Trends in post-mastectomy breast reconstruction types at a breast cancer tertiary referral centre before and after introduction of acellular dermal matrices.

Background: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution.

Methods: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs.

Management of hip fractures pre- and post-Major Trauma Centre activation.

Introduction: In April 2012, the activation of the regional trauma networks in England was carried out to improve the organisation of trauma care. NHS Trusts that could meet the highest standard of care to complex trauma were designated Major Trauma Centres (MTCs). MTCs receive patients fulfilling certain triage criteria, as well as secondary transfers from nearby trauma units.

The role of chronic norovirus infection in the enteropathy associated with common variable immunodeficiency.

Objectives: A severe enteropathy of unknown etiology can be associated with common variable immunodeficiency (CVID).

Methods: S tool and archived small intestinal mucosal biopsies from patients with CVID enteropathy were analyzed by PCR for the presence of Norovirus RNA. The PCR products were sequenced to determine the relationship of viral isolates.

Avoiding pitfalls in open augmentation rhinoplasty with autologous L-shaped costal cartilage strut grafts for saddle nose collapse due to autoimmune disease: the Cambridge experience.

Introduction: Saddle nose deformity due to autoimmune diseases such as Wegener's Granulomatosis and Relapsing Polychondritis is aesthetically, functionally and psychologically distressing for patients. However, "reliable" options for surgical correction remain limited in the literature. We present our experience of augmentation rhinoplasty in this patient population focussing on the techniques and pitfalls of L-shaped costal cartilage grafting.

Modification of the tensor fasciae latae flap for reconstruction of the abdominal wall: a case report.

Full-thickness periumbilical wounds after extensive abdominal surgery present a major challenge. In this case report the traditional tensor fasciae latae flap was modified, improving flap mobility while also facilitating donor defect repair.

Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study.

Objective: Recent evidence suggests that C-reactive protein (CRP) may predict development of diabetes in Caucasian populations. We evaluated CRP as a possible risk factor of the development of diabetes and metabolic syndrome in a 6-year study of 515 men and 729 women from the Mexico City Diabetes Study.

Research Design And Methods: Baseline CRP, indexes of adiposity, and insulin resistance (homeostasis model assessment [HOMA-IR]) were used to predict development of the metabolic syndrome, defined as including two or more of the following: 1) dyslipidemia (triglyceride >/=2.

Domain structure of hepatocyte growth factor/scatter factor (HGF/SF).

The modular structure of hepatocyte growth factor/scatter factor (HGF/SF) has facilitated structure-function analysis. Domain deletion experiments have established that the N-domain, kringle 1 and kringle 2 are essential for HGF/SF activity on target cells and that, conversely, truncated variants containing the N-domain and kringle 1 (NK1) or kringles 1 and 2 (NK2) exhibit partial agonistic or antagonistic activity depending on target cells and the presence of full length HGF/SF. The 3D structures of the six domains of HGF/SF have been modelled on the structure of homologues, offering interesting insights into putative mechanisms of domain interactions, receptor binding and activation.

Evolution of plasminogen-related growth factors (HGF/SF and HGF1/MSP).

HGF/SF and HGF1/MSP define a novel growth factor family whose members share the domain structure and the proteolytic process of activation of the blood proteinase precursor plasminogen. The amino acid and RNA sequences of HGF/SF and HGF1/MSP, the intron-exon organization of their genes and the predicted 3D structure of individual domains indicate that HGF/SF and HGF1/MSP evolved along with plasminogen and other members of the kringle-serine proteinase (KSP) superfamily from an ancestral gene that contained a single copy of the kringle domain, a serine proteinase domain and an activation peptide connecting the two domains. A series of intragenic duplications of the kringle domain, gene duplications, exon shuffling and deletions is responsible for the genes currently present in mammals, avians and amphibians.

Co-expression of the HGF/SF and c-met genes during early mouse embryogenesis precedes reciprocal expression in adjacent tissues during organogenesis.

Early experiments with cells in culture and recent targeting experiments have confirmed that the mesenchyme-derived growth factor hepatocyte growth factor/scatter factor (HGF/SF) is a paracrine agent that regulates the development of several epithelial and myogenic precursor cells during organogenesis. Here, we report the expression pattern of HGF/SF and its receptor, the product of the proto-oncogene c-met, during gastrulation and early organogenesis in mouse embryo. During gastrulation, the expression of HGF/SF and c-met overlaps.

HGF/SF inhibits junctional communication.

Hepatocyte growth factor/scatter factor (HGF/SF) is a fibroblast-derived protein that affects the growth, motility, and differentiation of epithelial and endothelial cells. We have investigated the effect of HGF/SF on junctional communication in mouse keratinocytes (MK cells). HGF/SF inhibited cell communication in MK cells as assessed by the transfer of a low-molecular-weight dye, Lucifer Yellow.

Universal cloning and direct sequencing of rearranged antibody V genes using C region primers, biotin-captured cDNA and one-side PCR.

Polymerase chain reaction (PCR) cloning has greatly facilitated the cloning of heavy and light chain genes from B cells and hybridomas and has been critical for the generation of natural antibody gene libraries for expression in bacteria and on filamentous phages. There remain difficulties, however, in cloning VH and VL genes from a number of mouse and rat hybridoma lines and from B cells from several other species due to insufficient sequence information. Here we describe a rapid and 'universal' strategy for cloning rearranged antibody genes from any species for which the sequence of the C segment(s) are known.

Methodological issues in screening for dementia.

Screening for dementia in populations presents particular difficulties for researchers. In the absence of gold standards for diagnosis, the methods used must be determined by the purposes of the study. In two-stage epidemiological study the screening wave and the diagnostic instrument should be considered together in relation to a third proxy gold standard such as progression of the disorder to moderate and greater severity and neuropathological diagnosis.

The Cambridge Project for Later Life: design and preliminary results.

The Cambridge Project for Later Life is the follow-up at 2.4 years of the Hughes Hall Project for Later Life, a prevalence study of dementia in Cambridge city in which 40% of the population aged 75 and over were screened for dementia. In the follow-up, 1,173 people were screened a second time, and using Mini-Mental Scale Examination scores were selected for a more intensive interview with CAMDEX.

A longitudinal study in progress: a five-year follow-up of women aged 70-79 years living in a rural community.

The study in progress is a 5-year follow-up of an epidemiological investigation of the indices of dementia in women aged 70-79. From the original sample of 365 women approximately 78 had died at 5 years. Of those remaining all are being reapproached for the purpose of reassessment using the same tools as the original study and informants of both surviving and decreased participants are likewise being contacted.

Induction of long-term survival of hamster heart xenografts in rats.

The aim of this study was to determine the mechanisms responsible for concordant xenograft rejection using the hamster-to-rat heart graft model. Even though it was known that rat CD4 positive T cells proliferated to hamster stimulators in mixed lymphocyte reactions, the depletion of CD4 positive T cells in rat recipients did not lead to an extension of xenograft survival. Suppression of T cell immunity using other monoclonal antibodies or cyclosporine also failed to improve survival.

Cadaveric renal transplantation in elderly recipients: is it worthwhile?

The aim of this study is to analyse whether or not old age alone significantly affects the outcome of patient and graft survival in cadaveric renal transplantation, and thus whether it should be a selection criterion for induction into transplant programmes, given the current shortfall in donor organs in the United Kingdom. Data is presented on all 307 solitary cadaveric renal allografts performed at Addenbrooke's Hospital, Cambridge between January 1983 and December 1987. Patients are divided into those aged less than 60 years (n = 243) and those aged 60 years and over (n = 45) at the time of transplantation.

In vitro and in vivo effects of monoclonal antibodies against T cell subsets on allogeneic and xenogeneic responses in the rat.

The Syrian hamster-to-rat represents an example of a concordant species difference, and therefore organ transplants using the hamster as the donor and the rat as the recipient are not rejected hyperacutely, as in discordant species combinations. Cellular mechanisms of xenogeneic rejection of hamster hearts by rats were studied both in vitro and in vivo, using monoclonal antibodies to rat T cell antigens. The results of this study reveal that CD4-positive cells of rats proliferated in vitro to both allogeneic stimulators and xenogeneic stimulators from a concordant strain, but required accessory cells of the responder phenotype to proliferate to discordant human stimulators.