PURPOSE: The purpose of this study was to assess the effect of quilting suture extent on the latissimus dorsi myocutaneous flap (LDMCF) donor site and the necessity of drainage.METHODS: Clinical data of 136 breast cancer patients, who underwent breast reconstruction using LDMCF between May 2014 and December 2015, were retrospectively reviewed. Patients were divided into three groups. Group A: quilting sutures were performed on half of the LDMCF donor site and a closed suction drain was inserted. Group B: quilting sutures were performed for the entire LDMCF donor site and a closed suction drain was inserted. Group C: quilting sutures were performed for the entire LDMCF donor site and no drain was inserted. The duration of drainage, total drainage, length of hospital stay, number of postoperative aspirations for seroma removal, and total aspirated volume were compared.RESULTS: In the comparison of groups A and B, group B showed better results including the total amount of drained seroma, drain maintenance period, number of aspirations for seroma removal after drainage tube removal, total aspirated seroma, and hospitalization period with statistical significance (P<0.05). In the comparison of groups B and C, group C without drain showed no difference in all other variables except mean total drained seroma volume. Therefore, group C was superior to group A and there was no difference compared to group B with drain, even though the drain was not inserted.CONCLUSION: Total quilting suture at LDMCF donor site can reduce seroma formation and eliminate the need for a drain tube.
Aspirations (Psychology) ; Breast Neoplasms ; Drainage ; Female ; Hospitalization ; Humans ; Length of Stay ; Mammaplasty ; Myocutaneous Flap ; Retrospective Studies ; Seroma ; Suction ; Superficial Back Muscles ; Sutures ; Tissue Donors

The aim of this study was to investigate the change of microbial contamination levels in the different areas and at the different time points after application of a quaternary ammonium compound (QAC) that has mechanical antimicrobial effect. The microbial contamination levels were measured in three different areas; unit chair handle, spit sink area and hand piece holder at different time points using adenosine triphosphate (ATP) monitoring system and ATP surface test kit. Hand piece holder showed the highest level of microbial contamination. In most of the clinics, QAC significantly reduced the levels of microbial contamination, and maintained antimicrobial activity for 4 to 6 months. QAC may be used effectively in dental clinics due to the duration of antimicrobial effect and the minimal exposure of chemicals and further studies are needed with large sample size.

Objective: To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. Methods: This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. Results: Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. Conclusion We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.

Objective: To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. Methods: This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. Results: Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. Conclusion We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.

Objective: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. Materials and Methods: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23–75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of followup with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar’s test or a generalized estimating equation. Results: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). Conclusion The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.