Rationale for white skin roll flap in unilateral cleft lip repair: A retrospective anthropometric measurement analysis.

BACKGROUND: Although the "white skin roll" of the lip is often considered a line, it is better defined as the subunit between the vermilion border and the upper lip horizontal groove. In many unilateral cleft lip repair techniques, this structure is approximated between both sides of the cleft without restoration. This study aimed to analyze the white skin roll height in patients with unilateral cleft lip. METHODS: This retrospective cohort study included 134 consecutive infants with unilateral cleft lip aged 3-6 months who underwent lip repair in a single institution between January 2019 and July 2021. White skin roll heights at the peak of the Cupid's bow on the non-cleft side (CPHIR), cleft medial element (CPHIL), and cleft lateral element (CPHIL') were measured, and differences in their averages were analyzed. RESULTS: The mean height was 1.70 ± 0.30 mm at CPHIR, 0.98 ± 0.33 mm at CPHIL, and 1.28 ± 0.32 mm at CPHIL.' The mean difference in height between CPHIR-CPHIL, CPHIR-CPHIL,' and CPHIL-CPHIL' groups was significant for each paired sample (p < 0.01). No difference was found between the complete and incomplete clefts or left and right clefts (p > 0.01). CONCLUSIONS: A significantly reduced mean height of the white skin roll was present more markedly on the cleft medial element than on the cleft lateral element. Therefore, we strongly support using a white skin roll flap on the cleft lateral element for unilateral cleft lip repair, embracing the concepts of subunits and lip contour lines.

Feasibility and Toxicity of Interval-Compressed Chemotherapy in Asian Children and Young Adults with Sarcoma.

Twelve Asian patients with sarcoma received interval-compressed (ic-) chemotherapy scheduled every 14 days with a regimen of vincristine (2 mg/m2), doxorubicin (75 mg/m2), and cyclophosphamide (1200-2200 mg/m2) (VDC) alternating with a regimen of ifosfamide (9000 mg/m2) and etoposide (500 mg/m2) (IE), with filgrastim (5-10 mcg/kg/day) between cycles. Carboplatin (800 mg/m2) was added for CIC-rearranged sarcoma. The patients were treated with 129 cycles of ic-VDC/IE with a median interval of 19 days (interquartile range [IQR], 15-24 days. Median nadirs (IQR) were neutrophil count, 134 (30-396) × 106/L at day 11 (10-12), recovery by day 15 (14-17) and platelet count, 35 (23-83) × 109/L at day 11 (10-13), recovery by day 17 (14-21). Fever and bacteremia were observed in 36% and 8% of cycles, respectively. The diagnoses were Ewing sarcoma (6), rhabdomyosarcoma (3), myoepithelial carcinoma (1), malignant peripheral nerve sheath tumor (1), and CIC-DUX4 Sarcoma (1). Seven of the nine patients with measurable tumors responded (one CR and six PR). Interval-compressed chemotherapy is feasible in the treatment of Asian children and young adults with sarcomas.

Risk factors for complications following immediate tissue expander based breast reconstruction in Taiwanese population.

BACKGROUND/PURPOSE: Breast cancer patients in Asia show considerable disparities from Caucasian patients, such as younger age of onset and lower rates of smoking, obesity, and diabetes. Findings of prior studies regarding risk factors associated with complications in tissue expander may not hold for Asian populations, since most of these studies involved Caucasian patients. In this study, we surveyed risk factors in the Taiwanese population, providing additional evidence about the important differences and discuss the implications for clinical practice. METHODS: Patients who underwent immediate, two-stage, tissue expander breast reconstruction from December 2008 to August 2014 in the National Taiwan University Hospital, Taipei, Taiwan were included. Follow-up observations of all patients were conducted until December 2014. Complications occurring during the tissue expander stage were evaluated. Multivariate regression modeling was used to identify risk factors for complications. RESULTS: A total of 246 consecutive, immediate, smooth round tissue expander placements were performed for breast reconstruction. The most common complication was skin necrosis (4.9%), followed by wound dehiscence (4.1%). In the multivariate model, body mass index (BMI) ≥ 24 kg/m2 was the only risk factor that reached statistical significance (odds ratio: 2.41, 95% confidence interval: 1.17-4.96). CONCLUSION: We provided evidence that racial disparities have an impact on the risk factors for complications associated with tissue expander breast reconstruction. BMI≥24 kg/m2 was the only risk factor significantly associated with complications. Clinically, BMI≥24 kg/m2, rather than the standard definition of obesity (BMI > 30 kg/m2), may be a more suitable cutoff point for risk in patients of Asian ethnicity.

Treatment and long-term follow-up of oral cancer postoperative sialorrhea with dermal sling operation.

INTRODUCTION: Reconstruction of a full-thickness defect that includes oral commissure presents a considerable challenge to maxillofacial and plastic surgeons. The goals of reconstruction are both functional and cosmetic. Sialorrhea, or drooling, is a major problem after flap reconstruction and influences the quality of life of the patient. In this article, we report on our experience performing a dermal sling operation to treat postoperative sialorrhea in patients with oral cancer. MATERIALS AND METHODS: Preoperative and postoperative levels of sialorrhea were evaluated based on the Drooling Severity and Frequency Scale. Dermal sling operations were performed on 27 patients from January 2000 to December 2013. In these patients, 12 cases were reviewed and followed up over 1 year. RESULTS: Of the 12 patients, 11 were men and one was a woman, with the mean age of 58 years (range, 40-79 years). There were no operative complications. The mean preoperative score was 4.75 (range, 3-7), and the mean postoperative score was 3.83 (range, 2-5). This change was significant (P=0.005), with valuation with the Wilcoxon signed rank test. The mean time of follow-up was 3.5 years (range, 1.1-7.7 years). CONCLUSIONS: The dermal sling operation is an acceptable treatment for postoperative sialorrhea in patients with commissure-involved oral cancer.

Regional identification, partition, and integral phase unwrapping method for processing moiré interferometry images.

We present a new method of regional identification, partition, and integral (RIPI) phase unwrapping for processing images, especially those with low quality, obtained from moiré interferometry experiments. By introducing the principle of preorder traversal of a general tree in data structures and then by applying the idea of a regional integral, the proposed method makes regional partition and phase evaluation much easier and more accurate, and it also overcomes the common faults that can occur when conventional approaches, such as line defects, are used. Examples are given to demonstrate the advantage and applicability of the proposed RIPI method when processing experimental images. It is shown that the proposed method works well for global phase distribution, and, at the same time, local mutational information is preserved and limited to its vicinity without affecting other parts.

Deposition and characterization of silica-based films by helicon-activated reactive evaporation applied to optical waveguide fabrication.

Planar silicon dioxide optical waveguides were deposited by use of a plasma-activated reactive evaporation system, at a low deposition temperature and with reduced hydrogen contamination, on thermally oxidized silicon wafers. The deposited films show a refractive-index inhomogeneity of less than 0.1%, a thickness nonuniformity of less than 5%, and a material birefringence of approximately 5 x 10(-4). Rib-type channel waveguides were formed on the deposited films by means of hydrofluoric acid etching. The transmission loss of the rib waveguides is determined to be as low as 0.3 dB/cm at a wavelength of 1310 nm for TE polarization, after subtraction of the calculated leakage and scattering losses. Owing to the presence of the OH vibrational overtone band, an additional loss peak of 1 dB/cm is found near the 1385-nm wavelength. The experimental results of transmission loss at wavelengths of 1310 and 1550 nm are compared with analytic expressions for interface scattering and leakage loss.