• Title/Summary/Keyword: Reconstruction Analysis

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Nipple-Areola Complex Necrosis after Nipple-Sparing Mastectomy with Immediate Autologous Breast Reconstruction

  • Cho, Jin-Woo;Yoon, Eul-Sik;You, Hi-Jin;Kim, Hyon-Surk;Lee, Byung-Il;Park, Seung-Ha
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.601-607
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    • 2015
  • Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.

A Comparative Analysis of Patient Satisfaction and Cosmetic Outcomes after Breast Reconstruction through BREAST-Q and the Judgment of Medical Panels: Does it Reflect Well in Terms of Aesthetics in Korean Patients?

  • Choi, Woo Jung;Song, Woo Jin;Kang, Sang Gue
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.488-493
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    • 2022
  • Background Currently, the BREAST-Q can effectively measure patient's satisfaction on the quality of life from the patient's perspective in relation to different type of breast reconstruction. However, evaluation of patient satisfaction and cosmetic outcomes in breast reconstruction may have potential to led bias. Methods To maximize the benefits of using BREAST-Q to evaluate clinical outcome, we performed comparative study focused on the correlation between postoperative BREAST-Q and cosmetic outcomes assessed by medical professionals. For the current analysis, we used three postoperative BREAST-Q scales (satisfaction with breast, psychosocial well-being, and sexual well-being). The Ten-Point Scale by Visser et al was applied to provide reproducible grading of the postoperative cosmetic outcomes of the breast. The system includes six subscales that measured overall aesthetic outcome, volume, shape, symmetry, scarring, and nipple-areolar complex. The photographic assessments were made by five medical professionals who were shown photographs on a computer screen in a random order. Obtained data were stored in Excel and evaluated by Spearman's correlations using SPSS Statistics. Results We enrolled 92 women in this study, 10 did not respond to all scales of postoperative BREAST-Q, the remaining 82 women had undergone breast reconstruction. The correlation between BREAST-Q score and aesthetic score measured by Ten-Point Scale for the three BREAST-Q scales all show positive values in Spearman's correlation coefficient. Conclusion A significant correlation without any bias observed was found between the patient's satisfaction measured by BREAST-Q after breast reconstruction and the medical expert's aesthetic evaluation.

Comparison of Outcomes in Immediate Implant-Based Breast Reconstruction: Acellular Dermal Matrix versus Inferior Dermal Flap

  • Ribeiro, Luis Mata;Meireles, Rita P.;Brito, Iris M.;Costa, Patricia M.;Rebelo, Marco A.;Barbosa, Rui F.;Choupina, Miguel P.;Pinho, Carlos J.;Ribeiro, Matilde P.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.158-165
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    • 2022
  • Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.

Analysis of Factors for Satisfying Functional Outcomes in Tongue Reconstruction (설결손의 재건 후 기능적 예측 인자의 분석)

  • Hong, Hyun Joon;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyoon;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.255-260
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    • 2008
  • Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. Methods: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months. Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance. Conclusion: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

A Study on Pattern Making by 3D Reconstruction of French Men's Costume in the Second Half of 19th Century - Focused on Redingote and Jaquette - (19세기 하반기 프랑스 남성복 유물의 3D 고증에 의한 패턴 제작에 관한 연구 - 르뎅고뜨(Redingote)와 자께뜨(Jaquette)를 중심으로 -)

  • Kim, Yang-Hee;Ryu, Kyung-Hwa;Bae, Ji-Ye
    • Fashion & Textile Research Journal
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    • v.22 no.1
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    • pp.11-24
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    • 2020
  • This research examines pattern production of 3 men's costumes in the second half of 19th century by 3D reconstruction to reveal technical aspects of mail costumes. The steps are as follows. First, an examination of selective type according to research study. Second, a pattern analysis of 3 historical male tops of 19th century referred to 9 pattern books of the France National Library collection. Third, a categorized type analysis that referred to paintings of the Musée d'Orsay collection. Fourth, a measurement and structure research of 3 historical garments of Fashion and Textile Museum collection. Fifth, the pattern making and fitting by 3D simulation. Research discussed the following subjects and results. First, main type of men's coat can be categorized by frac, redingote, jaquette, and veston. Second, the male costume pattern contained in pattern books was researched along with distinguished silhouettes and structures; X silhouette for frac and redingote, H silhouette for jaquette, and straight box silhouette for veston. Third, based on the analysis of representative type of men's costume per period conducted previous studies, 2 redingotes and a jaquette in the museum were selected and compared to other data such as image materials. Last, the following process was conducted for reconstruction; 'Drawing diagram-Primary pattern drafting by measurement value-3D virtual fitting-Checking the fit-Modification and complement'. We also obtained a 3D virtual reconstruction and a 2D research pattern that suggested a costume pattern by each type along with 3D reconstruction that included insights for male coat techniques of 19th century France.

Image Quality and Lesion Detectability of Lower-Dose Abdominopelvic CT Obtained Using Deep Learning Image Reconstruction

  • June Park;Jaeseung Shin;In Kyung Min;Heejin Bae;Yeo-Eun Kim;Yong Eun Chung
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.402-412
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    • 2022
  • Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

Human Acellular Dermis versus Submuscular Tissue Expander Breast Reconstruction: A Multivariate Analysis of Short-Term Complications

  • Davila, Armando A.;Seth, Akhil K.;Wang, Edward;Hanwright, Philip;Bilimoria, Karl;Fine, Neil;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.40 no.1
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    • pp.19-27
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    • 2013
  • Background Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. Methods Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). Conclusions The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.

Generation of the Structural Analysis Model Through the Reconstruction of the Topological Information of the Hull Structural Model (선체 구조 모델의 위상 정보 재구성을 통한 구조 해석 모델 생성)

  • Roh, Myung-Il;Yoo, Seong-Jin;Lee, Kyu-Yeul
    • Journal of the Society of Naval Architects of Korea
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    • v.43 no.2 s.146
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    • pp.246-257
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    • 2006
  • In the ship building industry, the generation of a structural analysis model, that is, a finite element model of a hull structure, has been manually performed by a designer and thus has required lots of time as compared with that of a mechanical part, because of many constraints, the complexity, and the huge size of the hull structure. To make this task automatic, a generation method of the structural analysis model is proposed through the reconstruction of the topological information of a hull structural model in this study. The applicability of the proposed method is demonstrated by applying it to the generation of the structural analysis model of a deadweight 300,000ton VLCC(Very Large Crude oil Carrier).