• Title, Summary, Keyword: necrosis

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Necrotic Complications in Nipple-Sparing Mastectomy Followed by Immediate Breast Reconstruction: Systematic Review with Pooled Analysis

  • Lee, Kyeong-Tae;Mun, Goo-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.51-64
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    • 2014
  • This study provides a systematic review of the literature on nipple-sparing mastectomy and necrotic complications in order to estimate the prevalence of necrotic complications and to investigate their significant predictors. A literature search was conducted using the MEDLINE and Ovid databases. A pooled analysis was performed for calculation of the prevalence of nipple-areolar complex (NAC) necrosis, mastectomy flap necrosis, and overall necrotic complications and to evaluate the relationships between necrotic complications and potential risk factors. A total of 44 papers were analyzed. The prevalence of overall necrotic complications was 13.7%, including 7.5% for NAC necrosis and 7.8% for mastectomy flap necrosis. Types of incisions showed significant association with the rates of NAC necrosis and mastectomy flap necrosis. Incisions involving the NAC showed a significantly higher rate of NAC necrosis than those not involving it. The prevalence of NAC necrosis was higher in the autologous tissue reconstruction group than in the prosthesis group. Active smoking and diathermy dissection were significant predictors of both NAC necrosis and mastectomy flap necrosis. The findings of this review suggest that there are several predictors of necrotic complications in nipple-sparing mastectomy. Appropriate patient selection, careful operative planning, and surgical technique refinements may reduce the risk of necrotic complications.

STUDIES OF THE APPEARANCE OF NECROSIS IN RICE (수도의 Necrosis 출현에 관한 연구)

  • Sang-Yull Jae;Kwang-Tae Choi
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.8 no.1
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    • pp.31-36
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    • 1970
  • This experiment was designed to get some information on the parts in which necrosis occurs first in the embryo of rice, and on the phenomenon of necrosis that develops into other parts. Norin No.6 harvested in 1967 was used for this experiment and necrosis appearance was investigated by the T.T.C. method. The results obtained are summarized as follows; 1) Necrosis of the embryo in rice occurred in the plumule initially. 2) It was observed that the necrosis developed from the plumule to the radicle. 3) Finally, it was shown that necrosis developed from the surface tissue of the embryo to the inside tissue.

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Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan (골주사검사(骨走査檢査)로 조기진단한 신장이식수술후 Avascular bone necrosis 2예(例))

  • Shin, Hyun-Ho;Kim, Han-Su;Ihm, Chun-Gyoo;Kim, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.97-102
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    • 1982
  • Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using 99mTc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using 99mTc-methylene diphosphonate.

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Axillary Bud Development and Necrosis for 'Heukgoosul' Grapevine ('흑구슬' 포도의 액아 형성 및 괴사발생)

  • Kwon, Yong-Hee;Kim, Eun-Joo;Park, Seo-Joon;Lee, Han-Chan;Ma, Kyeong-Bok;Park, Hee-Seung
    • Protected Horticulture and Plant Factory
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    • v.20 no.4
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    • pp.382-386
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    • 2011
  • This study aims to identify the cause for low appearance of flowers in 'Heukgoosul' grapevines, and determine basic characteristics of the axillary buds and types of necrosis in order to find out their influence on necrosis. As for $1^{st}$ to $4^{th}$ node, the closer buds were located to cane, the smaller the size of buds became. However, there was no difference in the size of an axillary bud in the upper part of the shoot above the 4th node. The bud necrosis occurrence in the $1^{st}$ node was the highest with 32% while buds in $4^{th}$ to $10^{th}$ node were normal with 84~96%. The size of buds in July was the largest with 6.40 mm, while buds showed no difference from August to October. The bud necrosis and main bud necrosis occurred most frequently in October, however accessory bud necrosis took place from July demonstrating no difference since then. The analysis on the relationship between shoot vigor and necrosis of axillary buds showed that the shoot diameter and internodes' length have no co-relationship with axillary bud necrosis, but there were negative relationship between the size of buds and necrosis occurrence, which was the most related to accessory bud necrosis. Therefore, despite the low occurrence of bud necrosis and healthy buds in 'Heukgoosul' grapevines, there was little appearance of flowers in the grapevines, which was attributable to the necrosis in the first bud. In conclusion, the research suggests spur pruning with three nodes kept intact yield.

Treatment of Avascular Necrosis of the Talus with Vascularized Fibular Graft (혈관부착 비골이식술을 이용한 거골 무혈성 괴사의 치료)

  • Chung, Duke-Whan;Kho, Duk-Whan
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.49-55
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    • 2000
  • Nonunion and avascular necrosis are well-recognized complications of severe ankle injury especially aftrer talar neck fracture. The treatment of avascular necrosis is controversial and methods of treatment are limited. Many modalities have been introduced for the treatment of avascular necrosis of talus. The prolonged non-weight bearing for 2~3 years is not practical but also is occasionally complicated by late segmental collapse. Operative treatment includes tibiotalar arthrodesis and talectomy with tibiocalcaneal arthrodesis, but arthrodesis in patients with talar avascular necrosis is technically demanding and cause stiff, immobile foot and relatively high failure rate was reported. It is desirable to preserve their original joint if possible. Vascularized fibular grafting has been reported as a joint preserving treatment option for osteonecrosis of the hip but has not been described for the ankle. The authors applied free vascularized fibular grafts for 3 cases of avascular necrosis of talus. We observed evidences of revascularization of necrotic talar body and progression of fracture healing and obtained satisfactory results at mean 8 months of follow-up. Vascularized fibular grafting is one of the better alternatives for treating avascular necrosis of talus. It is expected that vascularized fibular grafting can prevent the necrotic talar dome from progressing to collapse and promote directly restored vascularization and new bone formation.

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Nipple-Areola Complex Necrosis after Nipple-Sparing Mastectomy with Immediate Autologous Breast Reconstruction

  • Cho, Jin-Woo;Yoon, Eul-Sik;You, Hi-Jin;Kim, Hyon-Surk;Lee, Byung-Il;Park, Seung-Ha
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.601-607
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    • 2015
  • Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.

Cucumber Mosaic Cucumovirus-CARNA5 Causing Bud Necrosis on Table Tomato

  • Park, Hong-Soo;Ryu, Jae-Ki;Ahn, Kyung-Ku;Cho, Jeom-Deog;Kim, Jeong-Soo
    • The Plant Pathology Journal
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    • v.17 no.3
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    • pp.169-173
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    • 2001
  • Virus disease occurred up to 62% in average in the greenhouse production of table tomato Seokwang in Suwon, Korea. From symptomatic transition of the labeled tomatoes, two different symptoms, mosaic and bud necrosis, were developed independently. Cucumber mosaic virus necrosis strain (CMV-N) was isolated from table tomato showing bud necrosis symptoms. The isolate caused the bud necrosis on four tomato cultivars and locally infected Chenopodium spp. and Vicia faba by mechanical inculation. The 5th RNA segment, satellite RNA, was identified from CMV-N-infected plants by dsRNA analysis. Crystals of virus particles were observed in cytosols and vacuoles. The virus particles of CMV-N presented abundantly in xylem vessel.

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Exogenous spermidine ameliorates tubular necrosis during cisplatin nephrotoxicity

  • Yoon, Sang Pil;Kim, Jinu
    • Anatomy and Cell Biology
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    • v.51 no.3
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    • pp.189-199
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    • 2018
  • The hallmark of cisplatin-induced acute kidney injury is the necrotic cell death in the kidney proximal tubules. However, an effective approach to limit cisplatin nephrotoxicity remains unknown. Spermidine is a polyamine that protects against oxidative stress and necrosis in aged yeasts, and the present study found that exogenous spermidine markedly attenuated tubular necrosis and kidney dysfunction, but not apoptosis, during cisplatin nephrotoxicity. In addition, exogenous spermidine potently inhibited oxidative/nitrative DNA damage, poly(ADP-ribose) polymerase 1 (PARP1) activation and ATP depletion after cisplatin injection. Conversely, inhibition of ornithine decarboxylase (ODC) via siRNA transfection in vivo significantly increased DNA damage, PARP1 activation and ATP depletion, resulting in acceleration of tubular necrosis and kidney dysfunction. Finally, exogenous spermidine removed severe cisplatin injury induced by ODC inhibition. In conclusion, these data suggest that spermidine protects kidneys against cisplatin injury through DNA damage and tubular necrosis, and this finding provides a novel target to prevent acute kidney injury including nephrotoxicity.

The Effect of Low-Dose Nitroglycerin Ointment on Skin Flap Necrosis in Breast Reconstruction after Skin-Sparing or Nipple-Sparing Mastectomy

  • Yun, Min Ho;Yoon, Eul Sik;Lee, Byung-Il;Park, Seung-Ha
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.509-515
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    • 2017
  • Background Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. Methods A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. Results Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio=7.81; 95% confidence interval, 1.38 to 44.23; P=0.02). Conclusions Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.

Intraoperative Expansion Technique for Soft Tissue Necrosis after Liposuction (지방흡입술 후 연부 조직 괴사에 대한 술중 조직확장법을 이용한 치료)

  • Kim, Jae Hyun;Suh, In Suck;Tak, Kyoung Seok
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.462-468
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    • 2009
  • Purpose: The liposuction has been generalized & undergone in the field of plastic surgery and it has had a great influence on fat graft. But despite of liposuction and fat injection being performed widely, we did not focus on complication associated with donor site. So we reported satisfactory result with the intraoperative sustained limited expansion & direct closure to donor site tissue necrosis after liposuction and analyzed the cause & measures of donor site necrosis with the literature investigation Methods: From November 2007 to June 2008, we treated four cases of tissue necrosis and infection surrounding the thigh and forearm. Necrosis after liposuction was 1 case, donor site necrosis after fat injection were 3 cases and MRSA was detected in 2 cases. first, we debrided the necrotic tissue and treated with potadine gauze soaking dressing & susceptible antibiotics. After confirmation of healthy granulation tissue, we used intraoperative sustained limited expansion and closed directly of defect & observed the results. Results: The patient was displeased and worried with the unexpected damage concerning the donor site and the procedure concerning time and financial exhaustion, but after confirming no contracture of the scar tissues and only a thin or slightly widened line of scar, showed satisfaction. Conclusion: Because it is fastidious to avoid donor site complication after liposuction & fat injection, enough explanation and understanding on possible complication to donor site are necessary and careful surgery procedure & materials are required. But if donor site necrosis were occurred although close consideration of possible causes of necrosis, we should think about not only wound healing process but also the sequela like scar contracture & cosmetic effect and treat the most adequate method to satisfying both concerns.