• Archives of Plastic Surgery
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• 제48권2호
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• pp.194-198
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• 2021

Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed in an attempt to seek smaller and indistinct incisions. Robotic surgery system has been evolving under the concept of minimal invasive technique which is a recent trend in surgery. One of the latest version is the da Vinci SP Surgical System (Intuitive Surgical). In this report, we will share our experiences. Two patients underwent robot-assisted nipple-sparing mastectomy, each followed by immediate robot-assisted expander insertion and prepectoral direct-to-implant breast reconstruction, respectively. There was no open conversion or major postoperative complication. One patient experienced mild infection, which was resolved by intravenous antibiotic treatment. Simple docking process, multi-joint instruments, and thirdarm functionality are among the new surgical system's advantages. The present cases suggest that robot-assisted nipple-sparing mastectomy with immediate reconstruction using the da Vinci SP Surgical System is feasible and safe. The promising features and potential application of da Vinci SP in breast reconstruction need further study.

• 한국동물학회지
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• 제37권1호
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• pp.49-57
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• 1994

In the course of an investigation on the morphological variation of Korean striped bittering, Acheilognathus vamatsutae Mori, two kinds of morrholoflical types were found. Some morphological characters were compared between them and multivariate analysis was conducted. Since the difference of the barbel length between them was very significant (p < 0.01,1-test), they should be designated as L-and 5-type Hshes: fishes with long barbels and those with should barbels, respectively. Lateral line scales, snout length and prepectoral length showed a tendency that the observation could be distinguished from each other (p < 0.05, Duncan's multiple range tests. There were no individuals over 70 mm BL in S-type and so S-type fishes were somewhat dwarf than L-type fishes. The two types were also clearly distinguished by multivariate analyses using cluster and discriminant analyses. According to the observation on the four populations of the Naktong River, the blue-green stripe on the body side and the white band on the margin of anal fin in males of S-type fishes were well developed through the year but those of males of L-type fishes completely disappeared or became slender during nonbreedins season as that of females. Of the seven localities surveved, there were no places that the two types cohabit. S-type fishes are limited only in the Kumho and Wichon River of the Naktong River system but L-type fishes are distributed more widely In the Hongchon, Mangvons, Somjin, Mirang and Panbyon River.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.7-15
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• 2019

Breast animation deformity (BAD) has been reported to occur after submuscular implant placement following breast augmentation and immediate breast reconstruction. Despite its apparent impact on patients' quality of life, BAD has only recently become a topic of general concern. Its incidence and etiology have yet to be established. The aim of this systematic review was to identify papers that clearly defined and classified BAD and described how the degree of animation was assessed. We performed a search in PubMed and Embase. Studies meeting the inclusion criteria that described BAD after implant-based breast augmentation or immediate breast reconstruction were included. After screening 866 publications, four studies were included: three describing BAD after breast augmentation and one describing BAD after immediate breast reconstruction. The median percentage of patients with some degree of BAD was 58%. The highest percentages were found in patients operated on using the Regnault technique or the dual-plane technique (73%-78%). The lowest percentages were found following the dual-plane muscle-splitting technique (30%) and the triple-plane technique (33%). We found no studies meeting the inclusion criteria that analyzed BAD after prepectoral implant placement. This review of the current literature suggests that the degree of BAD is proportional to the degree of muscle involvement. Evidence is scarce, and the phenomenon seems to be underreported. Future comparative studies are warranted.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.36-41
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• 2024

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still preferring elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant-based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates were analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only perioperative prophylactic antibiotics for 24 hours. Results Of the 274 implants, 98 who were administered prophylactic antibiotics until drain removal had an infection rate of 3.06% (three implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had an infection rate of 4.49% (eight implants). A total of 11 patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistically significant effects in the risk of infection (p = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, and route of antibiotics is needed.

• 한국어류학회지
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• 제20권4호
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• pp.285-290
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• 2008

넙치 암컷과 강도다리 수컷을 인공교배하여 만든 잡종의 형태적 특징을 조사하였다. 잡종은 두 종의 중간 형태를 나타내지만 대부분의 형질이 수컷인 강도다리에 조금 더 가까웠다. 잡종은 체장에 대한 체고 비율이 56.3%로서 체고가 높고, 두장에 대한 문장 비율 20.6%, 두장에 대한 상악장 비율 34.2%이었으며, 체장에 대해 전배기장 10.5%, 전흉기장 32.2%, 전복기장 29.8%, 전둔기장 28.0%로서 강도다리 체형에 다소 가까웠다. 눈이 있는 쪽은 암황록색 바탕에 옅은 검은 얼룩이 흩어져 있으며, 강도다리 체측에 산재해 있는 작은 골판은 없다. 등지느러미에 6~20개, 뒷지느러미에 5~10개의 가로띠무늬가 있으나 가장자리로 갈수록 흐려져 불명료해진다. 지느러미 기조수는 등지느러미 60~66, 뒷지느러미 40~51, 꼬리지느러미 18~21, 가슴지느러미 11~12개였으며, 아가미의 새파수 13~18, 새사수 73~98개였다. 척추골수는 34~37개였으며, 미추골 시작부위에서 척추골 2~3개가 융합된 개체가 많았다.

• 한국어류학회지
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• 제33권3호
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• pp.157-166
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• 2021

떡납줄갱이 Rhodeus notatus와 흰줄납줄개 R. ocellatus 간의 자연 잡종으로 추정되는 3개체를 충청남도 아산시 좌부동 곡교천의 지류인 온양천 일대에서 채집하였으며, 이들의 부모종을 명확히 판별하기 위하여 형태학적 및 분자계통학적 분석을 수행하였다. 자연 잡종 3개체의 체색은 등 쪽이 연한 녹갈색으로 떡납줄갱이의 연한 갈색과 흰줄납줄개의 진한 녹갈색의 중간 색상이었고, 등지느러미 앞쪽 상단 및 뒷지느러미 바깥 가장자리에 붉은색을 나타내는 면적은 떡납줄갱이와 흰줄납줄개 간의 중간 크기로 나타나 전반적으로 부모종 간의 중간형질을 나타냈다. 계측 및 계수형질의 경우, 자연 잡종은 체장에 대한 가슴지느러미 기점거리의 비, 뒷지느러미 기점거리의 비와 두장에 대한 문장의 비, 양안 간격의 비, 미병장의 비, 미병고의 비 그리고 종렬비늘수 등에서 이들의 고유한 형질이 나타난 것으로 분석되었다. 핵 DNA의 rag1 유전자 영역에서 자연 잡종 3개체는 떡납줄갱이와 흰줄납줄개 간의 단일염기다형성 부위를 모두 반영하는 것으로 분석되었으며, 미토콘드리아 DNA의 cytb 유전자 영역을 이용한 분자계통도에서는 떡납줄갱이와 동일한 유전적 clade를 형성하였다. 따라서, 본 연구에서 분석한 자연 잡종 추정 개체들은 암컷 떡납줄갱이와 수컷 흰줄납줄개 간의 종간 잡종으로 판별되었다.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.42-51
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• 2024

Background Increasing concerns regarding the safety of textured surface implants have resulted in surgeons transitioning from textured tissue expanders (TEs) to smooth TEs. Given this change has only recently occurred, this study evaluated outcomes between smooth and textured TEs. Methods Women who underwent two-stage breast reconstruction using TEs from 2013 to 2022 were included. TE-specific variables, perioperative information, pain scores, and complications were collected. Chi-squared, t-test, and linear regression analyses were performed. Results A total of 320 patients received a total of 384 textured and 152 smooth TEs. Note that 216 patients received bilateral reconstruction. TEs were removed in 9 cases. No significant differences existed between groups regarding comorbidities. Smooth TEs had a higher proportion of prepectoral placement (p < 0.001). Smooth TEs had less fills (3±1 vs. 4±2, p < 0.001), shorter expansion periods (60±44 vs. 90±77 days, p < 0.001), smaller expander fill volumes (390±168 vs. 478±177 mL, p < 0.001), and shorter time to exchange (80±43 vs. 104±39 days, p < 0.001). Complication rates between textured and smooth TEs were comparable. Smooth TE had a greater proportion of TE replacements (p = 0.030). On regression analysis, pain scores were more closely associated with age (p = 0.018) and TE texture (p = 0.046). Additional procedures at time of TE exchange (p < 0.001) and textured TE (p = 0.017) led to longer operative times. Conclusion As many surgeons have transitioned away from textured implants, our study shows that smooth TEs have similar outcomes to the textured alternatives.