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Objective: This study aimed to describe the imaging features of adenoid cystic carcinoma (ACC) of the breast using multimode imaging., Materials and Methods: The findings from mammography, sonography, magnetic resonance imaging, or digital breast tomosynthesis in 11 patients with histopathologically confirmed ACC of the breast were reviewed. The imaging criteria included location, shape, size, number, margin, calcification, attenuation, echo and/or signal intensity, internal mass enhancement pattern, and dynamic-enhancement characteristics., Results: On mammography (n = 9), ACC demonstrated as an irregular or lobulated mass with indistinct or spiculated margins. Sonographically (n = 11), ACCs appeared as a hypoechoic solid or heterogeneous mass with minimum vascularity on color Doppler examination. With regard to magnetic resonance imaging (n = 9), 2 of the largest masses had an extensive high T2-weighted imaging (T2WI) signal and hypointense internal septations, which demonstrated delayed enhancement. Dynamic enhancement illustrated washout kinetics. The 7 smaller masses appeared isointense on T2WI, and their internal septations were unenhanced. Among them, 5 demonstrated plateau kinetics and 2 demonstrated persistent kinetics., Conclusions: Although ACC is a rare event in the breast, we believe that the following signs may suggest the diagnosis of this entity: a well-defined border, extensive high T2WI signals, and internal septations that demonstrate delayed enhancement in larger lesions.

Study Design: This is a retrospective, clinical, and radiologic study of posterior reduction and fusion of the C1 arch in the treatment of unstable Jefferson fractures., Objective: The aim of the study was to describe a new motion-preserving surgical technique in the treatment of unstable Jefferson fracture., Summary of Background Data: The management of unstable Jefferson fractures remains controversial. The majority of C1 fractures can be effectively treated nonoperatively with external immobilization unless there is an injury to the transverse atlantal ligament (TAL). Conservative treatment usually involves immobilization for a long time in Halo vest, whereas surgical intervention generally involves C1-C2 fusion, eliminating the range of motion of the upper cervical spine. We propose a novel method for the treatment of unstable Jefferson fractures without restricting the range of motion., Methods: A retrospective review of 12 patients with unstable C1 fractures between April 2008 and October 2011 was performed. They were treated by inserting bilateral posterior C1 pedicle screws or lateral mass screws interconnected by a transversal rod to achieve internal fixation. There were 8 men and 4 women, with an average age of 35.6 years (range, 20-60 y). Presenting symptoms included neck pain, stiffness, and decreased range of motion but none had neurological injury. Seven patients had bilateral posterior arch fractures associated with unilateral anterior arch fractures (posterior 3/4 Jefferson fracture, Landells type II), and 5 had unilateral anterior and posterior arch fractures (half-ring Jefferson fracture, Landells type II). Seven patients had intact TAL, and 5 patients had fractures and avulsion of the attachment of TAL (Dickman type II)., Results: A total of 24 screws were inserted. Five cases had screws placed in the lateral mass: 3 because of posterior arch breakage, and 2 because the height of the posterior arch at the entry point was <4 mm. The remaining 7 cases had pedicle screw fixation. One patient had venous plexus injury during exposure of lower margin of the posterior arch; however, successful hemostasis was achieved with Gelfoam. Postoperative x-ray and computed tomography scan showed partial breach of the transverse foramen caused by a screw in 1 case, and breach of the inner cortex of the pedicle caused by screw displacement in 1 case; however, no spinal cord injury or vertebral artery injury was found. The remaining screws were in good position. Patients were followed up for 6-40 months (average, 22 mo). All cases had recovery of range of motion of the cervical spine to the preinjury level by 3-6 months after surgery, with resolution of pain. At 6 months follow-up, plain radiographs and computed tomography scans revealed satisfactory cervical alignment, no implant failure, and satisfactory bony fusion of the fractures; no C1-C2 instability was observed on the flexion-extension radiographs., Conclusions: C1 posterior limited construct is a valid technique and a feasible method for treating unstable Jefferson fractures, which allows preservation of the function of the craniocervical junction, without significant morbidity.

Introduction: Although the subcutaneous tissue is considered as an attractive site for pancreatic islet transplantation, the success rate has been extremely low., Aims: To use basic fibroblast growth factor (bFGF) to induce neovascularization and sufficient blood flow around the space formed for grafted islets in the subcutaneous tissue to improve the islet survival., Methodology: In the experimental group, two bFGF-releasing devices were implanted bilaterally into the subcutaneous tissue (back) of diabetic Lewis rats. One week after implantation, in the same site, isolated rat islets were syngeneically transplanted after the removal of the devices. In the control group, two devices without bFGF were implanted before subcutaneous islet transplantation of the same number of islets., Results: One week after the implantation of the bFGF-releasing devices in the experimental animals, the devices induced angiogenesis by slow release of bFGF. After transplantation of islets, the neovascularized recipient rats showed significant decreases in nonfasting blood glucose concentration and maintained normoglycemia for more than 3 months. However, in the control group, all rats failed to achieve normoglycemia after transplantation in the absence of neovascularization., Conclusion: This study provides evidence that the subcutaneous tissue is a promising site for pancreatic islet transplantation, which suggests the acceptability of this treatment for diabetic recipients.

The technique of leukocyte filtration has been introduced into cardiac surgery to reduce leukocyte mediated reperfusion injury. When autologous whole blood (WB) is used as filtrate, it is more likely to be activated by the filter material than are banked red blood cell concentrates (RCC), because of its richness in plasma components. This study was designed to compare the activation of plasma components during leukocyte filtration from WB (n = 10) taken from the heart-lung machine, with RCC (n = 10) obtained from the blood bank. Leukocyte filters made from either cellulose acetate or polyester were used. Blood samples were taken simultaneously from the inlet and outlet of the filter after filtration of either 700 ml of WB or 350 ml of RCC. Results indicated that the complement cascade was activated, as reflected by the increase of C3a and C5a during filtration of WB by filters made from cellulose acetate. In contrast, there was no significant increase of C3a and C5a during filtration of RCC. The clotting system, indicated by fibrinopeptide A, and the fibrinolytic system, indicated by fibrinogen degradation products, were not activated during leukocyte filtration. These data suggest that it is the WB taken from the heart-lung machine rather than the RCC from the blood bank that is being activated during leukocyte filtration. Thus, careful selection of filter material is important for leukocyte filtration of autologous whole blood during cardiac surgery.

To evaluate the effects of pulsatile reperfusion on the post ischemic myocardium, two categories of sheep were put on cardiopulmonary bypass (CPB). In Category I, the hearts of 23 sheep were arrested by global ischemia for 30 min, reperfused with pulsatile flow in 10 animals (P group), and non pulsatile flow in 13 animals (NP group), and then defibrillated. The incidence of ventricular fibrillation was much higher in the NP group than the P group, 77% versus 40% (p < 0.05). The lipoperoxide products and creatinine kinase from coronary sinus blood were elevated, but there were no significant differences between the two groups during 2 hour reperfusion. In the P group, less ultrastructural damage was observed, and Na+ and H2O accumulations in the subendomyocardium were significantly less than in the NP group, at 7.11 +/- 0.60 versus 9.98 +/- 1.10 mg/g dry weight (p < 0.05) and 82.58 +/- 0.47% versus 84.3 +/- 0.38% (p < 0.05), respectively. In Category II, the ischemic time of 17 sheep (eight in the P group, nine in the NP group) was prolonged to 45 min, and animals were supported by CPB after defibrillation. Myocardial energy phosphates were measured with high-performance liquid chromatography, and triphenyltetrazolium chloride was used to delineate the infarct size. After 2 hour of reperfusion, there were no significant differences in myocardial AMP and ADP between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

In this study, we first examined in vitro a polyvinyl alcohol membrane to be used to contain hybrid islet cells, and second we tested a bioartificial pancreas with entrapment of pancreatic islets in polyvinyl alcohol membrane in rats with experimentally induced diabetes. The permeability of the polyvinyl alcohol membrane to different substances was studied in a two-cell chamber system. Glucose, insulin, and nutrients passed through the membrane easily, whereas the passage of immunoglobulin G was completely prevented, indicating that this membrane could be effective in protecting the bioartificial pancreas from immunorejection. Approximately 2,000 islets collected from three Sprague-Dawley rats were enclosed in a mesh-reinforced polyvinyl alcohol tube and transplanted into the peritoneal cavity of six Wistar rats with streptozotocin-induced diabetes. Their nonfasting serum glucose levels were significantly decreased for at least 12 days. Six diabetic rats receiving intraperitoneal transplantation of free islets without the tube showed a slight but significant decrease in nonfasting serum glucose levels for only 3 days. One diabetic rat with transplantation of the bioartificial pancreas had a significant and sustained decrease in nonfasting glucose levels from pretransplanted levels of 440-500 mg/dl to a mean value of 162 +/- 13 mg/dl for over 3 months without immunosuppression. The bioartificial pancreas was then removed, and glucose levels gradually increased to over 500 mg/dl. The results of the present study suggest that a bioartificial pancreas with entrapment of islets in a polyvinyl alcohol membrane could be a promising therapeutic approach to diabetes mellitus.