• Archives of Plastic Surgery
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• v.38 no.5
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• pp.621-626
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• 2011

Purpose: Implant-based breast reconstruction has multiple advantages such as decreased morbidity, shorter operative time and faster recovery. However, postoperative infection with tissue expander increases medical cost and causes a delay in concurrent antineoplastic treatment. To reduce tissue expander infection, it is important to identify related risk factors and minimize them when possible. Methods: A retrospective review of patient records in a single breast cancer center was performed. Eighty-six tissue expanders were placed in 80 women for postmastectomy breast reconstruction. Variables including patients'age, body mass index (BMI), preoperative breast volume, operation time, drain indwelling time, postoperative seroma/hematoma formation, chemotherapy, and radiation therapy were evaluated. Infection was defined as the status that shows any symptom of local inflammation and identification of pathogens. Representative values were compared through Student's t-test and univariate and multivariate analyses. Results: We examined 86 postmastectomy tissueexpanders which were placed between June 2004 and April 2010. Seven cases of tissue expander infection (8.1%) were identified. The infected tissue expander was removed in three of the cases. The relationship between BMI, and preoperative breast volume and that between infection and non-infection groups were significant ($p$ <0.05). Univariate analysis showed significant association between BMI ($p$=0.023) and preoperative breast volume ($p$=0.037). Multivariate analysis revealed that BMI and preoperative breast volume were independent variables regarding tissue expander infection. Conclusion: Certain characteristics of implant-based breast reconstruction patients increase infection rate of tissue expander. These risk factors should be monitored and evaluated before surgeries for more successful outcome.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.2
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• pp.329-338
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• 2005

Breast milk is general term for crude milk and mature that is secrete after two-three days of delivery. Because amount of milk secretion is different, disorder of milk secretion is to be classified into galactostasis and spontanous flow of milk. According to this point, we considered thirty four papers and got the conclusion about the concept, cause, therapeutic method and medication of secreation disorder. Therefore we report the result. galactostasis due to deficiency of the qi and blood, depression of liver qi, blood stasis of postpartum, excessiveness and so on. If the qi and blood is deficient, therapeutic method is enriching qi and benefiting blood, if the liver qi is deprssive, treatment is relieving the deprssive liver and regulating the circulation of qi. The milk is flowing spontanously and continously due to a prosperous condition of qi and blood, too deficiency of the qi and blood, depression of liver qi and so on. If the qi and blood is deficient, therapeutic method is tonifying and arresting the qi and blood, if Liver channel is stagnated fire, puring the liver of pathologic fire, relieving the deprssive liver and regulating the circulation of qi. Clinical study for the 1 case of the recurrent cervical cancer patient.

• Parasites, Hosts and Diseases
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• v.44 no.2 s.138
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• pp.151-156
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• 2006

A case of breast sparganosis was confirmed by surgical excision of a worm (fragmented into 5 pieces) in a 59-year-old Korean woman suffering from a palpable mass in the left breast. Mammography and ultrasonography characteristically revealed the presence of several well-defined, isodense and hypoechoic tubular masses, in the upper quadrant of the left breast, each mass consisting of a continuous cord- or worm-like structure. During surgery, a long segment of an actively moving sparganum of Spirometra sp. and 4 small fragments of the same worm, giving a total length of 20.3 cm, were extracted from the upper outer quadrant of the left breast and the axillary region. The infection source remains unclear, because the patient denied ingesting any snake or frog meat or drinking untreated water.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.261-266
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• 2008

We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after longterm retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.9-14
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• 2008

The most important concern to do parotidectomy is correct identification of the facial nerve and preservation of the nerve function. Many descriptions for the localization and branching types of the facial nerve trunk have existed. During the parotid surgery, it is necessary to have knowledges about the incidence and prognostic aspect of a invasion of the facial nerve by the parotid tumors. The method of the dissection and the surgical extent of the parotid gland would be decided not only by the anatomic variation of the facial nerve. but also the size and location of the tumor. Invasion of the facial nerve in parotid malignancies is the most significant factors affecting the prognosis, so radical parotidectomy which consists of the total extirpation of the parotid gland in conjunction with resection of the facial nerve is often required for proper management. Radical parotidectomy is advocated for the surgical treatment of high grade malignancies and in selective recurrent benign tumors intimately involving the facial nerve. Unfortunately, the morphologic and functional deficits created by sacrificing the facial nerve can be emotionally and physically traumatizing to the patient. Therefore, when the facial nerve is sacrificed, immediate reconstruction of the facial nerve should be necessary. Immediate nerve repair with direct anastomosis of the resected nerve ends or placement of a cable nerve graft provides the better cosmetic and functional results. Surgical resection remains the mainstay of treatment for cancer of the parotid gland, and there is general agreement that facial nerve should not be sacrificed unless the tumor is adherent to, or surrounds the nerve. The following statement is described general principles of troublesome management of the facial nerve during surgery for parotid tumor.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.41-45
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• 2013

Background: Merkel cell carcinoma (MCC) is a rare locally aggressive cutaneous neuroendocrine carcinoma with a high incidence of local recurrence, regional lymph node metastasis, followed by distant metastasis. Because of shortage of the retrospective study, standard treatment has not been established. The purpose of this study was to present the surgical treatment and outcome of 8 patients with MCC. Methods: We report our experiences with 8 patients who underwent treatment for MCC at our institution from 2000 through 2012. Two men and 6 women received treatment for MCC. The mean age was 76.4 years (range, 53 to 93 years). Results: The follow-up period ranged from 7 to 26 months (mean, 22.9). During the follow-up period, three of 8 patients had a relapse (mean time before recurrence, 10 months; 1 month, 7 months, and 22 months). After primary surgery, 3 patients underwent radiotherapy, and 1 patient received chemotherapy. Conclusion: MCC is an aggressive skin cancer with a high rate of local recurrence. Complete surgical excision is the mainstay of local treatment, but adjuvant radiotherapy should be considered for better local control.

• Journal of the Korean Physical Society
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• v.73 no.10
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• pp.1577-1583
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• 2018

Tumor-treating fields therapy involves placing pads onto the patient's skin to create a low- intensity (1 - 3 V/cm), intermediate frequency (100 - 300 kHz), alternating electric field to treat cancerous tumors. This new treatment modality has been approved by the Food and Drug Administration in the USA to treat patients with both newly diagnosed and recurrent glioblastoma. To deliver the prescribed electric field intensity to the tumor while minimizing exposure of organs at risk, we developed an optimization method for the electric field distribution in the body and compared the electric field distribution in the body before and after application of this optimization algorithm. To determine the electric field distribution in the body before optimization, we applied the same electric potential to all pairs of electric pads located on opposite sides of models. We subsequently adjusted the intensity of the electric field to each pair of pads to optimize the electric field distribution in the body, resulting in the prescribed electric field intensity to the tumor while minimizing electric fields at organs at risk. A comparison of the electric field distribution within the body before and after optimization showed that application of the optimization algorithm delivered a therapeutically effective electric field to the tumor while minimizing the average and the maximum field strength applied to organs at risk. Use of this optimization algorithm when planning tumor-treating fields therapy should maintain or increase the intensity of the electric field applied to the tumor while minimizing the intensity of the electric field applied to organs at risk. This would enhance the effectiveness of tumor-treating fields therapy while reducing dangerous side effects.

• Archives of Plastic Surgery
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• v.48 no.5
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• pp.473-482
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• 2021

Background The increasing number of bilateral breast cancer patients has been accompanied by a growing need for bilateral mastectomy with immediate reconstruction. However, little research has investigated the complications and aesthetic outcomes related to bilateral reconstruction. Therefore, we analyzed retrospective data comparing the outcomes of bilateral reconstruction using deep inferior epigastric perforator (DIEP) flaps or implants. Methods This study included 52 patients (24 DIEP group and 28 implant group) who underwent bilateral mastectomy with immediate reconstruction between 2010 and 2020. Patient demographics, surgical characteristics, and complications were recorded. The difference between the left and right position of the nipple-areolar complex with respect to the sternal notch point at the clavicle was measured, and breast symmetry was evaluated. Results The average weight of breasts reconstructed with DIEP flaps (417.43±152.50 g) was higher than that of breasts with implants. The hospitalization period and operation time were significantly longer in the DIEP group. Early complications were significantly more common in the implant group (36.53%) than in the DIEP group. The angles between the nipples and the horizontal line were 1.09°±0.71° and 1.75°±1.45° in the DIEP and implant groups, respectively. Conclusions Although the surgical burden is lower, breast reconstruction using implants requires greater attention with respect to implant positioning, asymmetry, and complications than DIEP flap reconstruction. DIEP flap reconstruction has a prolonged operation time and a high risk of flap failure, but yields excellent cosmetic results and does not require intensive follow-up. Patients should be consulted to determine the most suitable option for them.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.356-360
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• 2021

Background: Primary pulmonary malignant mesenchymal tumors are rare, constituting only 0.4% of all lung cancers. Since sarcomas are chemo/radio-resistant, surgical resection is the optimal treatment choice for patients with suitable medical conditions and tumor stage. In the present study, we analyzed the surgical outcomes and survival of primary pulmonary malignant mesenchymal tumors treated surgically. Methods: We retrospectively examined the records of patients with primary pulmonary malignant mesenchymal tumors who underwent surgical resection at our department between January 2010 and December 2020. Patient data were analyzed according to age, sex, tumor grade and stage, resection completeness, surgical type, and tumor histopathology. Results: Twenty patients were included in the study. There were 13 men (65%) and 7 women (35%). The median survival rate was 36 months (range, 19-53 months), and the 5-year overall survival rate was 37%. Unfavorable prognostic factors for overall survival included parietal pleural invasion (p=0.02), high tumor grade (p=0.02), advanced tumor stage (p=0.02), and extensive parenchymal resection (pneumonectomy and bilobectomy, p=0.01). The median length of disease-free survival was 31 months (interquartile range, 21-41 months), and the 5-year disease-free survival rate was 32%. The most unfavorable prognostic factors for recurrence were parietal pleural invasion (p=0.02), high tumor grade (p=0.01), and tumors requiring lung resection with chest wall resection (p=0.02). Conclusion: Primary malignant mesenchymal lung tumors are aggressive and have a high mortality rate. However, acceptable overall and disease-free survival rates can be obtained with surgical therapy.

• Annals of Coloproctology
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• v.34 no.6
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• pp.312-316
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• 2018

Purpose: Anemia is associated with poor treatment results for a variety of cancers. The effect of low hemoglobin levels on long-term outcomes after the treatment of patients with an anal squamous cell carcinoma (SCC) remains unclear. For that reason, this study aimed to investigate the effect of anemia on treatment outcomes following chemoradiation for an anal SCC. Methods: This was a retrospective study of all patients who underwent curative treatment for an anal SCC between 2009 and 2015 at 2 trusts in the United Kingdom. Data were collated from prospectively collected cancer databases and were cross-checked with operating-room records and records in the hospitals' patient management systems. Results: We identified 103 patients with a median age of 63 years (range, 36-84 years). The median overall survival was 39 months (range, 9-90 months), and the disease-free survival was 36 months (range, 2-90 months). During the follow-up period, 16.5% patients died and 13.6% patients developed recurrence. Twenty-two people were anemic prior to treatment, with a female preponderance (20 of 22). No differences in disease-free survival (P = 0.74) and overall survival (P = 0.12) were noted between patients with anemia and those with normal hemoglobin levels. On regression the analysis, the combination of anemia, the presence of a defunctioning colostomy, lymph-node involvement and higher tumor stage correlated with poor overall survival. Conclusion: In this study, anemia did not influence disease-free survival or overall survival. We suggest that the interaction between anemia and survival is more complex than previously demonstrated and potentially reliant on other coexisting factors.