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Silicone breast implants with smooth outer shells are associated with higher rates of capsular contracture, whereas textured implants have been linked to the development of breast implant-associated anaplastic large cell lymphoma. By assessing the gene expression profile of fibrous capsules formed in response to smooth and textured implants, insight into the development of breast implant-associated abnormalities can be gained.Miniature smooth or textured silicone implants were surgically inserted into female rats ( n = 10) and harvested for the surrounding capsules at postoperative week 6. RNA sequencing and quantitative polymerase chain reaction were performed to identify genes differentially expressed between smooth and textured capsules. For clinical correlation, the expression of candidate genes was assayed in implant capsules harvested from human patients with and without capsular contracture.Of 18,555 differentially expressed transcripts identified, three candidate genes were selected: matrix metalloproteinase-3 ( MMP3 ), troponin-T3 ( TNNT3 ), and neuregulin-1 ( NRG1 ). In textured capsules, relative gene expression and immunostaining of MMP3 and TNNT3 was up-regulated, whereas NRG1 was down-regulated compared to smooth capsules [mean relative fold change, 8.79 ( P = 0.0059), 4.81 ( P = 0.0056), and 0.40 ( P0.0001), respectively]. Immunostaining of human specimens with capsular contracture revealed similar gene expression patterns to those of animal-derived smooth capsules.An expression pattern of low MMP3 /low TNNT3 /high NRG1 is specifically associated with smooth implant capsules and human implant capsules with capsular contracture. The authors' clinically relevant breast implant rat model provides a strong foundation to further explore the molecular genetics of implant texture and its effect on breast implant-associated abnormalities.The authors have demonstrated that there are distinct gene expression profiles in response to smooth versus textured breast implants. Since surface texture may be linked to implant-related pathology, further molecular analysis of periprosthetic capsules may yield strategies to mitigate implant-related complications.

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has resulted in 2.5 million deaths globally. Previous studies have suggested the virus may affect the kidneys, resulting in hematuria, proteinuria and acute kidney injury;however, the studies did not differentiate microscopic hematuria (MH) from gross hematuria (GH). In this study, we investigated the clinical outcomes and risk factors associated with GH compared to MH in COVID patients. METHODS: Following IRB approval, 250 consecutive medical records of COVID patients admitted to a tertiary care university hospital from 3/15/20 were analyzed. Patients without a urinalysis during the admission were excluded, the remaining 157 patients were included in the analysis. Patients were divided into three categories based on the presence of hematuria during the admission: none, microscopic hematuria (MH) and gross hematuria (GH). Outcomes including length of hospitalization, ICU admission, intubation, and lab values were compared amongst the categories. Chi-square test was used to compare the categorical variables, while ANOVA and t-test were used for the parametric variables. RESULTS: Of the 157 patients, 66 (42%) did not have hematuria, 36 (22.9%) had MH and 55 (35%) had GH. As seen in Fig.1, GH was associated with worse clinical outcomes such as higher intubation rate at 49.1%, compared to 27.8% in MH (p

INTRODUCTION AND OBJECTIVE:Technological innovations of hydrophilic and antibiotic coated materials in the construction of the three-piece inflatable penile prosthesis (IPP) have resulted in decrea...