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Impact of Disturbed Wound Healing after Surgery on the Prognosis of Marjolin's Ulcer

  • Choi, Jae Yeon;Bae, Yong Chan;Nam, Su Bong;Bae, Seong Hwan
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.198-202
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    • 2013
  • Background Marjolin's ulcer is known to present a high proportion of recurrence and poor prognosis compared to other kinds of skin cancer. Based on our experience, Marjolin's ulcer patients who have received reconstructive surgery present a higher proportion of recurrence when there was disturbed wound healing after surgery. The impact of disturbed wound healing after surgery on the prognosis was examined in this study. Methods A retrospective study was carried out on 26 patients who were diagnosed with Marjolin's ulcer and received surgery in this hospital from 1996 to 2011. Histologic grading, lymph node metastasis at diagnosis, and the wound healing process were evaluated and chi-squared analysis applied in order to determine the correlation with recurrence. Results The proportion of recurrence increases in patients with a low histologic grade or lymph node metastasis at diagnosis. The proportion of recurrence is even higher when the problem occurs during the wound healing process after surgery. Conclusions Disturbed wound healing after surgery could be used as a sign to quickly identify the recurrence of carcinoma. Therefore, in the event a problem occurs in the wound healing process after surgery, one should keep in mind that this could be a sign of the possibility of recurrence and proceed with careful observation and active diagnosis through additional physical examinations, general X-ray tests, computed tomographys, magnetic resonance imagings, and so on, to obtain an early diagnosis of recurrence.

Recurrent late seroma after immediate breast reconstruction with latissimus dorsi musculocutaneous flap

  • Bae, Seong Hwan;Lee, Yong Woo;Nam, Su Bong;Lee, So Jeong;Park, Heeseung;Kang, Taewoo
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.267-271
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    • 2020
  • The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for breast reconstruction. However, it has the disadvantage of frequent seroma formation at the donor site, and late seroma has also been reported. The authors report histological findings after the surgical treatment of a late, repeatedly recurrent seroma at 10 years after breast reconstruction with LDMCF. In 2008, a 66-year-old female patient underwent immediate breast reconstruction with LDMCF. In 2015, a late seroma was found at the donor site. After aspiration and drainage, the seroma recurred again in 2018. Total surgical excision of the seroma was performed and bloody-appearing fluid was identified in the capsule. The excised tissue was biopsied. Histological examination revealed no evidence of blood in the fluid, and multinucleated giant cells with amorphous eosinophilic proteinaceous material were identified. The cyst was suggestive of chronic granulomatous inflammation. There was no recurrence at 8 months postoperatively. The patient described herein underwent surgical treatment of late seroma that recurred after immediate breast reconstruction with LDMCF, and histological findings were identified. These results may be helpful for other future studies regarding late seroma after breast reconstruction with LDMCF.

Analysis of the Effects of Breast Reconstruction in Breast Cancer Patients Receiving Radiotherapy after Mastectomy

  • Kim, Seong-Hwan;Kim, Jeong-Min;Park, Sun-Hyung;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.222-226
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    • 2012
  • Background : Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods : We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results : Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions : It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

Effect of organic acids in dental biofilm on microhardness of a silorane-based composite

  • Hashemikamangar, Sedighe Sadat;Pourhashemi, Seyed Jalal;Talebi, Mohammad;Kiomarsi, Nazanin;Kharazifard, Mohammad Javad
    • Restorative Dentistry and Endodontics
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    • v.40 no.3
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    • pp.188-194
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    • 2015
  • Objectives: This study evaluated the effect of lactic acid and acetic acid on the microhardness of a silorane-based composite compared to two methacrylate-based composite resins. Materials and Methods: Thirty disc-shaped specimens each were fabricated of Filtek P90, Filtek Z250 and Filtek Z350XT. After measuring of Vickers microhardness, they were randomly divided into 3 subgroups (n = 10) and immersed in lactic acid, acetic acid or distilled water. Microhardness was measured after 48 hr and 7 day of immersion. Data were analyzed using repeated measures ANOVA (p < 0.05). The surfaces of two additional specimens were evaluated using a scanning electron microscope (SEM) before and after immersion. Results: All groups showed a reduction in microhardness after 7 day of immersion (p < 0.001). At baseline and 7 day, the microhardness of Z250 was the greatest, followed by Z350 and P90 (p < 0.001). At 48 hr, the microhardness values of Z250 and Z350 were greater than P90 (p < 0.001 for both), but those of Z250 and Z350 were not significantly different (p = 0.095). Also, the effect of storage media on microhardness was not significant at baseline, but significant at 48 hr and after 7 day (p = 0.001 and p < 0.001, respectively). Lactic acid had the greatest effect. Conclusions: The microhardness of composites decreased after 7 day of immersion. The microhardness of P90 was lower than that of other composites. Lactic acid caused a greater reduction in microhardness compared to other solutions.

The Stability of Penicillin G Potassium Injection after Reconstitution in Various Storage Conditions (Penicillin G Potassium 주사액 조제 후 보관방법에 따른 안정성)

  • Chang, Myung Soon;Shin, Hyun Taek;Su, Ok Kyung;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.71-76
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    • 1999
  • The stability of penicillin G potassium injection after reconstitution was evaluated in two different diluents of sodium chloride $0.9\%$ and dextrose $5\%$ in water stored at room temperature or refrigerated condition. The concentrations of penicillin G, stored for 24 hours at room temperature or for 10 days at refrigerated condition, were determined by HPLC. Also the pHs of the reconstituted solutions were monitored. The concentrations and pHs of penicillin G potassium 500,000 U/ml injection after reconstitution gradually decreased in all conditions. Stored at room temperature after reconstitution, a new peak which suspected as degradation products of penicillin G was detected in 5 hours in sodium chloride $0.9\%$, 4 hours in dextrose $5\%$ in water. At refrigerated condition, the new peak was detected in 4 days in both sodium chloride $0.9\%$ and dextrose $5\%$ in water. The degradation products of penicillin G allergy have been thought to be one of the substances responsible for evoking allergic reactions. In conclusion, the penicillin G potassium 500,000 U/ml injection after reconstitution was stable for 4 hours in sodium chloride $0.9\%$ 3 hours in dextrose $5\%$ in water solution at room temperature. At refrigerated condition, both solutions were stable for 3 days after reconstitution.

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Effect of Dentin Desensitizer on the Hypersensitivity of Teeth with Non-carious Cervical Lesions Subsequent to Ultrasonic Scaling (지각과민처치제가 초음파 스케일링 처리한 비우식성 치경부 병소가 있는 치아의 지각과민증에 주는 영향)

  • Cho, Jae-Hyung;Seok, Soohwang;Lee, Sang-Hyeok;Lim, Bum-Soon
    • Korean Journal of Dental Materials
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    • v.43 no.1
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    • pp.17-28
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    • 2016
  • The aim of this study was to evaluate the changes in dentinal permeability after application of dentin desensitizer on exposed dentin immediately after ultrasonic scaling to teeth with non-carious cervical lesions. Thirty caries-free extracted molars were fixed to slide glasses after horizontally being sectioned at 5 mm below the cemento- enamel junction (CEJ). The prepared specimen was connected to a fluid flow measuring device (nano-Flow), and a V-shaped cavity was formed at the CEJ to imitate the non-carious cervical lesion. After no fluid leakage was confirmed in the connected system with specimen, tooth surface was treated ultrasonic cleaning with piezoelectric ultrasonic scalers until dentinal tubules were exposed. And 6 different desensitizers were applied on exposed dentin. Real-time measurements of dentinal fluid flow were performed during ultrasonic scaling and application of dentin desensitizer. To evaluate the occlusion of exposed dentinal tubules, tooth surface was examined by SEM. Following results were observed. After ultrasonic scaling, more dentinal tubules were exposed on the tooth with non-carious cervical lesions compared to tooth without lesions. The rate of fluid flow measured with nano-Flow system had correlation with the degree of dentin occlusion observed with SEM after application of desensitizers on exposed dentin. Desensitizers with glutaraldehyde and HEMA did not decrease the rate of fluid flow and did not show dentin occlusion. Desensitizers with oxalate showed the limited effects on the rate of fluid flow and dentinal tubule occlusion. Desensitizer with resin monomer showed the significant effect on the rate of fluid flow and dentin occlusion.

Myocardial Protective Effects of Shenfu Injection after Mitral Valve Replacement Surgery; A Systematic Review and Meta Analysis. (승모판의 인공판막 치환술후 삼부주사액의 심근보호효과에 관한 체계적 문헌고찰 및 메타분석)

  • Bong-Jin Shin;Ji-Ho Kim;Mu-Hyeok Ahn;Jung-Nam Kwon
    • The Journal of Korean Medicine
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    • v.43 no.3
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    • pp.164-180
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    • 2022
  • Objectives: The purpose of this study was to evaluate the effects of shenfu injection on myocardial protective effects after mitral valve replacement surgery. Methods: We searched four international databases (PUBMED, Embase, Web of Science and CNKI) and three domestic electronic databases (OASIS, RISS and NDSL) for relevant studies. We used following keywords 'shenfu', 'valve replacement', 'mitral valve' at PUBMED, Embase and Web of Science; '二尖瓣', '参附注射液', '瓣膜' at CNKI and '이첨판', '판막', '삼부' at domestic databases. The search range included randomized controlled trials. When appropriate, meta-analyses were performed. Results: Seven randomized controlled trials were selected. All studies used Shenfu injection after mitral valve replacement surgery. We analyzed myocardial damage, cardiac function, patients' recovery rate, with various evaluation indicators. We also used meta-analysis for CK-MB, cTnI, MDA and voluntary recovery of heartbeat. CK-MB was analyzed in two subgroups: 8 hours and 24 hours after surgery. Std was -2.34(95% CI -4.10, -0.58) for 8 hours and -1.95(95% CI -4.79 to 0.88) for 24 hours. 8 hours showed statistically significant difference. cTnI appeared significant decrease with Std of -2.13(95% CI -2.60, -1.66). MDA showed significant decrease with Std of -0.95(95% CI -1.43 to -0.47). Voluntary recovery of heartbeat significantly increased with the odd ratio of 4.34(95% CI 1.76, 10.70). Conclusions: We suggest that Shenfu injection after Mitral valve replacement surgery may have significant myocardial protective effects in terms of reducing myocardial damages, reactive oxygen species, increasing cardiac function and patients' recovery after surgery. However, the evidence is limited, further research is required.

Change of phase transformation and bond strength of Y-TZP with various hydrofluoric acid etching

  • Mi-Kyung Yu;Eun-Jin Oh;Myung-Jin Lim;Kwang-Won Lee
    • Restorative Dentistry and Endodontics
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    • v.46 no.4
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    • pp.54.1-54.10
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    • 2021
  • Objectives: The purpose of this study was to quantify phase transformation after hydrofluoric acid (HF) etching at various concentrations on the surface of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), and to evaluate changes in bonding strength before and after thermal cycling. Materials and Methods: A group whose Y-TZP surface was treated with tribochemical silica abrasion (TS) was used as the control. Y-TZP specimens from each experimental group were etched with 5%, 10%, 20%, and 40% HF solutions at room temperature for 10 minutes. First, to quantify the phase transformation, Y-TZP specimens (n = 5) treated with TS, 5%, 10%, 20% and 40% HF solutions were subjected to X-ray diffraction. Second, to evaluate the change in bond strength before and after thermal cycling, zirconia primer and MDP-containing resin cement were sequentially applied to the Y-TZP specimen. After 5,000 thermal cycles for half of the Y-TZP specimens, shear bond strength was measured for all experimental groups (n = 10). Results: The monoclinic phase content in the 40% HF-treated group was higher than that of the 5%, 10%, and 20% HF-treated groups, but lower than that of TS-treated group (p < 0.05). The 40% HF-treated group showed significantly higher bonding strength than the TS, 5%, and 10% HF-treated groups, even after thermal cycling (p < 0.05). Conclusions: Through this experiment, the group treated with SiO2 containing air-borne abrasion on the Y-TZP surface showed higher phase transformation and higher reduction in bonding strength after thermal cycling compared to the group treated with high concentration HF.

A 10-year follow-up study on clinical outcomes of dental implant rehabilitation using surgical guide

  • Haoyun Li;Mi Young Eo;Kezia Rachellea Mustakim;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.70-79
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    • 2024
  • Objectives: The surgical guide is a static computer-assisted device used for implant surgery planning and guidance. By taking an impression and referring to the patients' three-dimensional computed tomography scan of the desired implant site, a surgical guide can be created. During surgery, the surgical guide aids in achieving the designed implant placement position and direction. We examined and evaluated the long-term clinical outcomes of implant surgery using surgical guides. Materials and Methods: This study investigated a total of 15 patients with 32 implants that were placed using surgical guides from 2009 to 2011 with a mean follow-up period extended beyond 10 years. Patient demographics and implant survival rates were recorded. We analyzed marginal bone loss (MBL) by assessing the radiographs acquired at installation, three months after installation, and one month, one, two, and five years after prosthesis delivery. Results: The mean patient age was 57.33 years at implant placement. Of the 32 implants, five implants were placed in the anterior region and 27 implants were in the posterior region. Six implants failed and three of them were replaced, resulting in an 81.25% survival rate. The mean follow-up period was 10 years and nine months. Mean MBL compared to post-installation was significantly higher than at three months after installation, and one month, one, two, and five years after prosthesis delivery. Mean MBL at three months after installation, and one month, one year, and two years were significantly higher compared to the previous visit (P<0.05). However, MBL at five years after prosthesis delivery did not differ significantly compared to at two years. Conclusion: In this study, implant rehabilitation assisted by surgical guides exhibited favorable survival rates. With the limitation of the sample amount in this study, further research and more samples are required to evaluate the long-term clinical effectiveness of surgical guides.

The Effect of Basic Cardiopulmonary Resuscitation Training Education Program for High School Students (고등학생에게 적용한 기본심폐소생술 실기교육프로그램 효과)

  • Kim, Soon-Sim;Kam, Sin
    • Korean Journal of Health Education and Promotion
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    • v.23 no.4
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    • pp.155-171
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    • 2006
  • Objective: The purpose of this study was to apply the Basic CPR(Cardiopulmonary resuscitation) training education program and identify its effects on knowledge of Basic CPR and skills of Basic CPR in second grade high school students. Methods: The training program was conducted for 16 weeks between March 26 and July 9, 2005 using a non-equivalent control group pretest-post test design by dividing 60 students in a half for both the experimental group and the control group. General characteristics, the effect of the education were evaluated with $x^2-test$, t-test, ANCOVA, Repeated Measure ANOVA and Bonferonni with SPSS 11.0/pc. Result: After the CPR education program application, knowledge score in the experimental group increased to 20.57 right after the education from 9.32, the score measured before the training, 19.11 after 8 weeks and 18.29 after 12 weeks. On the contrary, the control group's score showed no significant before the training. According to the result of knowledge score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in knowledge at every point(p<0.001). In the effect durability for knowledge of the training education program in process time after the training program in the experimental group, the durability of effect was identified despite the elapsing time. Scores of skills for Basic CPR increased from 1.21, the score measured before the training program, to 30.07 right after the education, 23.50 after 8 weeks and 17.57 after 12 weeks in experimental group. On the contrary, the control group showed an immaterial increase. According to the result of skill score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in skill at every point(p<0.001). The score for skill increased significantly right after the education compared to the score prior to the education. Conclusions: These findings suggest that Basic CPR training education program facilitate knowledge of CPR and skill of CPR in high school students. Therefore, it would be necessary to include the Basic CPR training program in high school education curriculum. However, the effect of Basic CPR knowledge maintains for a few period, and the effect of maintaining the skill is shorter than the maintenance of knowledge so regular reeducation is considered to be needed.