Background: Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio. Methods: All breast reconstructions using the round block technique after BCS were included in this analysis. Patients’ data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated. Results: In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation. Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

Bioresorbable vascular scaffold (BRS) is an innovative device that provides structural support and drug release to prevent early recoil or restenosis, and then degrades into nontoxic compounds to avoid late complications related with metallic drug-eluting stents (DESs). BRS has several putative advantages. However, recent randomized trials and registry studies raised clinical concerns about the safety and efficacy of first generation BRS. In addition, the general guidance for the optimal practice with BRS has not been suggested due to limited long-term clinical data in Korea. To address the safety and efficacy of BRS, we reviewed the clinical evidence of BRS implantation, and suggested the appropriate criteria for patient and lesion selection, scaffold implantation technique, and management.
Coronary Disease ; Drug Liberation ; Drug-Eluting Stents ; Humans ; Korea ; Stents ; Thrombosis

BACKGROUND: Restenosis after successful percutaneous transluminal coronary angioplasty remains a major obstacle to the long-term success of the procedure. Uncontrolled proliferation and extracelluar matrix synthesis in response to mechanical injury are important contributors to this proces. External beam radiation or gamma radiation affects self-renewing tissues by arresting cell division, and therefore limits proliferation by reducing the number of clonal progenitors. The purpose of this study was to determine whether external beam radiation (EBR) could reduce the extent of neointimal formation after balloon injury in the rat carotid injury model and, if it could, to define the minimum effective dose. METHODS: 32 Sprague-Dawley rats (mean weight : 370+/-78g) underwent carotid injury by using 2F Fogarty balloon and EBR with doses ranging from 5 to 20 Gy. Rats were sacrificed after 2 weeks. The arteries were perfusin-fixed in paraformaldehyde. The dose was specified to a depth of 15mm. Histomorphometry was performed to compare external elastic lamina (EEL) area (mm2), lumen area (mm2)and neointimal area (mm2 of the injured segments. RESULTS: EEL area showed no significant difference in each different radiation group. Low dose EBR (5 Gy and 10Gy) had no significant impact on neointimal hyperplasia in rat carotid injury model. However, in high dose group (15Gy and 20Gy) neointimal area was significantly reduced (p<0.01) indicating high dose EBR markedly prevented neointimal hyperplasia. CONCLUSION: Radiation therapy may be an effective adjunctive method for reducing the restenosis rate after successful angioplasty in the rat carotid injury model.
Angioplasty ; Angioplasty, Balloon, Coronary ; Animals ; Arteries ; Cell Division ; Eels ; Gamma Rays ; Hyperplasia ; Rats* ; Rats, Sprague-Dawley