Surgical anatomy of the breast revisited

With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on innervation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin

Human CD34+/CD90+ ASCs Are Capable of Growing as Sphere Clusters, Producing High Levels of VEGF and Forming Capillaries

Background: Human adult adipose tissue is an abundant source of mesenchymal stem cells (MSCs). Moreover, it is an easily accessible site producing a considerable amount of stem cells. Methodology/Principal Findings: In this study, we have selected and characterized stem cells within the stromal vascular fraction (SVF) of human adult adipose tissue with the aim of understanding their differentiation capabilities and performance. We have found, within the SVF, different cell populations expressing MSC markers – including CD34, CD90, CD29, CD44, CD105, and CD117 – and endothelial-progenitor-cell markers – including CD34, CD90, CD44, and CD54. Interestingly, CD34+/CD90+ cells formed sphere clusters, when placed in non-adherent growth conditions. Moreover, they showed a high proliferative capability, a telomerase activity that was significantly higher than that found in differentiated cells, and contained a fraction of cells displaying the phenotype of a side population. When cultured in adipogenic medium, CD34+/CD90+ quickly differentiated into adipocytes. In addition, they differentiated into endothelial cells (CD31+/VEGF+/Flk- 1+) and, when placed in methylcellulose, were capable of forming capillary-like structures producing a high level of VEGF, as substantiated with ELISA tests. Conclusions/Significance: Our results demonstrate, for the first time, that CD34+/CD90+ cells of human adipose tissue are capable of forming sphere clusters, when grown in free-floating conditions, and differentiate in endothelial cells that form capillary-like structures in methylcellulose. These cells might be suitable for tissue reconstruction in regenerative medicine, especially when patients need treatments for vascular disease

Surgical anatomy of the breast revisited

With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on innervation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin.With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on inne­rvation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin

Effects of Topic Simvastatin for the Treatment of Chronic Vascular Cutaneous Ulcers: A Pilot Study

none5Recent research suggests that statins might be useful in the process of wound healing, playing a positive immune-modulatory role, improving microvascular function and reducing oxidative stress. The aim of this pilot study was to evaluate the efficacy of topic application of Simvastatin-based cream in the treatment of chronic vascular cutaneous ulcers, comparing this type of treatment to a collagen-based dressing, proven to be effective for ulcer treatment. A total of 20 ulcers were studied in 2 Groups of randomly-chosen patients for a period of one month. In the first Group a 0.5% Simvastatin-based cream was topically administered, while the second Group (control) was treated with an absorbable type I bovine collagen-based medication. Each week, wound healing progress was observed in both Groups, and the ulcers photographed. Wound healing rate was calculated by considering the absolute change in area and by the formula “healing ratio (%) = [(Area0 − Areat4)/Area0] × 100,” both sets of data being related to the days comprised in the study in order to calculate healing rate per day. Statistical analysis was performed by Student t test. Study endpoint equaling the time-course changes of ulcer areas. At the end of the study, when considering absolute change in area, the experimental Group appeared to heal better and faster than the control Group although differences between the Groups were not statistically significant. Conversely, rates of wound healing in the experimental and control Groups were 46.88% and 64% respectively, revealing statistically significant differences. (P < 0.05). In conclusion, topic application of a simvastatin-based cream proved to be well- tolerated but not effective in the management of vascular leg ulcers in a 4 week-period.noneRAPOSIO, Edoardo; Libondi, Guido; Bertozzi, Nicolò; GRIGNAFFINI, Eugenio; GRIECO, Michele PioRaposio, Edoardo; Libondi, Guido; Bertozzi, Nicolò; Grignaffini, Eugenio; Grieco, Michele Pi

Cell cycle analysis performed using Hoechst 33342 and Ki67 both on CD34 negative and positive cells.

<p>(A) Hoechst 33342 analysis performed CD34⁻ cells: G₀G₁ phase (98%), S phase (0,65%) and G₂M phase (0,50%); (B) Ki67 analysis performed CD34- cells: Ki67 (10%); (C) Hoechst 33342 analysis performed CD34⁺ cells: G₀G₁ phase (84%), S phase (5%) and G₂M phase (10%); (D) Ki67 analysis performed CD34+ cells: Ki67 (85%).</p

Spheres formation, cytometric analysis and telomerase activity.

<p>(A) Sphere clusters formed by CD34⁺/CD90⁺ cells in semisolid medium after 24 hours (Original Magnification×100); (B) Cytometric analysis on adherent cells for CD90 (80%) and CD34 (80%) antigens and on floating spheres for CD90 (2–3%) and CD34 (95–98%) antigens; (C) Telomerase activity of differentiated endothelial cells (ΔA = 0.160) was significantly reduced (p<0.001) respect to undifferentiated CD34⁺/CD90⁺ cells (ΔA = 0.377)</p

RT-PCR analysis.

<p>(A) Representative figure of RT-PCR showing mRNA transcript expression of CD90, CD34, CD44, CD54, VEGF, Flk-1, on cells in DMEM 10% FBS 7, 15 and 30 days of culture; (B) PPARγ and adiponectin on cells in adipogenic medium at 7 and (C) 30 days of culture.</p

Adipogenic differentiation.

<p>(A) ASCs in DMEM 10% FBS exhibit a fibroblast-like morphology (Original magnification 100×); (B) ASCs in adipogenic medium exhibit an adipocyte morphology (Original magnification 100×); (C) CD34⁺/CD90⁺ cells in DMEM 10% FBS showing negativity for adiponectin by immunohistochemistry (Original magnification 400×); (D) CD34⁺/CD90⁺ cells in adipogenic medium showing positivity for adiponectin by immunohistochemistry (Original magnification 100×); (E) CD34⁻/CD90⁻ cells in DMEM 10% FBS showing negativity for adiponectin by immunohistochemistry (Original magnification 100×); (F) CD34⁻/CD90⁻ cells in adipogenic medium showing negativity for adiponectin by immunohistochemistry (Original magnification 400×).</p