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Treatment of Pseudoangiomatous Stromal Hyperplasia of the Breast: Implant-Based Reconstruction with a Vascularized Dermal Sling

  • Jung, Bok Ki;Nahm, Ji Hae;Lew, Dae Hyun;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.630-634
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    • 2015
  • Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal lesion with incidental histologic findings. Surgical excision is recommended as the treatment of choice for PASH, although the recurrence rates after excision range from 15% to 22%. A 46-year-old-female presented with a six-month history of bilateral breast enlargement and painful sensation mimicking inflammatory carcinoma. Imaging studies demonstrated innumerable enhancing nodules in both breasts. Due to the growth of the lesions and progressive clinical symptoms, bilateral subcutaneous mastectomy was performed. Grossly, the specimens were round and well-circumscribed, and the histologic examination revealed PASH. After mastectomy, we created a pocket with the pectoralis major muscle and a lower skin flap, which was deepithelized. Anatomical mammary implants were inserted, and the nipple areolar complex was transferred to a new position as a free graft. The aesthetic result was satisfactory after twelve months of follow-up.

Early experiences with robot-assisted prosthetic breast reconstruction

  • Ahn, Sung Jae;Song, Seung Yong;Park, Hyung Seok;Park, Se Ho;Lew, Dae Hyun;Roh, Tai Suk;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.79-83
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    • 2019
  • Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.

Unusual Presentation of a Rib Osteochondroma as Hard Breast Lump in a Young Male: A Case Report (젊은 남성에서 딱딱한 유방 덩이로 만져진 갈비뼈 골연골종의 드문 증상: 증례 보고)

  • Vendoti Nitheesha Reddy;Krishnan Nagarajan;Vendoti Midhusha Reddy
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.270-274
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    • 2023
  • Osteochondroma arising from the rib is rare. They arise as bony outgrowths from the rib and extend either extrathoracically into the subcutaneous plane or intrathoracically compressing the lung or mediastinal structures. A 23-year-old male patient presented with complaints of breast lump since last year. On clinical examination, a hard bony projection with lobulated contour was palpable. Chest radiograph and contrast-enhanced CT showed a bony outgrowth arising from the anterior aspect of costochondral junction of the right fourth rib with displacement of pectoralis major muscle anteriorly. Osteochondroma should be considered as a differential diagnosis in the presentation of hard lump in the breast along with other chest wall tumors.

Gelation Properties and Industrial Application of Functional Protein from Fish Muscle-2. Properties of Functional Protein Gel from Fish, Chicken Breast and Pork Leg and Optimum Formulation (기능성 어육단백질의 젤화 특성과 산업적 응용-2. 알칼리 공정으로 회수한 어육, 닭고기 가슴살 및 돼지 후지 육 기능성 단백질 젤의 특성과 최적화)

  • Jung, Chun-Hee;Kim, Jin-Soo;Jin, Sang-Keun;Kim, Il-Suk;Jung, Kyoo-Jin;Choi, Young-Joon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.10
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    • pp.1676-1684
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    • 2004
  • Gel properties of recovered protein from mackerel, frozen blackspotted croaker, chicken breast and pork leg using acidic and alkaline processing were evaluated. Myofibrillar protein from mackerel by acidic processing did not form a heat-induced gel. However, the recovered protein including sarcoplasmic protein formed heatinduced gel. Breaking force of gel from mackerel processed at pH 10.5 was the lowest. A deformation value of frozen blackspotted croaker was the highest, followed by chicken breast, pork leg and mackerel. Whiteness of frozen blackspotted croaker was the highest among heat-induced gel. Breaking force, deformation and whiteness were decreased by addition of recovered protein from mackerel, but price was increased. A breaking force and whiteness of heat-induced gel added recovered protein from chicken breast were increased, and the price was greatly decreased. When the constraint of breaking force, deformation and price of raw material were set up above 110 g, 4.5 mm and below 2,000 won/kg. A optimum formulation for blending protein was 36∼50% for frozen blackspotted croaker, 34∼40% for chicken breast, 14∼25% for pork leg. The heat-induced gel of recovered protein from frozen blackspotted croaker showed compact structure compared to that of recovered protein from mackerel. A formulation of chicken breast and pork leg based on blackspotted croaker can be used in surimi based seafood products having various texture.

Effects of Dietary Onion Supplementation of on the Physicochemical Properties of Duck Meat (양파의 급여가 오리고기의 이화학적 특성에 미치는 영향)

  • 송영민;진상근;김일석;조용조;김회윤;하경희;남기윤
    • Food Science of Animal Resources
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    • v.24 no.1
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    • pp.66-72
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    • 2004
  • The study was conducted to investigate the effect of dietary onion supplementation on physicochemical properties of duck meat. The ducks were raised for 38 days(1,500 g of live weight) in rice paddle and slaughtered. Samples including breast and leg were stored at 4$^{\circ}C$ for 12hrs and then used as experimental materials. The ducks were allotted into 3 treatments(C-0%, T1-3%, T2-6%) according to dietary supplementation of onion. The ducks meat were stored at 4${\pm}$1$^{\circ}C$ for 12hrs. In proximate analyses, the moisture, crude protein and crude ash of breast muscle were significantly increased(p<0.05) with increasing onion percentages but crude fat content was significantly decreased(p<0.05). The moisture and crude protein of leg muscles were significantly increased(p<0.05) with increasing onion percentages but crude fat and crude ash were significantly decreased(p<0.05). The pH of breast muscle was significantly decreased(p<0.05) with increasing onion percentages, the pH of leg muscle was be highest in T1(p<0.05). Water holding capacity(WHC) significantly increased(p<0.05) with increasing onion percentage in both muscles. Hunter L* was significantly decreased with increasing onion percentage in breast muscles while Hunter b* significantly increased(p<0.05). In fatty acids composition of duck meat, mono-unsaturated fatty acid(MUFA) significantly decreased(p<0.05) while poly-unsaturated fatty acid(PUSFA) and EFA(essential fatty acid) were significantly high(p<0.05) with increasing onion percentage.

Dietary Manipulation of Lean Tissue Deposition in Broiler Chickens

  • Choct, M.;Naylor, A.J.;Oddy, V.H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.5
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    • pp.692-698
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    • 2005
  • Two experiments were conducted to examine the effect of graded levels of dietary chromium and leucine, and different fat sources on performance and body composition of broiler chickens. The results showed that chromium picolinate at 0.5 ppm significantly (p<0.05) lowered the carcass fat level. Gut weight and carcass water content were increased as a result of chromium treatment. Body weight, plucked weight, carcass weight, abdominal fat pad weight, breast yield and feed efficiency were unaffected by chromium treatment. Leucine did not interact with chromium to effect lean growth. Dietary leucine above the recommended maintenance level (1.2% of diet) markedly (p<0.001) reduced the breast muscle yield. The addition of fish oil to broiler diets reduced (p<0.05) the abdominal fat pad weights compared to birds on linseed diets. Fish oil is believed to improve lean growth through the effects of long chain polyunsaturated fatty acids in lowering the very low-density lipoprotein levels and triglyceride in the blood, in the meantime increasing glucose uptake into the muscle tissue in blood and by minimizing the negative impact of the immune system on protein breakdown. The amount of fat in the diet (2% or 4%) did not affect body composition.

Evaluation of Bacteriophage Supplementation on Growth Performance, Blood Characteristics, Relative Organ Weight, Breast Muscle Characteristics and Excreta Microbial Shedding in Broilers

  • Wang, J.P.;Yan, L.;Lee, J.H.;Kim, In Ho
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.4
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    • pp.573-578
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    • 2013
  • A total of 720 1-d-old male broilers (Arbor Acres) with the initial BW = $45{\pm}2$ g were used in a 32-d experiment. Birds were randomly allotted into 1 of 4 treatments according to a completely random block design. Dietary treatments included: i) CON (basal diet), ii) ANT (CON+0.5 g antibiotics/kg feed (bacitracin methylene disalicylate)), iii) BP1 (CON+0.25 bacteriophage/kg feed), and iv) BP2 (CON+0.5 g bacteriophage/kg feed). The BWG and FI were not affected by dietary treatments throughout the whole experiment, whereas BP2 treatment reduced (p<0.05) the feed conversion ratio compared with the CON treatment during 0 to 14 d. The birds fed bacteriophages at the level of 0.25 g/kg increased (p<0.05) the relative liver weight. The inclusion of antibiotic and bacteriophage significantly reduced (p<0.05) the Escherichia coli and Salmonella concentration in the excreta compared with the NC group. Broilers fed the BP2 treatment had higher (p<0.05) lactobacillus counts compared with those fed NC and PC treatments. In conclusion, dietary supplementation of 0.5 g/kg bacteriophages increased feed efficiency and liver weight without effects on the breast muscle properties; also pathogens were inhibited by addition of bacteriophages.

Carcass Variables and Chemical Composition of Commercial Broiler Chickens and the Red Jungle Fowl

  • Iman Rahayu, H.S.;Zulkifli, I.;Vidyadaran, M.K.;Alimon, A.R.;Babjee, S.A.
    • Asian-Australasian Journal of Animal Sciences
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    • v.21 no.9
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    • pp.1376-1382
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    • 2008
  • The carcass characteristics and composition of both male and female commercial broiler chickens (CB) and the red jungle fowl (RJF) were compared at a common body weight of $800{\pm}25.6g$. The RJF and CB were 133 and 17 d of age, respectively, when they reached 800 g. The yields of breast and thigh portions and their muscle to bone ratios were higher for RJF as compared to CB. On the other hand, the latter had significantly greater hearts, livers and gizzards. The weights of the whole thigh and drumstick, and their muscles were lower in females than males. The CB had more abdominal fat than RJF. While sex had no significant effect on the absolute weights of abdominal fats in CB, the female RJF were fatter than their male counterparts. The fat and cholesterol contents of the breast and leg muscles of CB were significantly higher than those of RJF. The opposite was noted for protein content of both muscles. The effect of sex on fat and cholesterol contents varied according to muscle type. Comparison of CB and RJF at a common body weight suggested that the rate of development of body components have changed concomitantly with selection for rapid growth in the former.

Single-Port Transaxillary Robot-Assisted Latissimus Dorsi Muscle Flap Reconstruction for Poland Syndrome: Concomitant Application of Robotic System to Contralateral Augmentation Mammoplasty

  • Hwang, Yong-Jae;Chung, Jae-Ho;Lee, Hyung-Chul;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.373-377
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    • 2022
  • Currently, robot-assisted latissimus dorsi muscle flap (RLDF) surgery is used in treating patients with Poland syndrome and for breast reconstruction. However, conventional RLDF surgery has several inherent issues. We resolved the existing problems of the conventional system by introducing the da Vinci single-port system in patients with Poland syndrome. Overall, three patients underwent RLDF surgery using the da Vinci single-port system with gas insufflation. In the female patient, after performing RLDF with silicone implant, augmentation mammoplasty was also performed on the contralateral side. Both surgeries were performed as single-port robotic-assisted surgery through the transaxillary approach. The mean operating time was 449 (335-480) minutes; 8.67 (4-14) minutes were required for docking and 59 (52-67) minutes for robotic dissection and LD harvesting. No patients had perioperative complication and postoperative problems related to gas inflation. The single-port robot-assisted surgical system overcomes the drawbacks of previous robotic surgery in patients with Poland syndrome, significantly shortens the procedure time of robotic surgery, has superior cosmetic outcomes in a surgical scar, and improves the operator's convenience. Furthermore, concurrent application to another surgery demonstrates the possibility in the broad application of the robotic single-port surgical system.

The Physical Therapy Approaches on Post-Mastectomy (유방절제술 후 물리치료적 접근)

  • Jeon, You-Jin
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.439-457
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    • 2000
  • The causes, risk factors and sequelae of mastectomy were studied, and the physical therapy approaches on post-mastectomy was discussed in this study. It was found that the patients taken mastectomy have experienced pins and needles in muscle, weakening of muscle, pains, deterioration of motion in joint region and activities of daily living, psychiatric sequelae, and etc even after the conservertive therapies like the chemical therapy, radiotherapy, immunotherapy, and hormone therapy. However, few study on the physical therapy approaches for patients with breast cancer has been carried in Korea at present. The followings were proposed as the physical therapy approaches. 1. Shoulder joint motion approach to relax the limit of range of motion 2. Control of breathing exercise for dealing with removal of the pectorailis muscle 3. Method to reduce the edema of arms for tackling the cut of lymph node 4. Method to reduce pains, pins and needles 5. Support home exercise program after discharging from hospital, sexual life and pregnancy, and activities of daily living training method.

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