Wolfram D, Backovic A, Kaindl R, Hussl H, Wick G
Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
J Plast Reconstr Aesthet Surg. 2008;61(3):342-5. doi: 10.1016/j.bjps.2007.08.003. Epub 2007 Sep 24.
We present the case of a woman with a massive volume increase in her right breast 12 years after breast augmentation with saline-filled silicone mammary implants (SMI). Tenderness of and pressure pain in the enlarged right breast were noted on physical examination. Intraoperatively, the right implant was seen to be markedly enlarged, altered in colour and filled with a brownish fluid as compared to the other side. No macroscopic damage, including to the valve of the enlarged SMI, was noticed. The liquid in the inflated SMI was subjected to biochemical analysis. Although neither cells nor nucleic acids were detected, 4 mg/ml protein was found in the liquid of the autoinflated SMI. On SDS-PAGE separation, these proteins resolved in a pattern similar to that of serum proteins. This observation was corroborated by Western blots for several serum proteins. Surprisingly, proteins in the SMI liquid were significantly more glycosylated and oxidised than were serum proteins; this finding indicates a process of protein ageing. We hypothesise that the reason for this in vivo expansion was a defective valve and not colloid osmotic swelling, as previously suggested.
我们报告一例在植入生理盐水填充的硅酮乳房植入物（SMI）隆胸12年后右乳房出现大量体积增大的女性病例。体格检查发现右乳房增大且有压痛和触痛。术中可见右侧植入物明显增大，颜色改变，与另一侧相比充满褐色液体。未发现包括增大的SMI瓣膜在内的宏观损伤。对膨胀的SMI中的液体进行生化分析。虽然未检测到细胞和核酸，但在自动膨胀的SMI液体中发现了4mg/ml的蛋白质。在SDS-PAGE分离中，这些蛋白质的分离模式与血清蛋白质相似。这一观察结果通过几种血清蛋白的蛋白质印迹得到了证实。令人惊讶的是，SMI液体中的蛋白质比血清蛋白质有更显著的糖基化和氧化；这一发现表明存在蛋白质老化过程。我们推测这种体内扩张的原因是瓣膜缺陷，而非如先前所认为的胶体渗透肿胀。
