Background: The use of acellular dermal matrix (ADM) in breast reconstruction can inhibit capsular contracture, increasing the success rate of surgery. Adipose-derived stem cells (ADSCs) can effectively suppress foreign body reaction, which is a major cause of capsular contracture. This study aimed to elucidate the synergistic effects of combining ADSCs with ADM on capsule formation, utilizing a rat model. Methods: The study utilized 12 rats, equally divided into two experimental groups. Group A received silicone implants covered with ADM, while Group B was implanted with silicone prostheses wrapped in ADM, pre-seeded with ADSCs. Capsule formation was assessed through visual examination, histological analysis, and reverse transcription-polymerase chain reaction (RT-PCR) at 4 and 8 weeks post-implantation. Results: At 4 weeks, the mean capsular thickness was 177.16 μm in Group A and 170.76 μm in Group B; at 8 weeks, it was 196.69 μm in Group A and 176.10 μm in Group B. Statistical analysis showed no significant difference in capsule thickness between the groups (P>0.05). Histological findings indicated that Group A had more inflammatory cells and collagen fibers and reduced angiogenesis. RT-PCR showed that angiogenesis-promoting gene expression in Group B was 14% higher at 4 weeks and 156% higher at 8 weeks compared to Group A. Conclusion Although no statistically significant reduction in capsule thickness was observed, ADSC-seeded implants showed histological features associated with reduced inflammation and enhanced angiogenesis, suggesting potential benefits in capsule formation management.

Purpose: Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes. Methods: We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire. Results: The mean body mass index and specimen weight were 23.43 kg/m2 (range, 18.5–26.8) and 83.29 g (range, 15–290 g), respectively. The tennis racket and round-block techniques were chosen for small defects (< 10%–15%) in small- and medium-sized breasts.The rotational and perforator flap techniques were used for medium-sized defects. The latissimus dorsi (LD) flap technique was used for large defects (> 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results. Conclusion The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.

Background: In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness.
Methods: The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed.
Results: The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation.
Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia

PURPOSE: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. METHODS: Case1: A 50-year-old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51-year-old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. RESULTS: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. CONCLUSION: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstruction.
Breast ; Breast Implants ; Breast Neoplasms ; Fat Necrosis ; Female ; Fungi ; Humans ; Mammaplasty ; Mastectomy, Radical ; Middle Aged ; Necrosis ; Rectus Abdominis ; Skin

PURPOSE: Breast conserving surgery(BCS) for breast cancer has a common treatment protocol. Oncoplastic surgery represents a form of BCS which combines both a cosmetic mammoplasty approach and oncologic resection for the treatment of breast cancer. Depending on the tumor site, BCS can make an unsatisfactory cosmetic result, especially in inferiorly placed tumors. This study describes the use of oncoplastic techniques for inferiorly located breast tumors in immediate partial mastectomy reconstruction. METHODS: From September of 2006 to February of 2008, these techniques were used in 11 patients at the OO hospital. After BCS was preceded, breast reshaping by oncoplastic techniques were selected depending on the location and size of the tumor within the breast as well as the size of breast itself. Oncoplastic techniques after partial mastectomy included 'Wise pattern (inverted T)' reduction mammoplasty, 'vertical pattern' mammoplasty, 'J-pattern' mammoplasty. In order to improve the cosmetic outcome, repositioning of the nipple areola complex(NAC) or reshaping of the contralateral breast may be considered additionally. RESULTS: These techniques have been used in 11 patients. The mean age was 51 and the average follow- up period was 8 months. Eleven of these patients underwent the 'Wise pattern(inverted T)' reduction mammoplasty(n=6), 'vertical pattern' mammoplasty(n=3) and 'J-pattern' mammoplasty(n=2). There was one wound dehiscence during the follow-up periods. This complication was treated by conservative approach. The overall cosmetic result was evaluated in 6 months. The majority of patients were satisfied at the cosmetic result. CONCLUSION: Oncoplastic techniques in inferiorly located breast tumors could be a reasonable and safe option for breast cancer patients who desire conserving surgery with esthetical breast.
Breast ; Breast Neoplasms ; Clinical Protocols ; Cosmetics ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Nipples

OBJECTIVE: To study the changes in serum creatinine and correlation between gestational age or birth weight and serum creatinine in low birth weight infants in the immediate postnatal period. METHODS: Medical records of all premature infants, who were admitted to the neonatal intensive care unit of Hallym University Hospital between January 2003 and December 2007, were reviewed. 162 infants met our inclusion criteria. Medical records were reviewed for : birth weight, gestational age, length, gender, APGAR scores, use of medications, blood urea nitrogen (BUN) and serum creatinine (Scr) during the first days of life. Premature infants were separated into three groups according to their birth weight: 500 to 999 g; 1,000 to 1,499 g; and 1,500 to 2,000 g. RESULTS: Scr was found to decrease postnatally, however there was a delay in the decrease of Scr in the subgroup of infants<1,000 g BW, Scr was also found to decrease with increasing birth weight at 1 week after birth (Pearson test, p=0.01). Serum BUN was found to decrease with increasing birth weight at 1 week after birth (Pearson test, p=0.00). CONCLUSION: In low birth weight infants Scr decrease during the first days of life. However, in infants smaller than 1,000 g birth weight there is a delay in the decrease of their Scr that extends beyond the first days of life. Our findings indicate progression of renal function is directly correlated to birth weight.
Birth Weight ; Blood Urea Nitrogen ; Creatinine ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Medical Records ; Parturition

Mycoplasma pneumoniae (M. pneumoniae) infection causes a wide variety of clinical manifestations in children and young adults, the main one being pneumonia. M. pneumoniae is transmitted from person to person by infected respiratory droplets. Symptoms caused by M. pneumoniae infection can be divided into those involving the respiratory tract, and those caused by extrapulmonary disease. M. pneumoniae infections may cause central nervous system (CNS) complications-with encephalitis being the most frequent-and stroke being a rare complication. The pathogenesis of the CNS disease is unclear; possibilities include direct infection and an immune-mediated reaction. We present two cases of CNS complications subsequent to infection with M. pneumoniae; both cases had convincing evidence of preceding M. pneumoniae respiratory disease with no evidence of viable M. pneumoniae in the cerebrospinal fluid. We report cases of encephalitis and stroke following a recent M. pneumoniae infection.
Central Nervous System ; Central Nervous System Diseases ; Child ; Encephalitis ; Humans ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory System ; Stroke ; Young Adult

Purpose: We analyzed the clinical features, management and outcome of small bowel intussusception in children compared with ileocolic intussusception. Methods: We retrospectively reviewed the records of 210 children with documented intussusception, in whom intussusception was initially diagnosed by ultrasonography during the four-year period of 2002 to 2005. Results: A total of 191 children were diagnosed with ileocolic intussusception and 19 were diagnosed with small bowel intussusception. Children with small bowel intussusception were older than children with ileocolic intussusception (P<0.05). In comparison to patients with ileocolic intussusception the characteristic presenting symptoms-such as currant jelly stool and palpable mass-were rarely observed in patients with small bowel intussusception. In ileocolic intussusception, air reduction (92.2%), or surgical reduction (7.3%) was performed; however, in small bowel intussusception, spontaneous reduction (78.9%) was observed and no surgical reduction was required in our study. Conclusion: Conservative management with close observation and follow-up sonographic evaluation rather than an immediate operation is recommended for children with small bowel intussusception.
Child ; Follow-Up Studies ; Humans ; Intussusception ; Retrospective Studies