Since the early detection rate of breast cancer is increasing and skin- or nipple-sparing mastectomies have become popularized recently, the need for breast reconstruction using implants is continuously increasing. Simplicity of surgical techniques, short operation time, short hospital stay, short recovery time, no need for donor site defects and scars, and reconstruction with tissue of same color, texture, and sensation are the main advantages of implant reconstruction. However, reconstructed breasts using implants tend to be less natural and ptotic, sensitive to external temperature, unable to adapt to the normal aging process of the breast, and may have implant related complications. In patients with postoperative radiation, implant reconstruction is not indicated because of decreased skin flap circulation and increased implant related complications. Although autologous tissue reconstruction is known to produce natural and aesthetic breasts, similar results can be achieved by implant reconstruction when it is well indicated and performed with appropriate techniques by experienced surgeons. Implant reconstruction is best suited for young, active women with small round breasts and slender bodies.
Aging ; Breast ; Breast Implants ; Breast Neoplasms ; Cicatrix ; Female ; Humans ; Length of Stay ; Mammaplasty ; Mastectomy ; Sensation ; Skin ; Tissue Donors ; Tissue Expansion Devices

Background: Inflammation and structural remodeling may contribute to fibrogenesis in Crohn’s disease (CD). We quantified the immunoexpression of calretinin, CD34, and calprotectin as a surrogate for mucosal innervation, telocytes (interstitial cells playing a role in networking), and inflammation, respectively, and correlated them with bowel alterations in stricturing CD. Methods: Primary resection specimens for ileal CD (n = 44, 31 stricturing CD, 13 inflammatory CD) were identified. Left-sided ulcerative colitis and trauma cases were used as controls. Proximal and distal margin and middle (diseased) sections were stained for calretinin, CD34, and calprotectin. Microscopic images were captured from the mucosa (calretinin), submucosa (calprotectin), and myenteric plexus (CD34), and the immunostaining was quantified using image processing and analysis. Bowel thickness at the corresponding sections were measured and correlated with the amount of immunoexpression. Results: A total of 2,037 images were analyzed. In stricturing CD, submucosal alteration/thickening at the stricture site correlated with calprotectin staining and inversely correlated with calretinin staining at the proximal margin. Muscularis propria alteration/thickening at the stricture site correlated with mucosal calretinin staining at the proximal margin. Submucosal alteration/thickening at the proximal margin correlated with calretinin and CD34 staining at the proximal margin and inversely correlated with CD34 staining at the stricture site. Calretinin immunostaining at the distal margin was significantly higher in stricturing CD than the controls. Conclusions Inflammation and tissue remodeling appear to contribute to fibrogenesis in stricturing CD. Increased mucosal calretinin immunostaining distal to the diseased segment could be helpful in diagnosing CD in the right clinical context.

Purpose: The aim of this study was to analyze the effects of reduced fasting time on postoperative recovery in patients who underwent totally laparoscopic distal gastrectomy (TLDG). Methods: This retrospective study included 347 patients who underwent TLDG. Patients were divided into 2 groups:reduced fasting time group (n = 139) and conventional feeding group (n = 208). We compared the total hospital cost and recovery parameters, such as postoperative complications, mean hospital stay, day of first flatus, initiation of soft diet, and serum CRP levels, between the 2 groups. Results: The reduced fasting time group had a lower total hospital cost (P < 0.001) than the conventional feeding group.Regarding postoperative complications, there was no significant difference between the 2 groups (P = 0.085). Patients in the reduced fasting time group had a significantly shorter duration of mean hospital stay (P < 0.001), an earlier first flatus (P = 0.002), an earlier initiation of soft diet (P < 0.001), and lower level of serum CRP concentration (day of surgery, P = 0.036;postoperative days 2, 5, and 7, P = 0.01, 0.009, and 0.012, respectively) than patients in the conventional feeding group. Conclusion Reduced fasting time can enhance postoperative recovery in patients who undergo TLDG and may reduce medical costs.