Staphylococcal Toxic Shock Syndrome after Autologous Breast Reconstruction: A Case Report and Literature Review.

Staphylococcal toxic shock syndrome (TSS) is a rare but potentially life-threatening systemic bacterial intoxication. TSS is characterized by fever, hypotension, rash, digestive symptoms such as vomiting and diarrhea, multiorgan system involvement, and desquamation in the initial recovery period. We report a case of a 35-year-old woman who developed TSS caused by methicillin-resistant Staphylococcus aureus following deep inferior epigastric perforator flap breast reconstruction. Local findings are often not obvious in a case of TSS, which can make early diagnosis and appropriate initial treatment difficult. If a patient presents with characteristic symptoms of TSS after autologous breast reconstruction, TSS should be suspected and exploration of surgical wounds should be initiated as soon as possible.

Evaluation of overall and disease-free survival in patients with free flaps for oral cancer resection.

PURPOSE: Sarcopenia is characterized by depletion of skeletal muscle mass (SMM) and can cause increased postoperative complication in free flap procedure. One of the most important considerations while deciding the indication of the procedure is patients' survival. This study aimed to verify the relationship between low SMM and survival in patients who undergo oral cancer resection using free flap. METHODS: SMM was evaluated using the skeletal muscle index (SMI cm2 /m2 ), which was defined using cross-sectional areas of skeletal muscles on computed tomography at the level of the third lumbar vertebrae normalized for height. Overall, 111 patients who underwent primary oral cancer resection and free flaps were included. Multivariate Cox regression analyses were used to evaluate the prognostic factors for survival. RESULTS: A total of 25 patients (22.5%) were diagnosed with low SMM. The mean SMI was 42.2 cm2 /m2 . Multivariable analyses showed that increased age (hazard ratio [HR]; 4.98, p = .004), infiltrative growth pattern INF-c (HR; 3.83, p = .037), and low SMM (HR; 2.59, p = .034) were significant negative prognostic factors for overall survival. Increased age (HR; 3.18, p = .005), extra-nodal extension (HR; 3.30, p = .001), and low SMM (HR; 2.42, p = .017) were significant negative prognostic factors for disease-free survival. CONCLUSIONS: Low SMM is a significant negative prognostic factor for overall and disease-free survival in oral cancer patients undergoing free flap. Future prospective studies are warranted to identify effective preoperative exercise and nutrition programs to improve low skeletal muscle and survival rate in patients undergoing free flap procedures.

A Simple Low-Temperature Glass Bonding Process with Surface Activation by Oxygen Plasma for Micro/Nanofluidic Devices.

The bonding of glass substrates is necessary when constructing micro/nanofluidic devices for sealing micro- and nanochannels. Recently, a low-temperature glass bonding method utilizing surface activation with plasma was developed to realize micro/nanofluidic devices for various applications, but it still has issues for general use. Here, we propose a simple process of low-temperature glass bonding utilizing typical facilities available in clean rooms and applied it to the fabrication of micro/nanofluidic devices made of different glasses. In the process, the substrate surface was activated with oxygen plasma, and the glass substrates were placed in contact in a class ISO 5 clean room. The pre-bonded substrates were heated for annealing. We found an optimal concentration of oxygen plasma and achieved a bonding energy of 0.33-0.48 J/m2 in fused-silica/fused-silica glass bonding. The process was applied to the bonding of fused-silica glass and borosilicate glass, which is generally used in optical microscopy, and revealed higher bonding energy than fused-silica/fused-silica glass bonding. An annealing temperature lower than 200 °C was necessary to avoid crack generation by thermal stress due to the different thermal properties of the glasses. A fabricated micro/nanofluidic device exhibited a pressure resistance higher than 600 kPa. This work will contribute to the advancement of micro/nanofluidics.