capsular fibrosis
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2021 ◽  
pp. 229255032110511
Author(s):  
Philip H. Zeplin

Background: Capsular contracture is caused by an excessive fibrotic reaction similar as observed in other progressive fibrotic disorders. For their pathogenesis, several studies confirmed the importance of activins and follistatin. The aim of this study was to determine and analyze serum levels of Activin A and follistatin in patients with capsular contracture after aesthetic breast augmentation. Methods: The study included 361 female patients who underwent primary aesthetic breast augmentation, came for control examination after breast augmentation or for revision operation because of capsular contracture. Blood samples were taken and using a specific ELISA to determine the serum concentration levels of Activin A and Follistatin. Results: Ninety-six patients (n = 96), who developed a capsular contracture Baker ≥°III and underwent revision surgery were collected (capsular fibrosis group). One-hundred and fourteen patients (n = 114) were asymptomatic for capsular fibrosis Baker ≥°III after primary breast augmentation and 33 (n = 33) of them had developed no capsular fibrosis after more than 10 years (long-term group). For control group, blood samples were taken from 167 patients (n = 167) before primary aesthetic breast augmentation. Serum Activin A levels were significantly higher in the long-term Group compared with those in the capsular fibrosis- and the control groups. Follistatin levels were significantly lower in the capsular fibrosis group compared to the control- and the long-term groups. A small amount of control group patients (n = 16) developed a capsular fibrosis within 2 years after primary breast augmentation with significant lower follistatin levels. Retrospectively, they showed significantly lower serum follistatin levels than the control group even before the onset of capsular contracture. Conclusions: Capsular fibrosis has no effect on Activin A serum levels. In contrast, follistatin serum levels are lower in patients with capsular fibrosis. These results show that besides many other factors, a dysregulation of the Activin–follistatin axis may have importance on the pathogenesis of capsular contracture.


2021 ◽  
pp. 20-23
Author(s):  
O.I. Orenburkina ◽  
◽  
G.F. Khanova ◽  
A.E. Babushkin ◽  
◽  
...  

Purpose. Тo develop a method for the formation of anterior capsulorexis for the prevention of capsule block in cataract phacoemulsification with the implantation of a posterior chamber IOL. Material and methods. 135 people were studied, who were divided into two groups depending on the diameter of the performed anterior capsulorexis (CR). Group I (main) included 67 patients (67 eyes), who underwent CR according to the method proposed by the authors-in the form of an ellipse with a large axis of 7,0-7,5 mm along the tunnel incision and a small axis of 4.0-5.0 mm. Group 2 -68 patients (68 eyes), capsulorexis was produced in a round shape- 5-5.5 mm. Results. Complications during surgery – in patients of group 2, a capsule block and a tear in the anterior capsulorhexis were noted in 2.9% of cases, in 3% of cases posterior capsular fibrosis was diagnosed in each group, which required the performance of posterior capsulorhexis. In the late period in one patient of group 2 endothelial-epithelial dystrophy (EED) of the cornea developed, which required ultraviolet corneal crosslinking followed by keratoplasty. Conclusion. The proposed method for the creation of anterior capsulorexis in cataract phacoemulsification with the implantation of a posterior chamber IOL reliably eliminates the possibility of a capsule block due to the formation an oval shaped capsule hole. In addition, it reduces the risk of damage to the lens capsules, ensures reliable fixation of IOLs in the capsule bag and increases access for posterior capsulorhexis, if necessary. Key words: cataract phacoemulsification, posterior chamber IOL, oval capsulorexis, capsule block.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kotaro Tokuda ◽  
Yoshiaki Yamanaka ◽  
Yosuke Mano ◽  
Manabu Tsukamoto ◽  
Takafumi Tajima ◽  
...  

AbstractJoint contracture leads to major patient discomfort. Metformin, one of the most extensively used oral drugs against type 2 diabetes has recently been found to suppress tissue fibrosis as well. However, its role in suppressing tissue fibrosis in joint contractures remains unknown. In this study, we examined the role of metformin treatment in suppressing joint capsular fibrosis and the most effective time of its administration. Joint capsular fibrosis was induced by immobilizing the knee joints of mice using splints and tapes. Metformin was administered intraperitoneally every alternate day after immobilization. Histological and immunohistochemical changes and expression of fibrosis-related genes were evaluated. Metformin treatment significantly suppressed fibrosis in joint capsules based on histological and immunohistochemical evaluation. Joint capsular tissue from metformin-treated mice also showed decreased expression of fibrosis-related genes. Early, but not late, metformin administration showed the same effect on fibrosis suppression in joint capsule as the whole treatment period. The expression of fibrosis-related genes was most suppressed in mice administered with metformin early. These studies demonstrated that metformin treatment can suppress joint capsular fibrosis and the most effective time to administer it is early after joint immobilization; a delay of more than 2 weeks of administration is less effective.


2021 ◽  
Vol 263 ◽  
pp. 167-175
Author(s):  
Ozge Petek Erpolat ◽  
Ertugrul Senturk ◽  
Sanem Saribas ◽  
Burak Pasinlioglu ◽  
Ozlem Gulbahar ◽  
...  

Author(s):  
E.S. Pirogova ◽  
◽  
O.L. Fabrikantov ◽  
S.I. Nikolashin ◽  
◽  
...  

Purpose. To optimize the technique for the femtosecond laser-assisted anterior capsulorhexis creation in anterior capsular fibrosis. Material and methods. All patients were divided into two groups: group I included 12 patients with central and peripheral anterior capsule fibrosis who underwent anterior circular capsulorhexis creation using femtosecond laser LensX (Alcon, USA) with laser energy 10 and 15 μJ. Group II included 11 patients with central and peripheral anterior capsule fibrosis who underwent manual capsulorhexis. Results. In group II the operative complications occurred in 3 cases (27.3%), group I was uneventful. Conclusion. Femtosecond laser-assisted anterior capsulorhexis creation in patients with anterior capsule fibrosis allowed reducing the number of operative complications by 27% in comparison with manual capsulorhexis creation. It is advisable to use 10 μJ power to create the anterior capsulorhexis in the area of unaffected and slightly fibrotic anterior capsule cutting the fibrotic part of the anterior capsule by collet scissors. Key words: anterior capsolorhexis, fibrosis, anterior capsule.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Britta Kuehlmann ◽  
Isabel Zucal ◽  
Clark Andrew Bonham ◽  
Lydia-Marie Joubert ◽  
Lukas Prantl

Abstract Background Capsular fibrosis (CF) is the most common long-term complication in implant-based breast augmentation. It is well accepted that the foreign body response (FBR) instigates the development of fibrotic disease. Our study aims to compare murine and human samples of CF and describe the cellular and extracellular matrix (ECM) composition using scanning and transmission electron microscopy (SEM and TEM). Results Miniature microtextured silicone breast implants were implanted in mice and subsequently harvested at days 15, 30, and 90 post-operation. Isolated human capsules with the most aggravated form of CF (Baker IV) were harvested post-operation. Both were analyzed with SEM and TEM to assess cellular infiltration and ECM structure. An architectural shift of collagen fiber arrangement from unidirectional to multidirectional was observed at day 90 when compared to days 15 and 30. Fibrosis was observed with an increase of histiocytic infiltration. Moreover, bacterial accumulation was seen around silicone fragments. These findings were common in both murine and human capsules. Conclusions This murine model accurately recapitulates CF found in humans and can be utilized for future research on cellular invasion in capsular fibrosis. This descriptive study helps to gain a better understanding of cellular mechanisms involved in the FBR. Increases of ECM and cellularity were observed over time with SEM and TEM analysis.


2021 ◽  
Author(s):  
Paola Straticò ◽  
Giulia Guerri ◽  
Adriana Palozzo ◽  
Paola Di Francesco ◽  
Massimo Vignoli ◽  
...  

Abstract Background: Capsulitis leads to the release of inflammatory mediators into the joint causing capsular fibrosis and osteoarthrosis (OA). Strain elastosonography (SE) measures the elasticity of tissue evaluating its strain to an operator-dependent deformation. Aims of the study were to assess the feasibility of SE for evaluating the distal attachment of the joint capsule (DJC) of fore fetlocks in sound horses and in horses with fetlock OA and to evaluate differences in their elastosonographic aspect. After a whole lameness examination, fore fetlocks DJC were assigned to Group S and Group P and examined by two operators using SE. The inter-rater reliability (IRR), the intraclass (intra-CC) and interclass (inter-CC) correlation coefficients were used to compare colour grading scores, repeatability, reproducibility of elasticity index (EI) and strain ratio (SR). The same parameters were compared between groups. Findings were significant for P < 0.05. Results: Forty-one horses were included, 11 in Group S, 30 in Group P (16 with bilateral OA, 8 left and 6 right OA). IRRs ranged from good to excellent. For transverse and longitudinal scans, the EIs of Group S were 0.57-0.51, SRs were 0.32-0.28. Inter-CC and intra-CC were always > 0.8. In Group P, EI was 1.09-0.89, SRs was 0.78-0.72 with intra-CC and inter-CC >0.57. Significative differences of EI and SR were detected between groups, and between Group S and the affected limb of Group P.Conclusions: SE is a useful technique for evaluating the DJC, with good repeatability and reproducibility. DJC appears softer in sound horses.


Breast Care ◽  
2020 ◽  
pp. 1-7
Author(s):  
Lea Beier ◽  
Andree Faridi ◽  
Corina Neumann ◽  
Stefan Paepke ◽  
Christine Mau ◽  
...  

<b><i>Background:</i></b> Over the last decades, the number of acellular dermal matrix (ADM)-assisted implant-based breast reconstructions (IBBR) has substantially increased. However, there is still a lack of prospective data on complication rates. <b><i>Methods:</i></b> We performed a non-interventional, multicenter, prospective cohort study to evaluate complication rates of a human ADM in patients undergoing an IBBR after skin- and nipple-sparing mastectomies. Patients with primary reconstruction (cohort A) and patients undergoing a secondary reconstruction after capsular fibrosis (cohort B) using the human ADM Epiflex® (DIZG gGmbH, Berlin, Germany) were enrolled in this study. Patients were followed-up for 12 months after surgery. <b><i>Results:</i></b> Eighty-four eligible patients were included in this study of whom 28 women underwent a bilateral breast reconstruction, leading to 112 human ADM-assisted reconstructions in total (cohort A: 73, cohort B: 39). In 33.0% of the reconstructed breasts at least one of the complications of primary interest occurred, including implant loss 7.1%, seroma 15.2%; infection 5.4%, rash 8.0%, and Baker grade III/IV capsular fibrosis 2.7%, with no statistically significant differences between the cohorts. Previous radiation therapy was significantly associated with occurrence of any postoperative complication (OR 20.41; <i>p</i> value 0.027). <b><i>Conclusion:</i></b> The rates of most complications were comparable to the rates reported for other ADMs with relatively low rates of capsular fibrosis and infections. The rate of seroma was increased in our study. Prior radiation therapy increased the risk of any postoperative complications. Therefore, the use of ADM in these patients should be considered carefully.


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