Objective assessment of flap volume changes and aesthetic results after adjuvant radiation therapy in patients undergoing immediate autologous breast reconstruction.

BACKGROUND: The use of immediate breast reconstruction and adjuvant radiation therapy is increasing in breast cancer patients. This study aimed to analyze the aesthetic outcome and changes in flap volume in patients with breast cancer undergoing radiation therapy of the surgical site after immediate autologous tissue reconstruction. METHODS: Immediate abdominal free flap breast reconstruction following unilateral mastectomy was performed in 42 patients; 21 patients received adjuvant radiation (study group) and 21 patients did not (control group). To compare flap volume, three-dimensional computed tomography (CT) was performed before and after radiation. Also, aesthetic analysis was performed in both groups to evaluate shape changes. RESULTS: There was a 12.3% flap volume reduction after the completion of radiation in the experimental group that was significantly greater than the 2.6% volume reduction observed in the non-radiation group (P<0.01). There was no significant difference in the short- and long-term aesthetic results between the groups. CONCLUSIONS: When performing immediate autologous breast reconstruction, 14% volume overcorrection is recommended for patients in whom adjuvant radiation therapy is anticipated to improve aesthetic outcomes.

Nullifying tumor efflux by prolonged endolysosome vesicles: development of low dose anticancer-carbon nanotube drug.

As the majority of side effects of current chemotherapies stems from toxicity due to excessive dosing of anticancer drugs, minimizing the amount of drug while maximizing drug efficacy is essential to increase the life-quality of chemotherapy patients. This study demonstrated that the intracellular delivery of amide linked doxorubicin on carbon nanotube can nullify the efflux of cancer cells by achieving prolonged endolysosome delivery and can induce burst release of doxorubicin in an acidic hydrolase environment and, ultimately, can reduce the amount of anticancer drug by 10-fold compared to conventional effective drug dose. The clearance of accumulated carbon nanotubes in the liver was observed after 4 weeks, and analysis of liver toxicity markers showed no significant changes in GOT and GPT levels and release of pro-inflammatory cytokines across both short- and long-term periods.

Role of subnano-, nano- and submicron-surface features on osteoblast differentiation of bone marrow mesenchymal stem cells.

Subnano, nano and sub-micron surface features can selectively activate integrin receptors and induce osteoblast differentiation of bone marrow mesenchymal stem cells. Although it is widely accepted that nanoscale titanium surface roughness may promote differentiation of various osteoblast lineages, there has been no clear report on the threshold dimension of surface features and the optimized dimensions of surface features for triggering integrin activation and stem cell differentiation. This study systematically controlled titanium surface features from the sub-nano to sub-micron scales and investigated the corresponding effects on stem cell responses, such as integrin activation, cyclins, key transcriptional genes of osteoblast differentiation and osteoblastic phenotype genes. Surface features with sub-nano surface dimensions were insufficient to increase integrin activation compared to pure nanoscale titanium surface features. Although both pure nanoscale and nano-submicron hybrid scales of titanium surface features were sufficient for activating integrin-ligand proteins interactions through the α integrin subunits, only nano-submicron hybrid titanium surface features significantly accelerated subsequent osteoblast differentiation of primary mouse bone marrow stromal cells after 2 weeks. In addition, live cell analysis of human bone marrow mesenchymal stem cells on transparent titanium demonstrated rapid cytoskeletal re-organization on the nanoscale surface features, which ultimately induced higher expression of osteoblast phenotype genes after 3 weeks.

Arresting cancer proliferation by controlling the surface crystallinity of carbon materials without generating reactive oxygen species.

This study demonstrated that the surface crystallinity of carbon nanostructures is an additional independent factor that should be considered for the inhibition of cancer proliferation without activating reactive oxygen species (ROS). In addition, cytotoxic evaluation of both proliferating cancer cells and fully differentiated nerve cells (i.e. non-proliferative) showed selective cytotoxicity: single-walled and highly crystalline carbon nanostructures aggressively inhibited the proliferation of glioma cancer cells, but exhibited no notable cytotoxicity effects on differentiated nerve cells. Although single-wall carbon nanotubes have been shown to elicit potent proinflammatory responses by means of trigger ROS, our results demonstrated that highly crystalline carbon structures can be utilized as a selective antiproliferative agent against brain tumor cells without increasing the ROS level and without significant cytotoxic effects to adjacent nerve cells.

Composition and crystalline properties of TiNi thin films prepared by pulsed laser deposition under vacuum and in ambient Ar gas.

TiNi shape memory alloy thin films were deposited using the pulsed laser deposition under vacuum and in an ambient Ar gas. Our main purpose is to investigate the influences of ambient Ar gas on the composition and the crystallization temperature of TiNi thin films. The deposited films were characterized by energy-dispersive X-ray spectrometry, a surface profiler, and X-ray diffraction at room temperature. In the case of TiNi thin films deposited in an ambient Ar gas, the compositions of the films were found to be very close to the composition of target when the substrate was placed at the shock front. The in-situ crystallization temperature (ca. 400°C) of the TiNi film prepared at the shock front in an ambient Ar gas was found to be lowered by ca. 100°C in comparison with that of a TiNi film prepared under vacuum.

Analysis on migration and activation of live macrophages on transparent flat and nanostructured titanium.

The immunotoxicity of implanted nanostructured titanium is a paramount issue for vascular, dental and orthopedic applications. However, it has been unclear whether implanted surface nanostructures can inhibit or aggrevate inflammatory responses. Herein, macrophage activation, as evidence of migration, on transparent flat and nanostructured titanium correlated with pro-inflammatory protein synthesis and cytokine release. Through the real-time monitoring of initial cytoskeleton variations, this study identified that macrophage movement was restricted on nanostructured titanium compared to flat titanium surfaces. Furthermore, nanostructured titanium elicited secretion of fewer pro-inflammatory enzyme molecules and cytokines, as well as reduced nitric oxide production. All results collectively indicated that initial macrophage activation can be mitigated by nanoscale surface topography alone, without modification of surface chemistry or stiffness.