Surgical Management of Scalp Infantile Hemangiomas.

BACKGROUND: Scalp infantile hemangiomas (IHs) are usually focal lesions that can be both disfiguring and may lead to complications such as ulceration and bleeding. The clinical features of scalp IHs have not been previously studied. This study aims to identify the clinical characteristics associated with scalp IH, the indications for surgical intervention, and results of surgical treatment. METHODS: We performed a retrospective chart review of patients with scalp IH presenting to a tertiary care referral center over the past 7 years. Patients' demographics, clinical features, location, and treatment course were noted. RESULTS: One hundred fifty-one of 1916 total IH patients presented with a diagnosis of scalp IH (8%). The distribution of the scalp lesions was the following: 31.8% frontal, 46.7% parietal, 7.9% occipital, and 9.9% temporal. Fifty-eight percent were solitary and 42% were multifocal lesions. The size range of scalp IH is 1 × 1 cm to 8 × 6 cm. Two percent of patients with scalp IH presented with other facial IH. Primary indications for surgery were secondary to complications such as ulceration (23.2%) and alopecia (51.7%). Surgery included elliptical excision with primary closure (85.7%) or with rotational flap closure (14.3%). The average age of surgery was 3 years (1-8 years). Most patients had a good aesthetic outcome with satisfactory hair growth. CONCLUSION: Scalp IHs are morbid tumors which often cause alopecia and/or ulceration. In our experience, many scalp IHs eventually require surgical intervention. We find that early surgical excision is beneficial, as the tissues are easily manipulated secondary to scalp/soft tissue laxity and scarring is more favorable.

Synthesis and characterization of monodispersed core-shell/polystyrene-silica composite nanospheres as artificial dusts.

Monodispersed core-shell/polystyrene-silica composite nanospheres are synthesized as artificial dusts by a two-step process, the preparation of seed copolymer spheres and the formation of a silica layer on the seed spheres. The poly(styrene-co-MPS) copolymer spheres containing silanol groups are first prepared by emulsion polymerization using 3-(trimethoxysilyl)propyl methacrylate (MPS) as a co-monomer, potassium persulfate (KPS) as a initiator, and sodium dodecyl sulfate (SDS) as a stabilizer. The diameter of the copolymer spheres is in the range of 220-270 nm with very small coefficients of variation (CV), depending on the content of MPS. The thermal property of the copolymer spheres is also improved as the content of silica increases. Later a silica layer is formed on the seed copolymer spheres by a reaction with tetraethylorthosilicate (TEOS) in aqueous solution. The thickness of the silica layer formed is about 4 to 10 nm, which greatly improves the thermal stability of the copolymer spheres.

Feasibility of 4-point fixation using the preauricular approach in a zygomaticomaxillary complex fracture.

OBJECTIVE: A zygomaticomaxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. In some types of zygomaticomaxillary complex fracture, however, it is somewhat difficult to maintain the reduction after the surgery using 3-point fixation. In addition, surgery using 3-point fixation may cause malunion or nonunion. Thus, 4-point fixation using the coronal approach is alternatively considered. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of 4-point fixation using the preauricular approach are reported in this study. METHODS: This study was conducted on 172 patients who had a zygomaticomaxillary complex fracture and an isolated zygomatic arch fracture from March 2010 to September 2011. Open reduction and internal fixation were performed on the patients with a zygomaticomaxillary fracture, and closed reduction using the Gilles technique was performed on the patients with an isolated zygomatic arch fracture, among whom reduction using the preauricular approach was further performed on 17 patients who had insufficient intraoperative reduction or who had unsatisfactory intraoperative radiologic outcomes. An approximately 1.8-cm preauricular incision was made from 1.5 cm anterior to the helical root of the ear to 1 cm anterior to the tragus in a curved shape. After the incision, the temporoparietal fascia was dissected to confirm that the incision had reached the zygomatic arch behind the facture line. The reduction was performed, whereas the displaced fractured bone was being observed with the eyes, followed by the internal fixation. Plane x-ray and 3-dimensional head computed tomography were performed before the surgery, after the surgery, and 6 months after the surgery to examine the reduction status and outcomes of the displaced fracture. The mean follow-up period was 5.5 (range, 5-6) months. RESULTS: Reduction using the preauricular approach was further performed on 17 patients who showed unsatisfactory reduction among 172 patients with a zygomaticomaxillary complex fracture and an isolated zygomatic arch fracture. Reduction using the preauricular approach was further performed on the displaced fractured site that remained unrepaired in an intraoperative radiologic examination. In the postoperative 3-dimensional head computed tomography and plane x-ray, satisfactory reduction that showed exact correction was observed. In an outpatient follow-up, no complication such as nonunion or malunion was found, and facial symmetry was also shown. In addition, the preauricular scar was hardly observed. CONCLUSIONS: Exact reduction and internal fixation of a fracture site are required to restore the appearance and functions of the normal face and to reduce complications such as malunion or nonunion in patients with a zygomaticomaxillary complex fracture. If a complex fracture of the zygomatic body or facture of the zygomaticomaxillary buttress is accompanied by a fracture of the inferior orbital rim, and thus, if incomplete reduction or malunion is anticipated, 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach.

A quartz crystal microbalance-based sensor system coated with functional polymers for SO2 and NO2 detection.

In this work, a quartz crystal microbalance (QCM)-based adsorption sensor system with high sensitivity, selectivity, and reproducibility is designed and fabricated. The functional polymers such as polypyrrole, poly(3,4-ethylenedioxythiophene) (PEDOT), and polystyrene are coated on 8 MHz AT-cut quartz crystal surfaces as sensing materials for SO2 and NO2. All sensing materials on the QCM surface are characterized experimentally by SEM and AFM. The frequency shifts of the QCM by adsorption and desorption of gases are measured and analyzed to assess the practical applicability of the sensor system. The overall results show that the QCM coated with polypyrrole is highly selective for SO2 gas and that coated with PEDOT is for NO2. It is proven that the QCM-based adsorption sensor system is possible for monitoring SO2 and NO2 gases in the mixture of ppm level.

New sensitive moisture getter system by using aluminium complex and polyacetylene containing silyl group for display.

In this study, a novel moisture getter was fabricated from a new desiccant triethylaluminum [TEA] and a porous material poly(1-trimethylsilylpropyne) [PTMSP] as a binder and then was applied to organic light-emitting diode (OLED). After forming a film of 1.5 cm x 2.0 cm with 50 mg of PTMSP by a film-casting method, its property was measured. As a result, PTMSP (Mn:50 K) created a film with a relatively high porosity. PTMSP (60%) and TEA (40%) were mixed to fabricate a getter system with a good transmittance of over 80%. The fabricated getter, adopted in a OLED device, showed excellent features, as a level of commercialization: 490-hour shelf lifetime under the conditions of 60 degrees C and 90% RH.

Our Experiences in Nipple Reconstruction Using the Hammond flap.

BACKGROUND: Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. METHODS: Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. RESULTS: The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. CONCLUSIONS: In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.

Usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer.

BACKGROUND: Breast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer. METHODS: From September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons. RESULTS: The average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n=15), the lower lateral quadrant (n=2), and the central lateral area (n=3). Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes. CONCLUSIONS: Partial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer.