk barrels or artificial nipples.The behaviors′parameters were measured on 14,29 and 44 days.Body weight and body size of the calves were recorded on 15,30 and 45 days.Immune indicators were collected in quiet situation on 15,30 and 45 days.Compared with the barrel feeding method,calves fed by artificial nipples had less non-nutritive behaviors,stronger growth performances and higher immune levels.Artificial nipples gave calves sucking conditions and reduced the motivation of calves to suck each other,which might promote the development of complex stomachs,allow food to be better digested and more effective.It also reduced cross-infection indirectly which increased the calves'immunities.
文摘Objective: To probe the effect of mastoscopic in modified radical mastectomy operation for preserving nipple-areolar complex in the treatment of breast cancer. Methods: Thirty patients, with breast cancer of a diameter≤3 cm and a distance≥3 cm from the mammary areola were treated by mastoscopic from November 2003 to August 2006. After the lipoly- sis and suction of axillary fat, mastoscopic axillary lymph node dissection was performed. Results: The average operation time was 128.9 min (120–156 min), the intraoperative blood loss was 56 mL (30–100 mL). The mean lymph nodes harvested by endoscopy were 16 (6–34). Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2–29 months (mean, 16.6 months) found no local recur-rence. Conclusion:This model of operation can protect the upper limb function and has value of aesthetics of the brisket. What’s more, improve the quality of survive of the patients.
文摘Nipple adenoma is a rare benign condition that simulates malignancy. A 37-year-old woman presented with unilateral bloody nipple discharge for 1-year duration followed by severe nipple erosion. As biopsy revealed nipple adenoma and therefore, complete local excision was done. The final histopathology showed florid papillomatosis which was adequately excised. Nipple adenoma although rare entity this should be included in the differential diagnosis of any nipple erosion such as carcinoma and Paget’s disease of the breast specially when associated with bloody discharge in premenopausal women.
文摘BACKGROUND Male breast cancer(MBC)is an extremely rare condition and accounts for less than 1%of all breast cancers,and malignant tumors occur in less than 1%of the affected men.Mucinous breast cancer is extremely rare and accounts for 2%of all invasive breast cancers.Generally,MBC is accompanied by a retroareolar mass.CASE SUMMARY Herein,we report a case of male mucinous breast carcinoma(MMBC)without gynecomastia development and with mass localization outside the common retroareolar region,wherein the mass was a painless nodule in the right breast of a 64-year-old man.We also discuss the clinical and pathological characteristics of this unusual tumor.The excised breast specimen showed pure mucinous carcinoma.The patient had strong expression of estrogen and progesterone receptors,a low Ki-67 proliferation index of the tumor cells,and negative pathological axillary lymph nodes.The patient underwent modified radical mastectomy and axillary lymph node dissection,followed by tamoxifen hormone therapy.CONCLUSION To the best of our knowledge,this is the first case report of MMBC in the nonretroareolar region of the nipple without gynecomastia development.Mucinous tumors are easily missed during diagnosis,and the incidence of axillary lymph node metastases of chest mucinous tumors has increased.
文摘Background: Recent advances in breast reconstruction and the introduction of oncoplastic techniques have resulted in significant improvement in quality of life and psychological well-being of most patients. Nipple sparing mastectomy is a surgical technique that removes breast tissue while preserving the native skin envelope, infra-mammary fold and the NAC, which allows immediately reconstructed breasts to have an excellent cosmetic outcome. Aim: Our primary end point was for objective assessment of aesthetic outcome after NSM via more accurate new method and subsiding bias in that assessment and the secondary end point was for evaluating the influence of incision choice and recommending which incision is the best for each patient putting in mind cup size, degree of ptosis and body mass index of Egyptian patients. Methods: Starting January 2013 to November 2015, 74 patients with breast cancer underwent NSM with immediate reconstruction using LD flap with or without implant augmentation. Results: Incisions used are elliptical (37.8%), lateral (27%), peri-areolar (21.6%) and infra-mammary (13.5%). In 81.1% of the patients, the procedure was performed using extended LD flaps only, while in the remaining 18.9% the flaps were augmented using implant insertion. Axillary dissection was done in 68.9% of patients and SLN in 24.3% of patients. Overall aesthetic results were done by patient self-assessment, assessment by the surgeon, assessment by professional plastic breast surgeon and assessment by onco-plastic surgeon, and this was followed by statistical analysis of the agreement between the plastic surgeon and the onco-plastic surgeon. Conclusion: NSM is safe, feasible and offers adequate oncologic results along with excellent cosmetic outcome. Choice of incision and reconstruction should be tailored to suit each patient. Breast cancer patients can benefit from sound resection and enjoy a sense of wholeness.
