Gaps between the upper edges of brassiere mold cups and the breasts are one of the most serious issues in realizing comfort wearing of commercial brassieres for small-breasted women. The surplus ease amounts causing the fit problem were measured from 3D wearing images of the small-breasted women's brassieres. The effect after the removing the surplus ease amounts from the upper edge of mold cup was approved by subjective wearing evaluation. Since the volume distribution of mold cup can also affect the wearing sensation of brassiere, the subjective wearing sensation was compared for two brassieres of different volume distributions, VL, of which volume was concentrated at the lower cup, and VC, which has the thickest part at the nipple. As the results, the suitable sensation for cup volume and the natural wearing silhouette could be accomplished by removing the surplus ease amounts from the upper edge of mold cup to reduce the gaps between brassieres and the breasts, which could be accomplished through an approach reducing the volume near the upper edge of mold brassiere cup and making the volume concentrated at the lower cup. These works provide a useful information on the design of the brassiere mold cups for small-breasted women. Moreover, modeling methods of 3D scan data and 3D printing technique for making more accurate mold cases used in this research can be helpful to develop and evaluate clothing products in future.
We used to LASSO-Cox method for determining prognostic factors of male breast cancer survival and showed the superiority of this method compared to Cox proportional hazard model in low sample size setting. In order to identify and estimate exactly the relative hazard of the most important factors effective for the survival duration of male breast cancer, the LASSO-Cox method has been used. Our data includes the information of male breast cancer patients in Fars province, south of Iran, from 1989 to 2008. Cox proportional hazard and LASSO-Cox models were fitted for 20 classified variables. To reduce the impact of missing data, the multiple imputation method was used 20 times through the Markov chain Mont Carlo method and the results were combined with Rubin's rules. In 50 patients, the age at diagnosis was 59.6 (SD=12.8) years with a minimum of 34 and maximum of 84 years and the mean of survival time was 62 months. Three, 5 and 10 year survival were 92%, 77% and 26%, respectively. Using the LASSO-Cox method led to eliminating 8 low effect variables and also decreased the standard error by 2.5 to 7 times. The relative efficiency of LASSO-Cox method compared with the Cox proportional hazard method was calculated as 22.39. The19 years follow of male breast cancer patients show that the age, having a history of alcohol use, nipple discharge, laterality, histological grade and duration of symptoms were the most important variables that have played an effective role in the patient's survival. In such situations, estimating the coefficients by LASSO-Cox method will be more efficient than the Cox's proportional hazard method.
This study was conducted to investigate the growth performance indices among male commercial crossbred Korean native chickens from hatch to twelve weeks of age. A total of 312 one-day-old male birds were used for 6 groups of the commercial crossbred Korean native chicken within 1 paternal line and 6 maternal lines (1A, 2A, 3A, 4A, 5A, and 6A). The chickens were allocated to 24 battery cages to give 4 replicates per each crossbreed with 13 chickens per cage. Ad-libitum feeding was practiced throughout the experimental period and fresh water was available via nipple drinkers at all times. Body weight and feed intake were measured at two-week interval. Among six crossbreeds, the 2A group had the greatest (p < 0.05) body weight at week 8 and the greatest average daily weight gain in week 6 - 8. However, crossbreed 2A had the lowest viability (p < 0.05) at week 8 of all crossbreed groups as well as higher uniformity (p > 0.05) at week 2 than the others. No difference (p < 0.05) was found in any crossbreed Korean native chicken's growth performance indices including body weight, average daily gain, average daily feed intake, feed efficiency, uniformity, and viability after week 8. With this in mind, crossbreed 2A had greater bodyweight, average daily gain, average feed intake, and feed efficiency than the other Korean native chickens 84 days after hatch, although they had lower uniformity and viability than the others.
Purpose: The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. In order to satisfy that goal, variable reduction mammaplasty methods are performed, however, two methods such as vertical reduction method and inverted T-scar method are currently most used. We compared indications and advantages of the two methods and set up useful guidlines. Methods: For 15 years from 1995 to 2010, we experienced 84 patients (162 breasts). We performed vertical reduction method as Lejour's superior pedicle technique (45 patients) and inverted T-scar method as Goldwyn's inferior dermal flap technique (39 patients). We evaluated the result of the operation comparing patient's age, amount of resected tissue, complications and post-operative scars of the two methods. Results: The mean age was 36 years and the vertical reduction group was 3 years younger than inverted T-scar group. The mean breast tissue resection amount per one breast, inverted T-scar group (712 gm) was lagger than vertical reduction group (395 gm). Conclusion: There is no ideal method for reduction mammaplasty until now. However, we suggest that guide line, the vertical reduction method is effective for minimal and moderate macromastia in young and middle aged women and inverted T-scar method is appropriate for severe macromastia with ptosis in elderly women. Recently, all procedures tried shorter and smaller scar on the vertical line as small I, J or L shape scar, and inframammary fold as short inverted T-scar.
Lee, Ji Hwan;Chang, Choong Hyun;Park, Chan Heun;Kim, June-Kyu
Archives of Plastic Surgery
/
v.41
no.3
/
pp.258-263
/
2014
Background For early breast cancer patients, skin-sparing mastectomy or nipple-sparing mastectomy with sentinel lymph node biopsy has become the mainstream treatment for immediate breast reconstruction in possible cases. However, a few cases of skin necrosis caused by methylene blue dye (MBD) used for sentinel lymph node localization have been reported. Methods Immediate breast reconstruction using a silicone implant was performed on 35 breasts of 34 patients after mastectomy. For sentinel lymph node localization, 1% MBD (3 mL) was injected into the subareolar area. The operation site was inspected in the postoperative evaluation. Results Six cases of immediate breast reconstruction using implants were complicated by methylene blue dye. One case of local infection was improved by conservative treatment. In two cases, partial necrosis and wound dehiscence of the incision areas were observed; thus, debridement and closure were performed. Of the three cases of wide skin necrosis, two cases underwent removal of the dead tissue and implants, followed by primary closure. In the other case, the breast implant was salvaged using latissimus dorsi musculocutaneous flap reconstruction. Conclusions The complications were caused by MBD toxicity, which aggravated blood disturbance and skin tension after implant insertion. When planning immediate breast reconstruction using silicone implants, complications of MBD should be discussed in detail prior to surgery, and appropriate management in the event of complications is required.
Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.
Background: Breast cancer is the most common cancer among women worldwide. A very important factor in the timely treatment and prevention of progression is high breast cancer awareness. Rural women are at risk of latte stage breast cancer due to poor education and lack of access to medical facilities. Materials and Methods: This cross-sectional-descriptive study was conducted on 266 women (out of 300) aged over 18 in rural areas of Zabol, Southeastern Iran during July 2015 to October 2015. The data collection tool was a researcher-made questionnaire that measured participant knowledge of breast cancer in four aspects (general awareness, risk factors, mammography, and symptoms). SPSS 22 was used for statistical analysis. Results: Out of 266 participants, age information was available for 261. The age range was between 19 and 62, with a mean of $27{\pm}2.1years$. Most participants (154, 57.9%) had an average overall awareness of breast cancer. In the general awareness dimension, most participants (130, 48.9%) had poor scores. Most (166, 62.4%) also had average awareness about risk factors and many (137, 51.5%) had good awareness about mammography. Most participants did not know that changes in breast shape (232, 88.2%), dimpling of breast skin (192, 72.3%) and nipple discharge (183, 69.6%) are the main symptoms of breast cancer. ANOVA statistical analysis showed a significant relationship between awareness level and participant education and occupation (P<0.05). Conclusions: This study indicated average awareness of participants about breast cancer. Since rural women have lower levels of education, it is recommended that educational courses with contents about breast cancer, its risk factors, and symptoms be held for these women.
The ratio of small-breasted women occupies over 20% among Korean women in their twenties. However, the commercial brassieres for the small-breasted women were not fitted well to their breast shapes. In this research, the various commercial mold brasseries for small-breasted women were evaluated through the wearing test and the analysis of 3D images which were scanned from their torsos wearing the brassieres. In addition, professional panels performed the appearance evaluation based on the 2D front and side images captured from 3D images taken by 3D measurement systems. As the results, we found that small-breasted women preferred a 3/4 cup brassiere, of which volume is concentrated in the lower cup. The most preferred brassiere in wearing state shows that the characteristic angle between the chest and the upper cup is about 167 degrees, which is smaller than those of another brassieres, and that the ratio of the radius of curvature of the nipple part to that of the lower cup was about 0.78. These results provide important implications regarding the design of mold brassieres for small-breasted women in spite of the fact that these results represent the selected set of commercial brassieres. Therefore, further studies are highly demanded for the most suitable design information of mold cup for small-breasted women.
This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.
Purpose: TRAM flap reconstruction has settled down as a common method for breast reconstruction after mastectomy. There are a few surgical contraindication in TRAM flap surgery. Previous abdominal liposuction has been a relative contraindication in TRAM flap surgery. The authors present 2 patients of successful breast reconstruction using pedicled TRAM flaps, who previously underwent abdominal liposuction. Methods: Case 1: A 48-year-old woman with a right breast cancer visited for mastectomy and breast reconstruction. Her past surgical history was notable for abdominal liposuction 15 years ago. Skin sparing mastectomy and breast reconstruction with a pedicled TRAM flap was performed. Case 2: A 45-year-old woman with a left breast cancer visited us for mastectomy and autologous breast reconstruction. 3 years ago, she had an abdominal liposuction and augmentation mammaplasty in other hospital. Nipple sparing mastectomy and breast reconstruction was done using pedicled TRAM flap. Results: One year after the reconstruction, partial fat necrosis was developed in one case but there was no skin necrosis or donor site complication in both patients. Conclusion: As aesthetic surgery becomes more popular, increasing numbers of patients who have a prior abdominal liposuction history want for autologous tissue breast reconstruction. In these patients, TRAM flap surgery will be also used for breast reconstruction. But, the warning of fat necrosis and the use of preoperative Doppler tracing to evaluate the abdominal perforator may be beneficial to patients who had abdominal liposuction recently.
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