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Infective Costochondritis after Augmentation Mammoplasty: A Rare Case Report and Review of the Literature

  • Sally Min;Jinil Choi;Kwon Joong Na;Ki Yong Hong
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.488-491
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    • 2023
  • Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

Use of Artificial Intelligence for Reducing Unnecessary Recalls at Screening Mammography: A Simulation Study

  • Yeon Soo Kim;Myoung-jin Jang;Su Hyun Lee;Soo-Yeon Kim;Su Min Ha;Bo Ra Kwon;Woo Kyung Moon;Jung Min Chang
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1241-1250
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    • 2022
  • Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammography-detected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74-0.85) to 0.89 (95% CI, 0.85-0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%-44.5%) and 53.9% (95% CI, 50.9%-56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%-95.9%) vs. 92.6% (95% CI, 86.2%-99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%-89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%-96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%-62.9%) to 49.5% (95% CI, 46.5%-52.4%) (p < 0.001). Conclusion: AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.

The Effect of a Education regarding Women's Breast Self-Examination Teaching Methods (성인 여성의 유방 자가 검진 교육 방법에 따른 교육의 효과)

  • Kang Hee-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.1
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    • pp.81-95
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    • 1996
  • The purpose of this study was to investigate the effects of breast self-examination teaching methods which are printed material, videotape, demonstration used BSE model on women. The subjects for this study were non-medical professional 88 women in Kwangju. The data was collected from October 16 to November 24, 1995 by means of a structured questionnaire. For measuring BSE knowledge, Kim's(1994) instrument was used ard modified by researcher. For measuring BSE attitude based on health belief, Lee's(1982) & Kim's(1994) instrument was used and modified by researcher. Printed material from literature were reviewed by researcher, 'A woman's guide to breast self-examination' videotape by Nurse Practitioner Creation and BSE simulator by Narco were used 21 attitude scale and 13 knowledge scale were checked before and after teaching methods. The data was analyzed by frequency, paired t-test, ANOVA using the SAS program. The results were as follows : 1. The BSE total knowledge score after having teaching was higher than before, different significantly(t=-14.05, p=0.000). The most effective teaching method on BSE knowledge change was demonstration used BSE model in three teaching methods and was different significantly(F=8.44, p=0.000). 2. The BSE total attitude score after having teaching was changed to more positively, different significantly(t=4.59, p=0.000). The most effective teaching method on positive BSE attitude change was demonstration used BSE model in three teaching methods and was different significantly(F=3.21, p=0.045). 3. The HB score after having teaching was higher than before, and benefits, barriers and health concerns were different significantly(t=-2.51, p=0.014 ; t=-4.53, p=0.000 ; t=-3.71, p=0.000). Susceptibility and seriousness were not different significantly. 4. There were different significantly among knowledge, religion(F=3.92, p=0.013) and child (F=3.08, p=0.08). There were different significantly among attitude, age(F=4.65, p=0.05), mansturation state(F=4.39, p=0.016), and artificial abortion experience(F=5.18, p=0.026). There were different significantly among health concern, age(F=2.50, p=0.068), delivary experience(F=3.22, p=0.076), artificial abortion experience(F=5.46, p=0.023), and feeding(F=6.24, p=0.003). Printed material, videotape, and demonstration used BSE model may be valuable for changing positively knowledge and attitude related to BSE. Demonstration used BSE model was most effective teaching method in this study. Therefore, this study revealed that BSE teaching methods were a useful nursing intervention for promoting practice regularily and exactly on women.

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Disease Related Stress Experienced by women with Mastectomy : Q Methodology (유방 절제술 후의 질병관련 스트레스 : Q-방법)

  • Kim, Nam-Choi;Kim, Hee-Seung;Yoo, Yang-Sook;Yong, Jin-Sun;Song, Mi-Sun
    • Women's Health Nursing
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    • v.9 no.4
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    • pp.379-389
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    • 2003
  • Purpose: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. Method: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. Result : Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. Conclusion: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.

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Artificial Intelligence based Tumor detection System using Computational Pathology

  • Naeem, Tayyaba;Qamar, Shamweel;Park, Peom
    • Journal of the Korean Society of Systems Engineering
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    • v.15 no.2
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    • pp.72-78
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    • 2019
  • Pathology is the motor that drives healthcare to understand diseases. The way pathologists diagnose diseases, which involves manual observation of images under a microscope has been used for the last 150 years, it's time to change. This paper is specifically based on tumor detection using deep learning techniques. Pathologist examine the specimen slides from the specific portion of body (e-g liver, breast, prostate region) and then examine it under the microscope to identify the effected cells among all the normal cells. This process is time consuming and not sufficiently accurate. So, there is a need of a system that can detect tumor automatically in less time. Solution to this problem is computational pathology: an approach to examine tissue data obtained through whole slide imaging using modern image analysis algorithms and to analyze clinically relevant information from these data. Artificial Intelligence models like machine learning and deep learning are used at the molecular levels to generate diagnostic inferences and predictions; and presents this clinically actionable knowledge to pathologist through dynamic and integrated reports. Which enables physicians, laboratory personnel, and other health care system to make the best possible medical decisions. I will discuss the techniques for the automated tumor detection system within the new discipline of computational pathology, which will be useful for the future practice of pathology and, more broadly, medical practice in general.

Growth of Chaga Mushroom (Inonotus obliquus) on Betula platyphylla var. japonica (자작나무시루뻔버섯(차가버섯)을 접종한 자작나무로부터 버섯의 생장)

  • Ka, Kang-Hyeon;Jeon, Sung-Min;Park, Hyun;Lee, Bong-Hun;Ryu, Sung-Ryul
    • The Korean Journal of Mycology
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    • v.45 no.3
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    • pp.241-245
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    • 2017
  • Chaga mushroom (Inonotus obliquus), which has invaluable medicinal uses, grows only on living trees. To date, it is still harvested from its natural habitat and is not cultivated artificially. We artificially cultivated chaga mushrooms by inoculating its sawdust spawns on Betula platyphylla var. japonica in 2007, and monitored mushroom growth on the inoculated trees for 9 years. The mushrooms grew less than 1 cm per year, with the largest mushroom growing up to 9 cm in the 9 years of study. There was no difference in the growth (diameter at breast height) of trees with viable and non-viable I. obliquus. In conclusion, artificial cultivation of chaga mushroom was successful. Our findings suggest that selection of large B. platyphylla var. japonica as host tree could lead to better I. obliquus productivity. Further improvements of the method are needed to increase the success rate of I. obliquus inoculation.

A Feasibility Study on the Improvement of Diagnostic Accuracy for Energy-selective Digital Mammography using Machine Learning (머신러닝을 이용한 에너지 선택적 유방촬영의 진단 정확도 향상에 관한 연구)

  • Eom, Jisoo;Lee, Seungwan;Kim, Burnyoung
    • Journal of radiological science and technology
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    • v.42 no.1
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    • pp.9-17
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    • 2019
  • Although digital mammography is a representative method for breast cancer detection. It has a limitation in detecting and classifying breast tumor due to superimposed structures. Machine learning, which is a part of artificial intelligence fields, is a method for analysing a large amount of data using complex algorithms, recognizing patterns and making prediction. In this study, we proposed a technique to improve the diagnostic accuracy of energy-selective mammography by training data using the machine learning algorithm and using dual-energy measurements. A dual-energy images obtained from a photon-counting detector were used for the input data of machine learning algorithms, and we analyzed the accuracy of predicted tumor thickness for verifying the machine learning algorithms. The results showed that the classification accuracy of tumor thickness was above 95% and was improved with an increase of imput data. Therefore, we expect that the diagnostic accuracy of energy-selective mammography can be improved by using machine learning.

Long V-Y advancement technique for large nipple reconstruction in Asian women

  • Jang, Nam;Kim, Junekyu;Shin, Hyun Woo;Suk, Sang Woo
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.44-48
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    • 2021
  • Previously reported nipple-areolar complex reconstruction (NAR) methods involve multiple incisions and wide skin redraping, which increase retraction forces and heighten the risk of nipple-areolar complex (NAC) flattening. We introduce a NAR method using the long V-Y advancement technique that can overcome these disadvantages. A V-shaped flap is designed with the width of the flap base 4-5 mm larger than the diameter of the normal nipple. The flap length is designed to be at least 2.5 times its width. Dissection is performed to the top of the artificial dermal matrix or muscle layer. The nipple is constructed with the same projection as the contralateral side by folding the elevated flap. The tip of the elevated flap is apposed in the middle of the donor defect to minimize the deformity during donor site closure. A 3-point skin suture is applied to the upper third of the folded flap to mold its shape. Using this long V-Y advancement technique, we successfully decreased skin tension in NAC flaps and improved the maintenance of reconstructed nipple projection. The long V-Y advancement technique provides an easy, simple NAR method, effectively maintaining longer nipple projections and reducing breast deformities, especially in Asian women with relatively large nipples.

Feasibility Study for the Development of a Device for Pathological Tissue (병리학적 조직 진단장치 개발에 대한 타당성 분석 연구)

  • Ko Chea-Ok;Park Min-Young;Kim Jeong-Lan;Lee Ae-Kyoung;Choi Hyung-Do;Choi Jae-Ic;Pack Jeong-Ki
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.17 no.4 s.107
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    • pp.341-350
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    • 2006
  • In this paper, a new method for detecting breast cancer is proposed, which utilizes dielectric characteristics of pathological tissues and time delay of back scattered response, and its feasibility was investigated. We have developed a detection algorithm and verified it by numerical simulation and measurement for a prototype system. For a prototype system, we have fabricated experimental model(artificial breast with a cancer) and UWB(ultra-wideband) antenna. The results of the measurement simulation show an excellent detection capability of a cancer tissue. It is found that a good UWB antenna and a good calibration signal are key elements of such detection system. Further study is ongoing to develop a commercial system.

A study on the incidence of anemia according to feeding patterns and the status of weaning diet (수유 방법에 따른 빈혈의 빈도 및 이유식이에 대한 조사)

  • Kim, Hyun-Ji;Shin, Mee-Yong;Kim, Sung-Shin;Park, Jae-Ock;Kim, Chang-Hwi
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.875-880
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    • 2009
  • Purpose : Iron-deficiency anemia remains the most common nutritional deficiency in young infants. This study aimed to survey the actual condition of feeding patterns and weaning diet and to study the association between these factors and the prevalence of anemia in infants aged over 9 months. Methods : We studied 171 infants aged 9-24 months who were hospitalized in the general ward with mild to moderate acute illnesses. The mothers answered a questionnaire about the feeding patterns and the status of the weaning diet of their infants. The infants were divided into three groups: infants who were exclusively breast-fed, those who had been given mixed feeding, and artificial milk feeders. Results : The incidence of anemia was significantly higher in exclusively breast-fed infants (23/68, 33.8%) than in the infants with mixed feeding (11/62, 17.7%) and artificial milk feeders (5/41, 12.1%). The mothers' awareness about the state of their infants󰡑 weaning diet was not related to the presence of anemia in the exclusively breast-fed infants. About 70% of the infants had started the weaning diet before age 6 months in all three groups, without any difference according to feeding patterns. Conclusion : The incidence of anemia was significantly higher in the breast-fed group than in the other infants. Many mothers of breast-fed infants with anemia also believed that their infants were taking sufficient weaning foods. Therefore, further education of the mothers about iron-rich weaning foods and the importance of iron intake during infancy is needed to prevent anemia, especially in breast-fed infants.