Publications by authors named "Joon Seok Lee"

116 Publications

Impact on capsule formation for three different types of implant surface tomography.

Sci Rep 2022 Aug 8;12(1):13535. Epub 2022 Aug 8.

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 700-421, Korea.

Although capsular contracture remains one of the major problems following silicone breast implantation, the associated mechanism has yet to be determined. This study thus aimed to investigate capsule formation and capsular contracture using three types of implants with different surface topographies in vivo. Three types of implants (i.e., smooth, macrotexture, and nanotexture) with different surface topographies were inserted in a total of 48 Wistar rats. After 4 and 12 weeks, the samples were analyzed via histological, immunohistochemical, and Western blot examination. To identify implant movement, the degree to which implant position changed was measured. And the surface topography was characterized using scanning electron microscopy. Hematoxylin-eosin staining showed that the nanotexture type implant promoted significant decreases in capsule thickness at 12 weeks (P < 0.05), while Masson trichrome staining showed decreased collagen fiber density with the same implant type. Immunohistochemical and Western blot examination revealed reduced fibrosis markers (myofibroblast, and transforming growth factor beta-1) in the nanotexture surface implant. Meanwhile, implant location evaluation found that the nanotexture and smooth surface implants had significantly increased movement (P < 0.05). The nanotexture surface implant had been found to reduce capsule formation given that it minimizes the effects of factors related to foreign body reaction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-022-17320-xDOI Listing
August 2022

Effect of the Geometrical Structure on the Superhydrophobicity and Self-Cleaning Properties of Plasma-Treated Polyvinylidene Fluoride Fabrics.

ACS Omega 2022 Aug 21;7(30):26275-26288. Epub 2022 Jul 21.

Department of Textiles, Merchandising and Fashion Design, Seoul National University, Seoul 08826, Republic of Korea.

The purpose of this study is to develop superhydrophobic polyvinylidene fluoride (PVDF) fabrics to increase their water repellency and self-cleaning properties and to investigate the effects of the inherent fabric roughness on these properties. A PVDF fabric, composed entirely of electrospun PVDF filament yarns, and two PVDF/polyester (PET) fabrics with different weave densities are used. After treatment with O plasma for 12 min and CF plasma for 4 min, superhydrophobicity is achieved in all fabrics, resulting in an increase in water repellency and self-cleaning efficiency. The PVDF fabric with the lowest shedding angle exhibits the most pronounced droplet rebound behavior and the highest self-cleaning efficiency. Increases in surface inclination angle and droplet volume and a decrease in the drop fall height all contribute to conditions more favorable for water droplet repellency. The self-cleaning efficiencies of the plasma-treated PVDF fabric and high-density PVDF/PET fabric are higher for hydrophilic dust, in contrast to those of the untreated ones. The findings of this study are expected to enable the design of weaving or nano-structuring conditions that enhance the water repellency and self-cleaning properties of PVDF fabrics, for the development of stable energy-harvesting smart textiles.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acsomega.2c01999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352256PMC
August 2022

Useful vertical latissimus dorsi flap for partial breast reconstruction in every tumor location.

BMC Surg 2022 Jul 28;22(1):294. Epub 2022 Jul 28.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: We conducted a prospective cohort study to evaluate effective techniques for breast reconstruction after partial mastectomy due to breast cancer. Determining the method of reconstruction is often difficult as it depends on the location of the cancer and the amount of tissue excised.. Here, we present a new technique, using the vertical latissimus dorsi (LD) flap, that can be used in all partial mastectomies and can almost conceal scarring. We also compared these results to those of the mini LD flap.

Methods: We analyzed the data of a total of 50 and 47 patients, who underwent breast reconstruction with the mini LD flap and the vertical LD flap, respectively. Immediately after tumor excision, breast reconstruction was initiated. The skin flap for vertical LD was designed in a planarian shape, such that it may be hidden as much as possible and minimize bulging during closure, and the LD muscle flap was designed with a sufficient distance in the inferior direction.

Results: Our finding showed that the vertical LD flap group required significantly less total operation time than the mini LD flap group. While the mini-LD flap resulted in a scar that was difficult to conceal, the donor site scar of the vertical LD flap could not be seen easily, and no scar was visible on the back.

Conclusions: The vertical LD flap is useful for partial breast reconstruction, in all breast regions requires a rather small volume of the flap. Moreover, recovery was relatively fast with high patient satisfaction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12893-022-01741-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336010PMC
July 2022

ASO Visual Abstract: Prediction of Implant Size Based on Breast Volume Using Mammography with Fully Automated Measurement and Breast MRI.

Ann Surg Oncol 2022 Jul 19. Epub 2022 Jul 19.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1245/s10434-022-12019-9DOI Listing
July 2022

cAMP Signaling in Cancer: A PKA-CREB and EPAC-Centric Approach.

Cells 2022 06 24;11(13). Epub 2022 Jun 24.

BK21 FOUR KNU Creative BioResearch Group, School of Life Sciences, College of Natural Sciences, Kyungpook National University, Daegu 41566, Korea.

Cancer is one of the most common causes of death globally. Despite extensive research and considerable advances in cancer therapy, the fundamentals of the disease remain unclear. Understanding the key signaling mechanisms that cause cancer cell malignancy may help to uncover new pharmaco-targets. Cyclic adenosine monophosphate (cAMP) regulates various biological functions, including those in malignant cells. Understanding intracellular second messenger pathways is crucial for identifying downstream proteins involved in cancer growth and development. cAMP regulates cell signaling and a variety of physiological and pathological activities. There may be an impact on gene transcription from protein kinase A (PKA) as well as its downstream effectors, such as cAMP response element-binding protein (CREB). The position of CREB downstream of numerous growth signaling pathways implies its oncogenic potential in tumor cells. Tumor growth is associated with increased CREB expression and activation. PKA can be used as both an onco-drug target and a biomarker to find, identify, and stage tumors. Exploring cAMP effectors and their downstream pathways in cancer has become easier using exchange protein directly activated by cAMP (EPAC) modulators. This signaling system may inhibit or accelerate tumor growth depending on the tumor and its environment. As cAMP and its effectors are critical for cancer development, targeting them may be a useful cancer treatment strategy. Moreover, by reviewing the material from a distinct viewpoint, this review aims to give a knowledge of the impact of the cAMP signaling pathway and the related effectors on cancer incidence and development. These innovative insights seek to encourage the development of novel treatment techniques and new approaches.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/cells11132020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9266045PMC
June 2022

Comparative Study Between Radioisotope Uptake and Fluorescence Intensity of Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer.

J Breast Cancer 2022 Jun;25(3):244-252

Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

Recently, several breast surgeons have reported a new method for sentinel lymph node biopsy (SLNB) by using indocyanine green (ICG) with infrared camera. This study aimed to determine whether the lymph nodes (LNs) with ICG uptake are true SLNs and to assess the reliability of using only ICG for SLNB. Data were prospectively collected between April and September 2021. All palpable LNs were fat-trimmed and ordered from high to low signal of the gamma detector. The degree of radioisotope uptake and brightness of ICG staining of the axillary LNs detected with a fluorescent camera were compared and associated factors were analyzed. Discordance was defined as sentinel LNs (SLNs) showing a single uptake of radioisotope or fluorescence of ICG only, or when the orders of uptake and intensity degree were different between the 2 materials. A total of 79 SLNBs were performed on 78 patients with breast cancer. The breast cancer was classified as cTis-2N0-1. The discordance rate was 14/79 (17.7%) overall and 45/270 (16.7%) of the total retrieved axillary LNs. The first SLNs showed the lowest discordance rate of 6.3%, whereas the second and third SLNs showed higher discordance rates of 27.6% and 60.0%, respectively. There were no associated clinicopathologic factors that affected the discordance between uptake of radioisotope and fluorescence intensity of ICG. The use of ICG alone for SLNB may be insufficient because of the high discordance rates between radioisotopes and ICG uptake. However, the first SLN could be cautiously regarded as a true SLN.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4048/jbc.2022.25.e27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250879PMC
June 2022

Prognosis of Continuous Positive Airway Pressure Treatment to Velopharyngeal Insufficiency: Preliminary Study.

J Craniofac Surg 2022 Jun 28. Epub 2022 Jun 28.

Department of Plastic and Reconstructive Surgery.

Background: Cleft palate is a congenital malformation that causes hypernasality and decreases the intelligibility of pronunciation and leads to velopharyngeal insufficiency. It causes difficulty in language development. Many studies and treatments have been conducted to reduce this problem, but there are limitations. In this study, the effect obtained through continuous positive airway pressure (CPAP) treatment was analyzed by statistical methods.

Methods: From May 2012 to December 2018, using patient demographics, computed tomography (CT) scan, and nasalance test was performed on 25 patient groups treated with CPAP devices for 8 weeks to confirm the effect after 6 months.

Results: After CPAP treatment in a total of 25 patients, 13 patients had a therapeutic effect. The average age of the patient group with treatment effect (effective group [EG]) was 51.2months, and the patient group with no treatment effect (ineffective group [iG]) was 73.6 months. (P < 0.05). In CT data analysis, the highest palatal arch point was 6.31 mm in EG and 7.36 mm in IG, which was lower in EG (P < 0.01), and the distance from incisive foramen to posterior pharyngeal wall was 41.39 mm in EG and 49.07 mm in IG (P < 0.05).

Conclusions: Through the statistical analysis, the group of patients who were effective in treatment had a low age at the beginning of treatment, the height of highest palatal arch point was low on CT data, and the length of distance from incisive foramen to posterior pharyngeal wall was short. It will be helpful to set the CPAP treatment patient group with respect to the results and age and CT data when treating VPI patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000008665DOI Listing
June 2022

Effect of Breast Silicone Implant Topography on Bacterial Attachment and Growth: An Study.

In Vivo 2022 Jul-Aug;36(4):1703-1709

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea;

Background/aim: The mechanisms underlying capsular contracture remain unclear. Emerging evidence supports the inflammation hypothesis, according to which bacteria from an adherent biofilm cause chronic inflammation and collagen deposition on the implant and trigger capsular contracture. Our goal was to evaluate the effect of different types of breast implants on the growth of Staphylococcus aureus, S. epidermidis, and Pseudomonas aeruginosa, which are commonly found in biofilms in infection.

Materials And Methods: Bacteria were grown in tryptic soy broth at 37°C for 2, 6, and 24 h and subsequently incubated for 24 h on 12 shell sections of smooth, nano-, and macrotextured breast implants. After incubation, the solutions were ultrasonicated and bacterial numbers were determined by serial dilution. S. aureus were fixed, washed with phosphate-buffered saline, dehydrated in ethanol, and coated with a platinum film to visualize the presence of biofilms by scanning electron microscopy.

Results: The numbers of S. aureus and S. epidermidis attached to the smooth and nanotextured surface implants were significantly lower than those on the macrotextured surface for all incubation times, whereas the number of P. aeruginosa was non-significantly lowest on the nanotextured surface after 24h incubation. Biofilms on smooth and nanotextured implant surfaces showed patchy patterns on scanning electron microscopy in contrast to the continuous pattern detected on macrotextured implants.

Conclusion: Nanotextured breast implants may limit bacterial growth and thus prevent capsular contracture.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21873/invivo.12882DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301443PMC
June 2022

Prediction of Implant Size Based on Breast Volume Using Mammography with Fully Automated Measurements and Breast MRI.

Ann Surg Oncol 2022 Jun 20. Epub 2022 Jun 20.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: Determination of implant size is crucial for patients with breast cancer undergoing one-stage breast reconstruction. The purpose of this study is to predict the implant size based on the breast volume measured by mammography (MG) with a fully automated method, and by breast magnetic resonance imaging (MRI) with a semi-automated method, in breast cancer patients with direct-to-implant reconstruction.

Patients And Methods: This retrospective study included 84 patients with breast cancer who underwent direct-to-implant reconstruction after nipple-sparing or skin-sparing mastectomy and preoperative MG and MRI between April 2015 and April 2019. Breast volume was measured using (a) MG with a fully automated commercial software and (b) MRI with an in-house semi-automated software program. Multivariable regression analyses including breast volume and patient weight (P < 0.05 in univariable analysis) were conducted to predict implant size.

Results: MG and MRI breast volume was highly correlated with both implant size (correlation coefficient 0.862 and 0.867, respectively; P values < 0.001) and specimen weight (correlation coefficient 0.802 and 0.852, respectively; P values < 0.001). Mean absolute difference between the MR breast volume and implant size was 160 cc, which was significantly higher than that between the MG breast volume and implant size of 118 cc (P < 0.001). On multivariable analyses, only breast volume measured by both MG and MRI was significantly associated with implant size in any implant type (all P values < 0.001).

Conclusion: Breast volume measured by MG and MRI can be used to predict appropriate implant size in breast cancer patients undergoing direct-to-implant reconstruction in an efficient and objective manner.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1245/s10434-022-11972-9DOI Listing
June 2022

Prepectoral breast reconstruction with complete anterior implant coverage using a single, large, square-shaped acellular dermal matrix.

BMC Surg 2022 Jun 20;22(1):234. Epub 2022 Jun 20.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Jung-gu, Daegu, 41944, Korea.

Background: Several studies have discussed various methods of prepectoral direct-to-implant (DTI) breast reconstruction using an acellular dermal matrix (ADM) prosthesis to achieve full coverage. However, methods for anterior coverage have rarely been reported. In this study, prepectoral DTI breast reconstruction with complete anterior implant coverage was performed using a square piece of ADM. This study aimed to introduce our prepectoral DTI technique and determine its functional and cosmetic outcomes as well as compare them with those of existing subpectoral DTI techniques.

Methods: This prospective comparative study focused on 29 patients (35 breasts) and 34 patients (35 breasts) who underwent breast reconstruction via subpectoral implant insertion (control group) and anterior coverage prepectoral implant insertion (anterior coverage group), respectively. Postoperative complications were noted, and breast symmetry was evaluated using the Vectra H2 three-dimensional scanner. The modified Kyungpook National University Hospital Breast-Q (KNUH Breast-Q) scale was used to assess the patient's subjective satisfaction with the reconstruction and postoperative quality of life.

Results: No remarkable differences in terms of complications (seroma, skin necrosis, nipple-areola complex necrosis, hematoma, capsular contracture, and infection) were noted in both groups. Compared with controls, considerably better results were observed among those in the anterior coverage group in terms of the mean drain removal period. Furthermore, those in the anterior coverage group showed greater symmetry on three-dimensional scans than the controls; however, this was not statistically significant. Subjective satisfaction and postoperative quality of life measured using the KNUH Breast-Q scale were not significantly different between both groups.

Conclusions: Considering its stability, faster recovery time, and cosmetic benefit, prepectoral breast reconstruction with anterior implant coverage using a single, large ADM is a good choice to perform breast reconstruction with implant insertion in patients who have undergone mastectomy.

Level Of Evidence: II.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12893-022-01683-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9208117PMC
June 2022

ASO Author Reflections: Prediction of Implant Size Based on Breast Volumetry Using Mammography and Breast MRI in DTI Breast Reconstruction.

Ann Surg Oncol 2022 Jun 18. Epub 2022 Jun 18.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1245/s10434-022-12025-xDOI Listing
June 2022

MicroRNA-365a/b-3p as a Potential Biomarker for Hypertrophic Scars.

Int J Mol Sci 2022 May 30;23(11). Epub 2022 May 30.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu 41944, Korea.

The clinical aspects of hypertrophic scarring vary according to personal constitution and body part. However, the mechanism of hypertrophic scar (HS) formation remains unclear. MicroRNAs (miRNAs) are known to contribute to HS formation, however, their detailed role remains unknown. In this study, candidate miRNAs were identified and analyzed as biomarkers of hypertrophic scarring for future clinical applications. HSfibroblasts and normal skin fibroblasts from patients were used for profiling and validation of miRNAs. An HS mouse model with xenografted human skin on nude mice was established. The miRNA expression between normal human, normal mouse, and mouse HS skin tissues was compared. Circulating miRNA expression levels in the serum of normal mice and mice with HSs were also analyzed. Ten upregulated and twenty-one downregulated miRNAs were detected. Among these, miR-365a/b-3p and miR-16-5p were identified as candidate miRNAs with statistically significant differences; miR-365a/b-3p was significantly upregulated ( = 0.0244). In mouse studies, miR-365a/b-3p expression levels in skin tissue and serum were higher in mice with HSs than in the control group. These results indicate that miRNAs contribute to hypertrophic scarring and that miR-365a/b-3p may be considered a potential biomarker for HS formation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijms23116117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181131PMC
May 2022

Correction of a Secondary Bilateral Cleft Lip Nasal Deformity in Adults Using Repositioning of Both Lower Lateral Cartilages and Nasal Tip Plasty Through an Open Bilateral Reverse-U Incision.

J Craniofac Surg 2022 Mar-Apr 01;33(2):506-511

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, South Korea.

Background: Correcting a secondary bilateral cleft lip nasal deformity is very complex with many challenges due to its complexity. This study presents the surgical results after correcting a secondary bilateral cleft lip nasal deformity using isolation and repositioning of the lower lateral cartilages, the columellar strut, and an onlay graft on the nasal tip.

Method: Eighteen patients who had bilateral cleft lip nasal deformities and who had surgery performed between September 2013 and December 2019 were included in this study. The age of the patients ranged between 19 and 52 years. Open rhinoplasty with bilateral reverse-U incision was performed. The lower lateral cartilages were isolated and repositioned. Nasal tip support is provided using a columellar strut with a septal cartilage or Medpor strut. In the vertical component of the nasal tip, a conchal cartilage graft was used. The mean follow-up period was 2 years (ranging from 1 to 6 years).

Results: Fourteen of the 18 patients underwent photogrammetric evaluation. After surgery, the projection of the nasal tip and angle increased, but nasal bridge length decreased. The columella-labial angle significantly increased by 10.1% after surgery which was statistically significant (P < 0.05). The angle between the nostril axes significantly decreased by 46.2% postoperatively and also reached statistical significance (P < 0.05), indicating that the displaced alar base and lower nostril sill improved and the major axis of the nostril changed more vertically oblique. All patients were pleased with their surgical results.

Conclusion: The proposed technique was highly effective in correcting secondary bilateral cleft lip nasal deformities in adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000008265DOI Listing
April 2022

Correction of Severe Secondary Cleft Lip Nasal Deformity.

J Craniofac Surg 2022 Mar-Apr 01;33(2):404-408

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.

Background: The lower lateral cartilages (LLCs) are key elements for alar and tip support. Repositioning of both LLCs is an effective procedure for correcting a laterally spreading dome of LLCs and drooping nasal tip in cleft lip nasal deformity (CLND). The alar contour graft has become an essential component of rhinoplasty for correcting the concave or collapsed and retracted alar. Herein, onlay cartilage graft was combined with nasal tip plasty to correct hypoplastic cleft lateral crus or alar rim retraction, and with columella strut to obtain better aesthetic outcomes in patients with severe CLND.

Methods: Seven patients with severe secondary unilateral CLND, including hypoplastic cleft lateral crus or alar rim retraction, underwent rhinoplasty from October 2013 to April 2020. Both LLCs were isolated and repositioned approximated medially using tip suture technique combined with columella strut. A septal cartilage onlay graft was applied on the hypoplastic cleft lateral crus. Cartilage graft on the nasal tip was performed to further project and enhance the nasal tip. Photogrammetric evaluation of the operated patients and statistical analysis of the obtained data were performed.

Results: The average age at operation was 23.5 (range: 17-36) years. The follow-up period was 6-36 (mean, 14.3) months. All patients were enrolled by photogrammetric evaluation. Height of the medial nostril and short axis of the nostril on the cleft side were increased with a statistical significance of P < 0.05, indicating that depressed ala on the cleft side, which is a feature of CLND, was corrected similar to that of the noncleft side.

Conclusions: The alar contour cartilage graft, as an effective adjunctive technique, improves the alar margin, prevents the alar rim from collapsing, and provides supports to the cleft-side alar rim. It can be a prophylactic measure to prevent postoperative retraction in patients with weakened LLCs. Lower lateral cartilage repositioning, columellar strut, and nasal tip plasty are useful for correcting severe secondary unilateral CLND.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000008311DOI Listing
April 2022

Boomerang latissimus dorsi flap in total breast reconstruction: report of three cases.

Gland Surg 2022 Jan;11(1):290-299

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

The latissimus dorsi (LD) flap is one of the most useful techniques for autologous breast reconstruction, especially in Asians. However, for reconstruction of moderate to large volume breasts, it is difficult to achieve the desirable volume and projection with the classic extended LD flap. Although there is the option of concurrent application of an LD flap and a small silicone implant, this may lead to larger volume than desired; furthermore, an increasing number of patients prefer reconstruction with autologous tissue alone. In this case report, we present satisfactory outcomes for moderate to large breast reconstruction in three patients, using the boomerang LD flap technique, a modification of the conventional extended LD flap. The flap was harvested with a transverse incision along the brassiere line and a vertical incision under the arm adjusted for the breast width of the patient. Then, after tunneling to the breast, the autologous reconstructed breast was created with the boomerang LD flap before moving the flap. There were no severe intraoperative or postoperative complications. In one case, linear necrosis of the breast wound was observed and the patient underwent revision operation for treatment. Seromas were not observed in the donor site of the boomerang LD flap and healing was successful. However, the donor site incision was 1.5 to 1.6 times longer than that of the classic LD flap. Boomerang LD flaps allow immediate breast reconstruction after neoadjuvant chemotherapy, without the need of microsurgery or use of abdominal-based flaps and without using silicone implants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-21-595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825524PMC
January 2022

Wall shear stress on vascular smooth muscle cells exerts angiogenic effects on extracranial arteriovenous malformations.

Arch Plast Surg 2022 Jan 15;49(1):115-120. Epub 2022 Jan 15.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress.

Methods: VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted.

Results: Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue.

Conclusions: Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5999/aps.2021.00626DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795650PMC
January 2022

Nanomaterials for IoT Sensing Platforms and Point-of-Care Applications in South Korea.

Sensors (Basel) 2022 Jan 13;22(2). Epub 2022 Jan 13.

Division of Materials of Science and Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea.

Herein, state-of-the-art research advances in South Korea regarding the development of chemical sensing materials and fully integrated Internet of Things (IoT) sensing platforms were comprehensively reviewed for verifying the applicability of such sensing systems in point-of-care testing (POCT). Various organic/inorganic nanomaterials were synthesized and characterized to understand their fundamental chemical sensing mechanisms upon exposure to target analytes. Moreover, the applicability of nanomaterials integrated with IoT-based signal transducers for the real-time and on-site analysis of chemical species was verified. In this review, we focused on the development of noble nanostructures and signal transduction techniques for use in IoT sensing platforms, and based on their applications, such systems were classified into gas sensors, ion sensors, and biosensors. A future perspective for the development of chemical sensors was discussed for application to next-generation POCT systems that facilitate rapid and multiplexed screening of various analytes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/s22020610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781063PMC
January 2022

A nationwide cohort study on growth impairment by cleft lip with or without palate.

Sci Rep 2021 12 8;11(1):23609. Epub 2021 Dec 8.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 680 Gukchaebosanro, Jung-gu, Daegu, 41405, Republic of Korea.

There are very few nationwide studies discussing the height, weight, head circumference, and dental screening of children with cleft lip with or without palate (CL/P), with most reports on this subject based on a 1900s cohort. This study aimed to characterize CL/P children in the 2000s in terms of height, weight, head circumference, and dental screening. This nationwide population-based study evaluated the National Health Insurance Service-Infants and Children's Health Screening (NHIS-INCHS), specifically the height, weight, and head circumference of millions of children. Dental screening data, including the status of each tooth and comprehensive dental judgment, were also evaluated. Syndromic and nonsyndromic CL/P children had lower height, weight, and head circumference than no CL/P children until the age of 66-71 months. Children with cleft palate only or both cleft lip and palate showed similar results. Regarding dental screening, the primary teeth of CL/P children erupted later and fell out faster than no CL/P children. Dental caries was also more common in CL/P children. Children with CL/P had inferior general growth, regardless of palatoplasty surgery. More aggressive dental treatment was required for CL/P children due to the instability of primary teeth and tendency for caries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-03052-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655029PMC
December 2021

The effects of surgical treatment and sclerotherapy for intramuscular venous malformations: a comparative clinical study.

Arch Plast Surg 2021 Nov 15;48(6):622-629. Epub 2021 Nov 15.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision.

Methods: Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement.

Results: Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group.

Conclusions: Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5999/aps.2021.00913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627944PMC
November 2021

Simultaneous nipple reconstruction in autologous breast reconstruction.

Gland Surg 2021 Oct;10(10):2966-2977

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: Reconstruction of the nipple-areola complex is the final step in surgical restoration of the breast. Nipple-areola reconstruction was previously done after an interval of several months using variable techniques, often resulting in low projection and flattened breast mound over time. We present algorithm of simultaneous nipple reconstruction (SNR) that leaves adequate residual projection and naturally shaped breast mound.

Methods: Forty patients underwent a skin-sparing mastectomy and nipple excision between October 2016 and December 2020. In the control group, 21 patients underwent delayed nipple reconstruction for 6 months after breast reconstruction. The experimental group of 19 patients underwent nipple and breast reconstruction simultaneously. We collected relevant information and photographs of nipple profiles of both groups in the preoperative, postoperative 6-month, and postoperative 1-year time periods. We also examined the ratio between the reconstructed and contralateral nipples.

Results: Scores regarding patient satisfaction questionnaire averaged higher in experimental groups to every category. The control group's scores gradually declined over time and the experimental group showed lesser decline. At the 1-year postoperative follow-up, the mean projection of the immediately reconstructed nipple was approximately the same as the contralateral nipple at 91%, whereas the delayed reconstructed nipple resulted in a 77% ratio.

Conclusions: Nipple reconstruction should no longer be considered as a secondary complement to immediate breast reconstruction. The nipple appears to be essential component of breast reconstruction for patient. SNR with immediate breast reconstruction is a simple and reliable technique, giving stable aesthetic results over time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-21-338DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575712PMC
October 2021

Influence of Irradiation on Capsules of Silicone Implants Covered with Acellular Dermal Matrix in Mice.

Aesthetic Plast Surg 2022 Apr 10;46(2):937-946. Epub 2021 Nov 10.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: In advanced breast cancer, radiotherapy is recommended as adjuvant therapy following breast reconstructive surgery. This inevitably led to growing concerns over possible complications of radiotherapy on implants. In this experimental animal study, we investigated the utility of acellular dermal matrix (ADM) wraps around implants as preventive management for radiotherapy complications.

Methods: Black mice (C57NL6; n = 32) were assigned to groups that either received radiation or did not: groups A and B underwent surgery using implants without radiotherapy; while groups C and D underwent surgery using implants with radiotherapy for one and three months, respectively. The hemispheric silicone implants with an 0.8-cm-diameter were inserted on the left back of each mouse, and implants wrapped by ADM were inserted on the right back. The Clinic 23EX LINAC model was used for irradiation at 10 Gy. The samples were evaluated by gross assessment, histological analysis, immunohistochemical analysis, and the Western blotting test.

Results: The H&E staining analysis showed that membrane thickness is smallest in group A, followed by groups C, D, and B. In a Masson trichrome histological analysis, collagen fibers became less dense and more widespread over time in the groups that received an ADM. Immunohistochemistry findings were similarly constant. However, the expression of TGF-β1 was increased in the irradiated groups, whereas it was decreased in the non-irradiated groups as observed over time.

Conclusions: Radiotherapy was shown to increase risk factors for capsular contracture, including inflammatory response, pseudoepithelium, thinning of membrane, and TGF-β1 expression over time; however, the accompanying framework using an ADM as a barrier between implant and tissue was shown to be effective in alleviating these risks.

No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-021-02618-4DOI Listing
April 2022

The Effect of Orthognathic Surgery on Changes in Masticatory Muscle Volume in Patients With Facial Asymmetry.

J Craniofac Surg 2021 Nov 2. Epub 2021 Nov 2.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.

Abstract: The masseter muscle changes remarkably with orthognathic surgery and has a marked influence on the contours of the lower face. If the postoperative volume change of masticatory muscles, including the masseter muscles, can be predicted, it will facilitate preoperative planning and outcome prediction. This study investigated the association of masticatory muscle volume according to the presence or absence of facial asymmetry, and evaluated whether the volume of masticatory muscles, including that of the masseter muscle, changes after orthognathic surgery in facial asymmetry patients.Twenty patients who underwent LeFort I osteotomy and bilateral sagittal segmentation ramus osteotomy (BSSRO) with facial asymmetry between 2011 and 2017 were assigned to the asymmetric group. Additionally, 207 patients with a simple nasal fracture between 2016 and 2019 were included as the common group. Three-dimensional computed tomography images were retrospectively analyzed and compared between the asymmetric group and common group.The volume of both temporal and masseter muscles differed according to facial asymmetry, with the asymmetry in the muscle volume increasing in proportion to the degree of facial asymmetry. The difference in masseter volume on the shortened and lengthened sides was significantly reduced after orthognathic surgery, but a difference of about 1 cm3 remained. Additionally, the masticatory muscle volume on the lengthened side tended to be decreased more than that on the shortened side.Consideration of the postoperative change in the volume of the masticatory muscles may be helpful in planning orthognathic surgery in facial asymmetry patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000008322DOI Listing
November 2021

Porcine training models for endoscopic and robotic reconstructive breast surgery: a preliminary study.

Gland Surg 2021 Aug;10(8):2346-2353

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: With recent advances in surgical techniques, minimally invasive methods for reconstructive breast surgery are being investigated. To enhance surgical proficiency through training and minimize predictable complications before human application, we conducted a preliminary experimental study of reconstructive breast surgery using a porcine model.

Methods: Between February and March 2019, four 3-month-old pigs underwent a bilateral mastectomy and immediate breast reconstruction with a latissimus dorsi (LD) flap or silicone implants. After performing the mastectomy by dissecting the pectoralis profundus in the subcutaneous plane, the pig was placed in the decubitus position, and ultrasound-guided marking was used to design the LD flap. The thoracodorsal artery was marked, and a 4-cm incision was made on the midaxillary line. An additional endoscopic incision was made in the inferior margin of the LD flap; a 2-hole approach was used for endoscopic LD flap elevation. In the silicone implant model, a silicone implant (Allergan, smooth, round type, 90 cc) was placed using a single incision (4-5 cm).

Results: Eight mastectomies followed by breast reconstruction with LD flap elevation or silicone implant models were performed on four pigs. Serious complications, such as active bleeding, did not occur. However, heat dispersion to the skin flap that became thinner by endoscopic dissection caused a second-degree burn in one pig.

Conclusions: This preliminary study of endoscopic or robot-assisted minimally invasive reconstructive breast surgery demonstrates that a porcine training model is a highly valuable experimental model for surface anatomy verification, incision plan selection, instrument selection, operator proficiency enhancement, and complication prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-21-398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411080PMC
August 2021

Comparison of surface topography and roughness in different yttrium oxide compositions of dental zirconia after grinding and polishing.

J Adv Prosthodont 2021 Aug 26;13(4):258-267. Epub 2021 Aug 26.

Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Republic of Korea.

Purpose: The purpose of this study was to compare the surface roughness, phase transformation, and surface topography of dental zirconia with three different yttrium oxide compositions under same grinding and polishing conditions.

Materials And Methods: Three zirconia disks (IPS e.max ZirCAD LT, MT, MT multi, Ivoclar Vivadent AG, Schaan, Liechtenstein) were selected for experimental materials. Sixty-nine bar-shaped specimens were fabricated as 12.0 × 6.0 × 4.0 mm using a milling machine and glazing was conducted on 12.0 × 6.0 mm surface by same operator. With a custom polishing device, 12.0 × 6.0 mm surfaces were polished under same condition. Surface roughness (Ra[µm]) was measured before grinding (C), after grinding (G), and at every 3 steps of polishing (P1, P2, P3). X-ray diffraction and FE-SEM observation was conducted before grinding, after grinding, and after fine polishing (P3). Statistical analysis of surface roughness was performed using Kruskal-Wallis test and Mann-Whitney-U test was used as a post hoc test (α = .05).

Results: There were no significant differences of surface roughness between LT, MT, and MM groups. In LT, MT, and MM groups, P3 groups showed significantly lower surface roughness than C groups. X-ray diffraction showed grinding and polishing didn't lead to phase transformation on zirconia surface. In FE-SEM images, growths in grain size of zirconia were observed as yttrium oxide composition increases.

Conclusion: Polished zirconia surface showed clinically acceptable surface roughness, but difference in yttrium oxide composition had no significant influence on the surface roughness. Therefore, in clinical situation, zirconia polishing burs could be used regardless of yttrium oxide composition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4047/jap.2021.13.4.258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410306PMC
August 2021

Study on polyethylene-based carbon fibers obtained by sulfonation under hydrostatic pressure.

Sci Rep 2021 Sep 9;11(1):18028. Epub 2021 Sep 9.

Department of Fiber System Engineering, Yeungnam University, Gyeongsan, 712-749, Republic of Korea.

Polyethylene based carbon fibers were studied using high density polyethylene(HDPE) fibers and linear low density polyethylene(LLDPE) fibers with various melt flow index. The draw ratio of the polyethylene fibers and the sulfonation mechanism were investigated under hydrostatic pressures of 1 and 5 bar in the first time. The influence of the melt flow index of polyethylene and types of polyethylene fibers on the sulfonation reaction was studied. Carbon fibers were prepared through the sulfonation of LLDPE fibers possessing side chains with a high melt flow index. The polyethylene fibers, which exhibited thermoplastic properties and plastic behavior, were cross-linked through the sulfonation process. Their thermal properties and mechanical properties changed to thermoset properties and elastic behavior. Although sulfonation was performed under a hydrostatic pressure of 5 bar, it was difficult to convert the highly oriented polyethylene fibers because of their high crystallinity, but partially oriented polyethylene fibers could be converted to carbon fibers. Therefore, the effect of fiber orientation on fiber crosslinking, which has not been reported in previous literature, has been studied in detail, and a new method of hydrostatic pressure sulfonation has been successful in thermally stabilizing polyethylene fiber. Hydrostatic sulfonation was performed using partially oriented LLDPE fibers with a melt flow index of 20 at 130 °C for 2.5 h under a hydrostatic pressure of 5 bar. The resulting fibers were carbonized under the following conditions: 1000 °C, 5 °C/min, and five minutes. Carbon fibers with a tensile strength of 2.03 GPa, a tensile modulus of 143.63 GPa, and an elongation at break of 1.42% were prepared.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-97529-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429680PMC
September 2021

Aesthetic outcomes and complications following post-mastectomy radiation therapy in patients undergoing immediate extended latissimus dorsi flap reconstruction and implant insertion.

Gland Surg 2021 Jul;10(7):2095-2103

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Jung-gu, Daegu, Korea.

Background: Complications of radiotherapy after implant-based reconstruction include capsular contracture development, seroma formation, and reoperation for implant removal or replacement. However, there is a lack of studies regarding aesthetic outcomes and complication rates following radiation therapy among patients undergoing latissimus dorsi (LD) flap-based reconstruction with implant insertion for volume shortage. The present study aimed to evaluate clinical and aesthetic outcomes of post-mastectomy radiation therapy (PMRT) among patients receiving both LD flap reconstruction and implant insertion.

Methods: This study comprised 66 patients who underwent mastectomy and breast reconstruction between March 2014 and July 2019. Patient demographics and outcomes were compared among patients who did and did not receive PMRT. Aesthetic outcomes were compared using gross photographs. The incidence of complications, including seroma formation, flap necrosis, nipple-areola complex necrosis, hematoma development, and capsular contractures, was compared between groups.

Results: No differences in aesthetic outcomes using gross photos during outpatient follow-up were observed between the radiation and control groups. No significant difference in the frequency of complications was observed between groups.

Conclusions: The use of implants and LD reconstruction are inevitable in a proportion of patients due to a lack of LD flap volume. For these patients, PMRT could be safe treatment option if the necessary precautions are implemented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-21-219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8340333PMC
July 2021

Metabolic Evidence Rather Than Amounts of Red or Processed Meat as a Risk on Korean Colorectal Cancer.

Metabolites 2021 Jul 16;11(7). Epub 2021 Jul 16.

Department of Toxicology, College of Pharmacy, Sookmyung Women's University, Seoul 04310, Korea.

The incidence of colorectal cancer (CRC) has increased in Korea, a newly- Asian country, with the dramatic increase of meat intake. To assess the risks of red or processed meat consumption on CRC, we performed a case-control study with biological monitoring of urinary1-OHP, PhIP, and MeIQx for the meat exposure; dG-C8 MeIQx and dG-C8 PhIP for HCA-induced DNA adducts; and homocysteine and C-reactive protein (CRP) in blood as well as malondialdehyde (MDA) and 31fatty acids in urine for inflammation and lipid alteration. We further analyzed global DNA methylation and expression of 15 CRC-related genes. As a result, the consumption of red or processed meat was not higher in the cases than in the controls. However, urinary MeIQx and PhIP were associated with the intake of red meat and urinary 1-OHP. MDA and multiple fatty acids were related to the exposure biomarkers. Most of the 31 fatty acids and multiple saturated fatty acids were higher in the cases than in the controls. Finally, the cases showed upregulation of , which is related to pro-inflammatory fatty acids. This study describes indirect mechanisms of CRC via lipid alteration with a series of processes including exposure to red meat, alteration of fatty acids, and relevant gene expression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/metabo11070462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303103PMC
July 2021

The Usefulness of Endoscopic Harvesting of the Latissimus Dorsi Flap for Breast Reconstruction Using a Single-Port and CO Gas Insufflation Technique.

Aesthetic Plast Surg 2021 12 30;45(6):2681-2690. Epub 2021 Jul 30.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Daegu, 41944, South Korea.

Background: In the recent trend toward less aggressive approaches to breast reconstruction, minimally invasive harvesting of the latissimus dorsi (LD) flaps has long been a desirable goal. Endoscopically-assisted LD flap harvesting was reported as a method for minimizing scar formation and reducing donor-site morbidity. This study investigates the surgical outcomes of endoscopically-assisted immediate breast reconstruction with LD muscle flaps.

Materials And Methods: This prospective study included 21 patients who underwent endoscopically-assisted breast reconstruction with LD muscle flap and 20 patients who underwent breast reconstruction with conventional harvesting LD musculocutaneous flap. In patients with nonexcised skin or possible primary closure, the reconstruction was performed with endoscopically-assisted LD muscle flaps using the single-port and CO gas insufflation technique. The patients were classified into groups according to the location of the defect and mastectomy type. Moreover, patient satisfaction was investigated 6 months after surgery.

Results: In patients who underwent endoscopically-assisted breast reconstruction with LD muscle flaps, the scar of the donor-site was vertical, and the size was 4 cm to be obscured when lowering the arms. In comparison with patients who underwent breast reconstruction with conventional LD flaps, those who underwent endoscopically-assisted breast reconstruction with LD muscle flaps showed shorter hospital stay and no difference in patient satisfaction.

Conclusion: Endoscopically-assisted breast reconstruction with LD flaps showed no difference in patient satisfaction with good esthetic results compared with conventional LD flaps. The endoscopic LD muscle flap harvest technique using a single-port and CO2 insufflation technique can be very useful in breast reconstruction that does not require a skin paddle.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00266-021-02467-1DOI Listing
December 2021

Clinical assessment and management of auricular arteriovenous malformation: retrospective study.

Arch Craniofac Surg 2021 Jun 25;22(3):141-147. Epub 2021 Jun 25.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases.

Methods: Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation.

Results: Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients.

Conclusion: Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7181/acfs.2021.00192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8257445PMC
June 2021

Alteration in skeletal posture between breast reconstruction with latissimus dorsi flap and mastectomy: a prospective comparison study.

Gland Surg 2021 May;10(5):1587-1597

Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: The latissimus dorsi (LD) flap is used in cases of immediate breast reconstruction after total or partial mastectomy. However, studies on the effect of unilateral LD flap reconstruction on skeletal posture and comparison with results from mastectomy-only have been sparse. Thus in this prospective, observational study, we compared skeletal posture and functional recovery in patients who underwent a mastectomy-only versus those who underwent breast reconstruction with a LD flap after mastectomy.

Methods: From January 2018 to February 2020, a total of 54 patients were enrolled. The control group included 23 patients who underwent mastectomy-only and the experimental group included 31 patients who underwent breast reconstruction using a LD flap immediately after mastectomy. We assessed the Cobb's angle in spine X-rays, parameters derived from photometry, computed tomography (CT), and 3D scanning preoperatively (T0), 6 months post-surgery (T1), and 1-year post-surgery (T2). We also evaluated functional outcomes, such as pain intensity, disability of the upper extremities, and quality of life.

Results: In the control and experimental groups, the average age was 58.7/46.2 years, body mass index (BMI) was 24.9/22.5, and excised mass weight was 386.8/259.1 g, respectively. In the control group, differences in the Cobb's angle were significant between T0 and T2 (P=0.003). There were significant differences in the Cobb's angle and time interaction effects between the two groups (P=0.015). The degree of change in the Cobb's angle between T0 and T1 was positively correlated with change in the vertical distance from the 3D scanner midline to the nipple (P=0.009).

Conclusions: The experimental group showed improved recovery in skeletal posture compared to the control group. Further, discovering the parameters that can predict the change of skeletal posture through a 3D scanner will have clinical significance. Accordingly, performing breast reconstruction by unilaterally applying the LD muscle is a safe, reliable, and useful method of autologous tissue transfer for breast cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-21-31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184393PMC
May 2021
-->