Late-onset Total Necrosis in Deep Inferior Epigastric Perforator Flap after Contrast Enhanced Computed Tomography.

There seems to be an incessant debate regarding the duration of dependency of free flaps on pedicle vessels and the extent to which neovascularization from surrounding tissue contributes to the fortification of the free flaps. Although animal studies have suggested that pedicle vessels can be safely divided 5-8 days postoperatively without flap failure in fasciocutaneous flaps, recent clinical reports, particularly concerning the deep inferior epigastric perforator (DIEP) flap, cast doubt on this assumption. This report highlights a singular case of delayed-onset total necrosis in a DIEP flap following a contrast enhanced computed tomography (CECT) scan conducted 48 days post reconstructive surgery.

Three Case Reports of Adult-onset Still Disease Associated with Breast Implantation.

Autoimmune syndrome induced by adjuvants (ASIA) is an uncommon clinical condition reported by Shoenfeld et al. Although this syndrome is not scientifically validated, numerous reports on it have been published, and the manifestations are postulated to be diverse, including generalized symptoms such as chronic fatigue, myalgia, arthralgia, or dry mouth, induced by exogenous substances, specifically adjuvants, which can encompass vaccines, organisms, and silicone. Concurrently, adult-onset Still disease (AOSD) is also an infrequent ailment, characterized by spiking fever, arthritis, skin rash, lymphadenopathy, and serositis.

Squamous Cell Carcinoma of the Scalp Arising in a Site of Synthetic Hair Grafts.

Synthetic hair implantation was developed in the 1970s and initially gained popularity until major cutaneous complications, such as facial swelling, severe dermatitis, recurrent cellulitis, and cicatricial alopecia, became an issue. In particular, the procedure has been suggested to have a possible causal relationship with squamous cell carcinoma (SCC). This article describes the third reported case in the English literature of SCC arising in a site of synthetic hair grafts.

Effectiveness of Skin Graft in the Chest for Postburn Cervical Contractures.

Skin grafts (SGs) offer a simple and reliable means of correcting postburn cervical contractures. However, their use has a high risk of contracture recurrence, as proper postoperative care is often difficult to perform. Splinting and pressure therapy are challenging in the neck, which has complex multidirectional mobility and contains critical structures.

Scarless Total Breast Reconstruction with a Fat-augmented Latissimus Dorsi Flap.

Total breast reconstruction with a fat-augmented latissimus dorsi flap (F-LDF) is a breakthrough approach that surmounts the shortcomings of the latissimus dorsi flap (LDF), such as volume insufficiency. Unlike the abdominal flap, the LDF can be harvested as a sole muscle flap without a skin paddle. This makes it possible to perform breast reconstruction with no donor-site scar when breast skin replacement is not required (eg, nipple-sparing mastectomy, two-stage reconstruction using a tissue expander).

Successful Salvage of Pedicled Latissimus Dorsi Flap after Venous Thrombosis by Selective Thrombolytic Therapy.

While the use of free flaps has become routine and is associated with a low complication rate, pedicled flaps remain a solid reconstructive option in various clinical situations. Pedicled flaps provide a reliable vascular supply and involve a simple surgical procedure. Although the procedure is advantageous from the standpoint of a low rate of flap ischemia, thrombosis, and total flap loss, these complications are still occasionally observed due to intraoperative pedicle injury, postoperative torsion, or compression.

Successful reconstruction of an intrathoracic tracheal defect using a muscle flap and conchal cartilage graft.

Background: Malignant invasion of the respiratory tract is a common complication in advanced cases of esophageal carcinoma. Resection and reconstruction can be extremely challenging, particularly when the invasion is intrathoracic. A circumferential tracheal resection with direct tracheal closure or mediastinal tracheostomy is often performed, but the outcome is not always favorable, with high morbidity rates, loss of vocal function, and reduced quality of life.

The Prognostic Impact of Determining Resection Margin Status for Multiple Colorectal Metastases According to the Margin of the Largest Lesion.

Background: Although the prognostic role of surgical margin status after resection of colorectal liver metastasis (CRLM) has been previously examined, controversy still surrounds the importance of surgical margin status in patients with multiple tumors.

Methods: Patients who underwent curative-intent surgery for CRLM from 2000 to 2015 and who presented with multiple tumors were identified. Patients with R1 resection status determined by the closest resection margin of the non-largest tumor were classified as R1-Type 1; patients with R1 status determined by the resection margin of the largest tumor were defined as R1-Type 2.

Targeting Notch Signaling and Autophagy Increases Cytotoxicity in Glioblastoma Neurospheres.

Glioblastomas are highly aggressive tumors that contain treatment resistant stem-like cells. Therapies targeting developmental pathways such as Notch eliminate many neoplastic glioma cells, including those with stem cell features, but their efficacy can be limited by various mechanisms. One potential avenue for chemotherapeutic resistance is the induction of autophagy, but little is known how it might modulate the response to Notch inhibitors.

Mutant KRAS and GNAS DNA Concentrations in Secretin-Stimulated Pancreatic Fluid Collected from the Pancreatic Duct and the Duodenal Lumen.

Objectives: The analysis of secretin-stimulated pancreatic fluid is being evaluated as an approach to improve the early detection of pancreatic cancer and pancreatic precursor neoplasms. The method of pancreatic fluid sampling may have a significant impact on tumor marker measurements. The aim of this study was to compare concentrations of mutant DNA in pancreatic fluid from patients who had samples collected from both the pancreatic duct and duodenal lumen.