Breast reconstruction using TRAM flap after mastectomy has been widely adopted and regarded as a gold standard method. In patients with the abdominal midline scar, insufficient blood circulation to regions contralateral to the pedicle disables inclusion of them in the TRAM flap design. So modifications including Double- pedicled TRAM, Super-charged, Turbo-charged, Bipedicled free TRAM et al. have been attempted to resolve the problem of circulatory interruption by midline scar. The authors designed a new bipedicled free TRAM flap to avoid limitations like epigastric buldging, significant abdominal weakness and complexity of flap insetting. The two donor arteries(right and left deep inferior epigastric arteries) are anastomosed to the proximal and distal ends of divided internal mammary arteries using the reverse flow. Vein anastomoses were performed in the same manner through the divided venae comitantes. Two patients having infraumbilical midline scar underwent breast reconstruction using author`s new flap. Flaps survived without fat necrosis or partial flap loss in both patients and their results in aesthetic aspects were very satisfactory. Compared to previous method for breast reconstruction of patients having infraumbilical midline scar, author's new method is useful and effective in terms of the aesthetic and technical aspect.
Blood Circulation ; Breast* ; Cicatrix* ; Fat Necrosis ; Female ; Humans ; Mammaplasty* ; Mammary Arteries ; Mastectomy ; Tissue Donors ; Veins

Deformities of the auricular region that have been resulted from burns or other traumatic injuries emotionally devastate the patients and frustrate the surgeons. The surgical procedure for ear reconstruction varies depending upon the quality and quantity of available skin in the auricular region after burns and other facial trauma for the coverage of cartilage framework. Postauricular skin, postauricular fascia, temporoparietal fascia have been used for traumatized ear reconstruction according to the literature. But toral ear reconstruction in the cases of severe trauma like burn or traffic accident is one of the most difficult problems because of its paucity and poor quality of the available skin in the auricular region. The author reports two cases of traumatized ear reconstruction using a prefabricated radial forearm fasciocutaneous free flap made of an autogenous costal cartilage framework. This flap is valuable for the reconstruction of severely traumatized ear when local tissue or other free flaps are improper to select.
Accidents, Traffic ; Burns ; Cartilage ; Congenital Abnormalities ; Ear* ; Fascia ; Forearm* ; Free Tissue Flaps* ; Humans ; Skin

OBJECTIVES: The purpose of this study was to evaluate the periodontal status of adolescents aged 15 years in Jinju city. METHODS: The study subjects were 506 adolescents aged 15 years in Jinju city. We investigated the prevalence and severity of periodontal disease using the Community Periodontal Index (CPI) recommended by the WHO. Data on the frequency of daily tooth-brushing were collected through self-reported questionnaires. The information obtained on both the periodontal health status and frequency of daily toothbrushing of adolescents in Jinju city was compared with the data from the 6th Korea National Health and Nutrition Examination Survey 2013-2015 (KNHANES-VI). The software utilized in the analysis was SPSS version 23. Statistical significance was set at P < 0.05. RESULTS: The rate of healthy periodontal status in Jinju city was lower compared to KNHANES-VI (57.7% versus 63.7%). The rate of gingival bleeding in Jinju city and KNHANES-VI was 11.3% and 10.8%, respectively. The rate of calculus in Jinju city and KNHANES-VI was 31.0% and 25.6%, respectively. The rates of gingival bleeding and calculus were not significantly different between Jinju city and KNHANES-VI. The healthy periodontal segments in Jinju city were more than those in KNHANES-VI (5.43 versus 5.25). The bleeding periodontal segments in Jinju city were less than those in KNHANES-VI (0.25 versus 0.45). However, the periodontal segments with calculus in Jinju city were not significantly different from those of KNHANES-VI (0.31 versus 0.30). The frequency of daily tooth-brushing in Jinju city was more than that in KNHANES-VI (2.67 versus 2.47). CONCLUSIONS: These findings suggest that appropriate oral health education should be widely conducted to promote periodontal health in adolescents.
Adolescent ; Calculi ; Education ; Gyeongsangnam-do ; Hemorrhage ; Humans ; Korea ; Nutrition Surveys ; Oral Health ; Periodontal Diseases ; Periodontal Index ; Prevalence ; Toothbrushing

OBJECTIVES: This study aimed to investigate factors related to the periodontal health of 12-year-old children.METHODS: In 2015, the Korean Children's Oral Health Survey from the Ministry of Health & Social Welfare conducted a nationwide representative sample comprised of 23,702 12-year-old children. The calibration-trained dentists examined the gingivitis and dental calculus of the children taking into consideration of the Löe and Silness gingival index to diagnose gingivitis with a modified gingivitis scale. We used questionnaires to collect data from the children on dental treatments, the experience of dental pain and gingival bleeding, self-perceived oral health, and oral health behaviors. Data were analyzed using a complex samples Chi-square test, general linear model, and logistic regression. Significance was determined at P < 0.05.RESULTS: The prevalence of gingivitis was higher among males (OR 1.57), among children with poor perception (OR 1.19), dental calculus (OR 3.68), or gingival bleeding experience (OR 2.00), and among children not using dental floss (OR 1.69) or tongue cleaner (OR 1.90). The prevalence of dental calculus was higher among children with gingivitis (OR 3.82) and among children who had not visited a dental clinic in the preceding year (OR 1.31). However, dental calculus was lower among children with a higher frequency of daily toothbrushing (OR 0.75), intake of cariogenic foods (OR 0.90), or a higher DMFT index (OR 0.91).CONCLUSIONS: Children with dental calculus and gingival bleeding who did not visit a dental clinic in the preceding year also had a higher prevalence of gingivitis and dental calculus. The prevalence of children's dental calculus was lower among children with a high frequency of daily toothbrushing.
Child ; Dental Calculus ; Dental Clinics ; Dental Devices, Home Care ; Dentists ; Gingivitis ; Hemorrhage ; Humans ; Linear Models ; Logistic Models ; Male ; Oral Health ; Periodontal Index ; Prevalence ; Social Welfare ; Tongue ; Toothbrushing