The inframammary fold is a defining element in the shape and structure of the female breast. It should be preserved whenever possible in ablative procedures and recreated accurately when the breast is reconstructed after mastectomy. To date, no accurate anatomic description of this essential structure exists. Previous studies have suggested that the fold is produced by a supporting ligament running from the dermis in the fold region to a variety of locations on the rib cage. This clinic's experience with mastectomy, augmentation mammaplasty, and breast reconstruction does not support the existence of a ligamentous structure. To define the structure of the inframammary fold, 10 female and 2 male cadavers were studied. The anterior chest wall was removed en bloc and frozen in orthostatic position. Parasagittal sections were made of the inframammary fold with the chest wall intact. After decalcification of the ribs and routine histologic preparation, thin sections were stained with Gomori's trichrome. On light microscopic examination, no demonstrable ligamentous structure of dense regular connective tissue could be identified in the fold region in any of the 12 specimens. Superficial and deep fascial layers were uniformly observed anterior to the pectoralis major and serratus anterior muscles. The superficial fascia was connected to the dermis in the fold region in a variety of configurations. In some cases, the deep fascia fused with the superficial fascia and dermis at the fold level. In other cases, bundles of collagen fibers arising from the superficial fascial layer were found to insert into the dermis at the inframammary fold, slightly inferior to it, or both. These bundles were observed consistently in sections from the sternum to the middle axillary line. They were distinct from Cooper's suspensory ligaments, which are seen more superiorly in the glandular tissue.

No abstract

This study was a retrospective chart review of hospital records and autopsy reports of 499 children nine years old or younger in-volved in motor vehicle collisions from 1994 to 1998. The objective was to evaluate the frequency and severity of injuries as a function of age, re-straint use, and seat position. We found that 33% of the children were unrestrained and 20% were improperly restrained. Unrestrained children had the highest mean Maximum Abbreviated Injury Scores (MAIS) and Injury Severity Scores (ISS), accounted for 70% of the fatalities, and had the highest incidence of head in-juries. Although most of the head injuries were superficial, 80% of the fatalities were the result of a head injury. Improperly restrained children had the highest frequency of abdominal injuries. Regardless of restraint use, the back seat was associated with fewer head injuries and lower mean MAIS and ISS scores compared to the front seat. Also, properly restrained children in the front seat had lower mean MAIS and ISS scores than unrestrained children in the back seat, suggesting that restraint use is more beneficial than seat position.

Postnatal hamsters were examined for a metabolic response to cold by measuring oxygen consumption at ambient temperatures of 25", 30", 33", and 36°C. In conjunction with this, colonic temperatures were recorded, and the animals were examined for brown adipose tissue development.During the first ten days of postnatal development hamsters increased their 0 2 consumption linearly as ambient temperature was raised from 25" to 36°C. Thus, they are initially poikilothermic. Body temperatures were directly dependent on environmental temperature, and no mature brown fat deposits had yet developed.On days 11 and 12, O2 consumption curves began to vary from a linear relation with ambient temperature, and small inflexions developed at 30" and 33°C. By postnatal days 14 and 15 maximal values were recorded at 25°C. Simultaneously, brown fat deposits developed definitive characteristics and body temperatures came to range only slightly below adult temperatures during exposure at 25°C.During the latter stage of maturation studied in these experiments, days 17 to 21, the animals achieved homeothermic stability between 25" and 36°C. Only 25°C prompted a metabolic increase, 30" to 36°C became a zone of thermal neutrality, and body temperatures came to equal or exceed adult temperatures. The animals had gained significant weight, thereby increasing thermal insulation, and brown fat deposits had accumulated additional lipid.

Exchange-transfusion to hematocrit 20 with isotonic perfluorochemical (PFC) emulsions containing 3% hydroxyethylstarch (HES) in rats breathing 100% oxygen produced significant reductions of hepatic PO2 and blood flow in comparison to rats hemodiluted with isotonic 3% or 6% HES solution. The results indicate that PFC and/or emulsifiers were associated with adverse effects on liver blood supply.