Jewell Plastic Surgery Center

Anecdotal reports and one case-control study suggested an association, without evidence of causation, between breast implants and anaplastic lymphoma kinase-negative anaplastic large T-cell lymphoma (ALCL), a rare non-Hodgkin's lymphoma. This review summarizes the published evidence, including case reports and epidemiologic studies. A PubMed search limited to English language articles was conducted using the search terms "breast implant" and "lymphoma," "primary T-cell breast lymphoma," or "breast implant and ALCL" to identify all published cases of breast-associated ALCL. A total of 18 publications were retrieved describing 27 cases of ALCL in breast implant recipients. Breast-associated ALCL occurred in women with and without implants. Approximately 78 percent of cases (21 of 27) were CD30 anaplastic lymphoma kinase-negative, with an indolent clinical course. Both saline- and silicone-filled devices were identified; however, implant style and surface texture were largely unreported. The tumor stage at diagnosis was I in 16 of 27, II or higher in seven of 27, or unreported in four of 27. No prospective epidemiologic study has linked implants and ALCL; however, a single case-control study in Dutch women reported increased odds of association between ALCL and implants, and an estimated frequency of one in 1 million women with and without breast implants. An association, without evidence of causation, was reported between breast implants and ALCL. Further study is required to confirm this association. Breast-associated ALCL occurred rarely in women with and without breast implants and had a primarily indolent clinical course, which may provoke a revision of the World Health Organization nomenclature for lymphoma; however, aggressive clinical behavior was also reported. The cases of ALCL were not confined to a specific type of implant. Risk, V.

Tactile hypersensitivity is a common sequela of traumatic hand injury. Vibration is used clinically to reduce this hypersensitivity. The purpose of this study was to determine if vibration has an effect on tactile threshold and if so to determine the duration of that effect. Mean tactile thresholds were determined for 24 healthy adults by means of a pressure aesthesiometer. The experimental group (6 men, 6 women) received 10 minutes of vibration. Mean tactile thresholds were redetermined at the end of the 10-minute treatment period in the experimental group and after a 10-minute rest period in the control group (6 men, 6 women). Thresholds were also redetermined at 5-minute intervals for the next 20 minutes in all subjects. The experimental group showed a significant change in mean tactile threshold after 10 minutes of vibration (p less than .001). This difference remained at 5 (p less than .001) and 10 (p less than .05) minutes postvibration but not at 15 and 20 minutes. No significant change in mean tactile threshold was found in the control group. The results indicate that vibration does increase tactile threshold in "normal" hands and the effect lasts for at least 10 minutes. The application of this information to the clinical setting is discussed.