Patients with osmidrosis are particularly concerned with malodour elimination after surgery. Open excision of the subcutaneous apocrine glands through a small incision seems to be the most logical and effective method available for osmidrosis. However, literature on long-term results and complications after such surgery based on large case series are rare. From January 2005 to May 2008, 256 consecutive patients with axillary osmidrosis were treated with our subcutaneous glands excision technique, of which 206 could be followed up from 3 to 40 (mean 18.1) months. Patients ranged in age from 14 to 52 (mean 23.4) years and the female to male ratio was 131:75. Among the 206 cases, 183 cases had family histories of the disease and 16 were accompanied with axillary hyperhidrosis. Postoperatively, as high as 97% of the patients achieved good results in terms of malodour elimination during the follow-up period. All patients reported reduction in axillary sweating; among them 16 patients complicated with axillary hyperhidrosis reported a significant reduction. Axillary hair growth was much reduced in most (95%) patients, and four female patients complicated with axillary hirsutism were extremely satisfied with axillary hair reduction. Early postoperative complications included haematoma (0.7%), seroma (1.2%), folding of skin flap (0.7%), pressure blister (3.6%), contact dermatitis (1%), superficial epidermis necrosis (37%), small granuloma (0.5%), wound infection (0.7%) and wound dehiscence (5.1%). Late complications included comedones (1.2%), milia (0.5%), sebaceous cyst (or with abscess)(0.7%), hypertrophic scar (1%), temporary skin pigmentation (0.5%), temporary mild lactation (0.5%) and temporary sweating outside the axillae (1%). In general, 196 patients (95%) were totally satisfied with the procedure and nine (4.4%) patients partially satisfied, with only one (0.5%) regretful. The procedure has a very high success rate with minor complications. It should become the preferred procedure for the surgical treatment of axillary osmidrosis.

We report on a 16-year-old boy with Noonan syndrome who had short stature, hypertelorism, mild hearing loss, webbed neck, pectus deformities, hypertrophic cardiomyopathy, low posterior hairline, redundant skin, café au lait spot, curled hairs, foetal pads, and undescended testes. The father and a sister of the boy were also found with mild webbed neck, being possibly mildly affected individuals. The significant webbed-neck deformity of the boy was completely corrected by subcutaneous resection of the proximal half of the hypertrophic fascia bands, through small incisions hidden within the hairline. The advantage of this procedure is simple, safe and effective, with no visible scar on the surface of the neck.

Axillary osmidrosis is a troublesome and distressing problem. Medical treatment is only temporally effective. From March 2003 to November 2004, 36 patients with axillary osmidrosis (nine cases combined with axillary hyperhidrosis) have been treated by excision of the subcutaneous glands via a small transverse incision, of which 31 cases could be followed up for a minimum of 3 months (average 7.3 months). In terms of malodour elimination, 30 cases had good results, one had fair result, and none had a poor result. All patients reported significant reducing of sweating, especially those with hyperhidrosis. Postoperative complications were minor, including small haematoma (one axillae), small seroma (two axillae), and superficial epidermal necrosis (21 axillae) which were all spontaneously healed within a week. Twenty-nine (93.5%) patients were very satisfied with the procedure and two (6.5%) patients satisfied, with none regretful. The operation has the advantage of a high success rate in radical elimination of the malodour with minor complications.

Presenilin 1 (PS1) is required for the proteolytic processing of Notch and the beta-amyloid precursor protein (APP), molecules that play pivotal roles in cell-fate determination during development and Alzheimer's disease pathogenesis, respectively. In addition, PS1 interacts with beta-catenin and promotes its turnover through independent mechanisms. Consistent with this activity, we report here that PS1 is important in controlling epidermal cell proliferation in vivo. PS1 knockout mice that are rescued through neuronal expression of human PS1 transgene develop spontaneous skin cancers. PS1-null keratinocytes exhibit higher cytosolic beta-catenin and beta-catenin/lymphoid enhancer factor-1/T cell factor (beta-catenin/LEF)-mediated signaling. This effect can be reversed by reintroducing wild-type PS1, but not a PS1 mutant active in Notch processing but defective in beta-catenin binding. Nuclear beta-catenin protein can be detected in tumors. Elevated beta-catenin/LEF signaling is correlated with activation of its downstream target cyclin D1 and accelerated entry from G(1) into S phase of the cell cycle. This report demonstrates a function of PS1 in adult tissues, and our analysis suggests that deregulation of beta-catenin pathway contributes to the skin tumor phenotype.

Pim-3, a proto-oncogene with serine/threonine kinase activity, was enhanced in hepatocellular carcinoma (HCC) tissues. To address the roles of Pim-3 in HCC development, we prepared transgenic mice that express human Pim-3 selectively in liver. The mice were born at a Mendelian ratio, were fertile and did not exhibit any apparent pathological changes in the liver until 1 year after birth. Pim-3-transgenic mouse-derived hepatocytes exhibited accelerated cell cycle progression. The administration of a potent hepatocarcinogen, diethylnitrosamine (DEN), induced accelerated proliferation of liver cells in Pim-3 transgenic mice in the early phase, compared with that observed for wild-type mice. Treatment with DEN induced lipid droplet accumulation with increased proliferating cell numbers 6 months after the treatment. Eventually, wild-type mice developed HCC with a frequency of 40% until 10 month after the treatment. Lipid accumulation was accelerated in Pim-3 transgenic mice with higher proliferating cell numbers, compared with that observed for wild-type mice. Pim-3 transgenic mice developed HCC with a higher incidence (80%) and a heavier burden, together with enhanced intratumoral CD31-positive vascular areas, compared with that observed for wild-type mice. These observations indicate that Pim-3 alone cannot cause, but can accelerate HCC development when induced by a hepatocarcinogen, such as DEN.Oncogene advance online publication, 18 January 2010; doi:10.1038/onc.2009.504.

Tumour necrosis factor-alpha (TNF-alpha) is an important inflammatory factor that acts as a master switch in establishing an intricate link between inflammation and cancer. A wide variety of evidence has pointed to a critical role of TNF-alpha in tumour proliferation, migration, invasion and angiogenesis. The function of TNF-alpha as a key regulator of the tumour microenvironment is well recognised. We will emphasise the contribution of TNF-alpha and the nuclear factor-kappaB pathway on tumour cell invasion and metastasis. Understanding the mechanisms underlying inflammation-mediated metastasis will reveal new therapeutic targets for cancer prevention and treatment.British Journal of Cancer advance online publication, 19 January 2010; doi:10.1038/sj.bjc.6605530 www.bjcancer.com.

In the present study, the effects of long-term exogenous glucocorticoids administration and dietary supplementation of alpha-tocopheryl acetate on the induction of lipid peroxidation in skeletal muscle were investigated. Male broiler chicks were randomly assigned to 2 diet treatments: the basal diet supplemented with 20 (low level of vitamin E) or 200 (high level of vitamin E) mg of vitamin E (as dl-alpha-tocopheryl acetate)/kg of diet. At 35 d of age, the chickens in each dietary treatment were randomly divided into 3 groups of 30 chickens and subjected to the following treatments: daily s.c. injection of dexamethasone (DEX, 2 mg/kg of BW) for 6 d, sham injection of saline (control), or the sham-treated pair-fed control that maintained the same feed intake as DEX treatment (pair-control). The results showed that the growth of chickens was suppressed by DEX, whereas it was improved by the high level of vitamin E treatment. The DEX treatment resulted in augmented plasma concentrations of TBA reacting substances. Muscle TBA reacting substances levels were higher in DEX chickens at both 24- and 48-h time points postslaughter. Vitamin E supplementation suppressed the formation of lipid peroxidation in both plasma and skeletal muscle tissues. Muscle activity of superoxide dismutase was significantly increased by DEX treatment in both musculus pectoralis major and musculus biceps femoris and maintained as such during the initial 48 h postmortem. The result of the present study indicated that DEX treatment increased the saturation level of skeletal muscle fatty acids. These results suggest that vitamin E supplementation was favorable for the performance of broiler chickens by alleviating the oxidative stress induced by DEX treatment.

BACKGROUND: Lichen sclerosus (LS) is a chronic inflammatory skin disease, the pathogenesis of which is poorly understood. AIM: To evaluate the role of hypoxia-ischaemia (HI) in vulvar LS. METHODS: Samples from five patients with vulvar LS and five control subjects were collected for analysis by transmission electron microscopy (TEM) to reveal the ultrastructural changes of organelles and dermal blood capillaries. Samples from 37 patients with vulvar LS and 12 control subjects were collected for immunohistochemistry to detect the expression of vascular endothelial growth factor (VEGF) and the hypoxia markers hypoxia-inducible factor (HIF)-1alpha and glucose transporter (Glut)-1. RESULTS: Using TEM, the mitochondria of basal cells and vascular endothelial cells in vulvar LS tissue were found to be swollen with loss of cristae, and the rough endoplasmic reticulum had luminal swelling and ribosomal detachment. Damage to vascular endothelial cells, disorganization of capillary architecture and loss of capillaries were also seen. By immunohistochemistry, moderate to intense staining of VEGF was seen in almost 90% of control sections vs. about 55% of LS sections. Glut-1 expression was negative or weak in 75% of control sections vs. moderate to very strong in about 80% of vulvar LS sections. Nuclear staining of HIF-1alpha was not found in LS or control tissue. CONCLUSIONS: HI is involved in the pathogenesis of vulvar LS.

In order to determine the prevalence of GIGYF2 (Grb10-Interacting GYF Protein 2) variants in the Chinese population and to better understand the association between GIGYF2 and Parkinson's disease (PD), we conducted the genetic screening of GIGYF2 in the Chinese population. Twelve exonic variants were identified in 52 familial PD probands and 56 healthy controls. Non-synonymous point variants (Thr25Ala, Asn457Th and Pro460Th) were analyzed in 510 PD patients and 481 healthy controls of Chinese Han ethnicity. The insertion and deletion variants in Exon 25 (Ins Q 1212, Ins QQ 1217, Del Q 1210, Del Q 1216 and Del PPQ1217_1219) are not related to the onset of familial PD. Our data indicate the GIGYF2 variants are not associated with PD in the mainland Chinese Population.

Abstract Background Skin cancer surgery is usually performed on the face, and more specifically on and around the midfacial apertures. Each defect generated by the exeresis of a face tumor can be repaired by various advancement, rotation or transposition flaps techniques. Therefore the choice of the closure axis of a defect and its cicatricial and orificial consequences is decisive. Results The closure of a defect is usually made by symmetrically suturing its edges, across the incision axis according to the rule of halves. However, the closure axis of a defect is intentional and characterized by the subcutaneous suture axis which determines the induced tension orientation, and thus the possible displacement of the aperture free margins. The horizontal stretching principle guarantees the lack of impact on the 3 major apertures of the midfacial frame: eye, nostril and mouth. Conclusions This biomechanical concept is decisive to repair midfacial defect with functional and aesthetic results. It also provides objective arguments for the reparative techniques prioritization and the ability to codify those to be recommended as first-line treatment in the surgical management of the face cutaneous tumours.

The ichthyoses are a collection of scaling skin diseases or keratinizing skin disorders giving the appearance of "fish skin," of which harlequin ichthyosis is the most severe form. It is characterized by profound thickening of the keratin skin layer, armorlike scales that cover the body, and contraction abnormalities of the eyes, ears, and mouth. We report a case of a 6-week-old boy with harlequin ichthyosis and severe bilateral upper and lower eyelid cicatricial ectropion who underwent surgical repair with full-thickness postauricular skin autografts. To our knowledge, this is the youngest reported case and the only case of harlequin ichthyosis in which postauricular skin grafts were used.

Aim: To introduce a small-incision technique for fascia lata (FL) harvesting for the frontalis suspension blepharoptosis procedure. Technique and Methods: A skin incision was made along a line between the lateral condyle of the tibia and the anterior superior iliac crest, starting 4-5 cm above the knee and extending upward 2-2.5 cm. Approximately 8 cm superior to the first incision, a second skin incision was made with the same length. The FL was dissected from the subcutaneous tissue from 1 cm above the superior border of the upper incision to 1 cm below the inferior border of the lower incision. A 15 mm x 5-10 mm strip of FL was excised. The fascial defect was left open. Subcutaneous and deep layers were closed with three 4-0 plain catgut sutures and the skin was closed with subcuticular 5-0 prolene sutures. Results: The technique was used in 22 patients from 4 to 47 years of age (mean: 18.29) for 34 frontalis sling procedures. Mean follow-up time was 6.17 (3-16) months. Wound hematoma (1/22, 4.5%), wound discharge (2/22, 9%), pain at rest (100%, for up to 4 days), pain on walking (20/ 22, 90%; for up to 3 weeks), and limping (13/22, 59.1%; for up to 7 days) were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Conclusion: The small-incision FL harvesting procedure is a good alternative method when the FL stripper is not available.

Mucous cysts are common problems seen by hand surgeons. Surgical excision of symptomatic cysts is the most commonly accepted treatment. Removal of large mucous cysts often requires simultaneous flap coverage or skin grafting for the resulting defect. We present the use of a dorsal advancement flap to permit excellent skin coverage after cyst excision with a tension-free closure.

We performed extrapleural pneumonectomy (EPP) with combined resection of the diaphragm and pericardium via a lower door open (LDO) thoracotomy to treat right malignant pleural mesothelioma (MPM) in a 57-year-old man. Specifically, we extended the standard posterolateral thoracotomy skin incision along the anterior costal arch, and performed the thoracotomy by cutting into the 6th to 9th costal cartilage. The resulting defect of the diaphragm and pericardium were reconstructed with a reversed latissimus dorsi (LD) muscle flap and a fascia lata graft, respectively. The patient had an uneventful postoperative course without dyspnea or dysfunction of the extremities. The LDO thoracotomy provided a good operative field, especially for the costo- and cardiophrenic angles, allowing a complete resection of the diaphragm to be performed easily. Furthermore, the reversed LD muscle flap and fascia lata graft proved to be ideal autologous materials for reconstruction of both the diaphragm and the pericardium.

The efficiency was studied of vascularized tissue complexes in 346 cancer patients with extensive facial injuries to the head and neck who had undergone combined treatment. Free microsurgical autotransplantation was carried out in 7 (2%) patients, deltapectoral graft--151 (44%), sternocleidomastoid myocutaneous flap--39 (11%), pectoralis major flap--10 (3%), bi- and tri-lobed flap--55 (16%), temporal musculoperiosteal flap--25 (7%), cheek flap--24 (6.9%), thoraco-dorsal axillary flap--24 (6.9%), frontal flap--6 (1.7%), free-flap transfer--5 (1.5%). Although most vascularized tissue complexes were placed in previously irradiated areas, primary engraftment was reported in 249 (72%) patients, while peripheral or partial necrosis in distal part of flap- in 97 (28%). Good cosmetic and functional results were obtained in 298 (86%) patients who considered themselves cured.