Khang Nguyen - Academia.edu (original) (raw)
Papers by Khang Nguyen
Plastic and Reconstructive Surgery - Global Open
Background: Lipoabdominoplasty has evolved over the last 6 decades through contributions from num... more Background: Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery. Methods: The authors review historical perspective and provide a contemporary examination of trends in lipoabdominoplasty. Results: In 1967, Pitanguy popularized abdominoplasty (without liposuction) as a technique for augmenting ventral hernias repairs and subsequently for aesthetic improvement of the abdomen. After the introduction of suction assisted lipectomy by Illouz in 1983, abdominoplasty became a central tool in a diverse armamentarium of anterior and lateral abdominal wall contouring procedures. Liposuction was initially utilized with mini-abdominoplasty in order to improve contour. Subsequently, Matarasso advanced the safe combination of liposuction with full abdominoplasty. Additionally, he systematized the variety of cutaneous undermining, excision, and liposuction procedures utilized in abdominal contouring as indicated by the degree of skin laxity and musculofascial diastasis. Lockwood advocated high lateral tension closure of the superficial fascial system of the abdomen to improve the contour of the hips and flanks. Saldanha advanced selective undermining and anterior abdominal wall perforator preservation to minimize wound healing and seroma complications associated with lipoabdominoplasty procedures. Conclusion: In abdominal contour surgery, surgeons can rely on classic techniques and algorithms that have withstood the test of time while modifying their approaches with advances backed by compelling and rigorously obtained evidence.
Journal of Reconstructive Microsurgery, 2022
Background Accurate assessment of regional lymph node basins is critical for oncological manageme... more Background Accurate assessment of regional lymph node basins is critical for oncological management of breast cancer. The internal mammary lymph node (IMLN) basin directly drains the medial pole of the breast, but biopsy is not commonly performed. While the axillary sentinel lymph node sample remains the standard of care, the majority of patients who have been found to have a positive IMLN biopsy have simultaneously had negative axillary sentinel lymph nodes. This study prospectively examines routine IMLN biopsy during microsurgical breast reconstruction. Methods An IRB-approved study of routine IMLN biopsies in 270 consecutive patients who underwent microsurgical breast reconstruction was performed from July 1, 2018, to June 1, 2021. Recorded data included unilateral or bilateral breast reconstruction, unilateral or bilateral IMLN sampling, patient demographics, disease stage, and pathologic findings of IMLN. Results The majority of patients, 240 of 270 patients (88.9%), had bilate...
2017 Fifteenth IAPR International Conference on Machine Vision Applications (MVA), 2017
Depth from Defocus (DFD) is known as a technology which is able to estimate depth by a monocular ... more Depth from Defocus (DFD) is known as a technology which is able to estimate depth by a monocular camera, without any additive devices. However, it has to get two blurred images with different focused distance sequentially so that subjects or the camera itself can move in the short interval of consecutive shots. Conventional DFD is intolerant to such image shift especially in the weak texture part. In this paper, a new evaluation function for DFD is shown in order to achieve the motion robustness in frequency domain. The Conventional DFD algorithm is modified considering the image shift, and in the derived formula both shift and phase components vanished. As for DFD technology, the formula is insensitive to the image shift because the defocus blur appears only in the amplitude part. As a result, we also confirmed that our algorithm overcomes conventional methods especially for the real life with rapidly moving subjects.
Journal of Animal Science, 2021
The use of probiotics may be an effective strategy in sustainable pig production. The objective o... more The use of probiotics may be an effective strategy in sustainable pig production. The objective of this experiment was to examine the effects of Lactobacillus fermentum LfQi6 (LF) on sow and litter performance. First parity, gestating sows (UNL Resource Population Rep x DNA Genetics Duroc; n = 28) were allotted one of two treatment groups. Treatment groups consisted of a control group (CTL) fed a standard gestation and lactation diet for the duration of the study, while the experimental group was fed CTL supplemented with 10^10 CFU LF per day from d 80 of gestation through lactation. Individual piglet body weights (BW) were recorded weekly. LF sows tended to enter the farrowing crates lighter than the control sows (209.93 vs 200.91kg; P = 0.0794). LF sows had a smaller loin eye area when compared to CTL sows (6.24 vs 5.86 cm2; P = 0.0374) when entering the farrowing crates. However, LF sows tended to lose less loin area per day when in the crate (0.025 vs 0.012 cm2/d; P = 0.078); re...
Journal of Animal Science, 2021
The use of probiotics may be an effective strategy in sustainable pig production. The objective o... more The use of probiotics may be an effective strategy in sustainable pig production. The objective of this experiment was to examine the effects of Lactobacillus fermentum (LF) on nursery pig performance. Weaned pigs (n = 70; average initial BW 6.464 kg) were randomly allotted to 1 of 3 treatments, forming 6 replicates per treatment. Treatments included: 1) pigs fed a standard nursery diet (NRC 2012); CTL; 2) pigs fed CTL with the addition of 10^10 CFU LF per day for phase 1 (wk 2 and 3; LF1); and 3) pigs fed CTL with the addition of 10^10 CFU LF per day for phase 1 and phase 2 (wk 2 thru 5). A common diet was fed during adaptation (wk 1) and during a wash out phase (wk 6). Individual piglet BW were recorded weekly along with pen feed disappearance. No differences were observed in BW by the end of phase 1; at the end of phase 2 the pigs fed LF had a lower BW than the others (19.38, 19.22, 17.3 kg; P = 0.031). This was associated with a reduced feed efficiency seen in week 5 (0.679, 0.6...
The Breast Journal, 2020
Introduction: Clinical significance of internal mammary (IM) lymph node biopsy during microvascul... more Introduction: Clinical significance of internal mammary (IM) lymph node biopsy during microvascular free flap breast reconstruction remains controversial. Some microsurgeons may choose to biopsy an IM lymph node during routine IM vessel dissection. The authors reviewed the results of IM lymph node biopsy during autologous breast reconstruction. Methods: A retrospective chart review of patients who underwent autologous breast reconstruction during a seven-year period (January 2010 to January 2017) was performed. Patient demographic data, disease staging, flap details, pathology reports, and adjuvant treatment were evaluated. Results: A total of 230 patients with a mean age of 52.1 (SD 9.3) underwent IM lymph node biopsy (n = 297). Single IM lymph node was removed in 169 patients, 2 nodes were removed in 56 patients, 3 nodes in 4 patients, and 4 nodes in a single patient. Histopathologic analysis demonstrated presence of IM lymph node metastasis in 16 patients (7.0%). Thirteen patients were found to have metastatic IM lymph nodes in the setting of immediate reconstruction. Three patients were found to have metastatic IM lymph nodes in the setting of delayed. Five out of 16 patients (31.3%) had negative axillary sentinel lymph node biopsy and IM lymph nodes were the only site of nodal metastases. All five of these patients were upstaged accordingly and received adjuvant therapy based on the discussion at the multidisciplinary breast tumor conference. Conclusions: Opportunistic internal mammary lymph node sampling during autologous breast reconstruction can be performed with minimal morbidity and has significant impact on the disease staging and adjuvant treatment.
Dermatology Online Journal, 2020
Journal of Cutaneous Pathology, 2021
International journal of dermatology, Aug 2, 2017
References 1 Wolf R, Orion E, Matz H. The baboon syndrome or intertriginous drug eruption: a repo... more References 1 Wolf R, Orion E, Matz H. The baboon syndrome or intertriginous drug eruption: a report of eleven cases and a second look at its pathomechanism. Dermatol Online J 2003; 9: 2. 2 H€ ausermann P, Harr T, Bircher AJ. Baboon syndrome resulting from systemic drugs: is there strife between SDRIFE and allergic contact dermatitis syndrome? Contact Dermatitis 2004; 51: 297–310. 3 Weiss JM, Mockenhaupt M, Sch€ opf E, et al. Reproducible drug exanthema to terbinafine with characteristic distribution of baboon syndrome. Hautarzt 2001; 52: 1104–1106. 4 € Ozkaya E. Current understanding of Baboon syndrome. Expert Rev Dermatol 2009; 4: 163–175. 5 Miyahara A, Kawashima H, Okubo Y, et al. A new proposal for a clinical-oriented subclassification of baboon syndrome and a review of baboon syndrome. Asian Pac J Allergy Immunol 2011; 29: 150–160.
Journal of the American Academy of Dermatology, Jan 28, 2016
Human polyomavirus (HPyV)6 and HPyV7 are shed chronically from human skin. HPyV7, but not HPyV6, ... more Human polyomavirus (HPyV)6 and HPyV7 are shed chronically from human skin. HPyV7, but not HPyV6, has been linked to a pruritic skin eruption of immunosuppression. We determined whether biopsy specimens showing a characteristic pattern of dyskeratosis and parakeratosis might be associated with polyomavirus infection. We screened biopsy specimens showing "peacock plumage" histology by polymerase chain reaction for HPyVs. Cases positive for HPyV6 or HPyV7 were then analyzed by immunohistochemistry, electron microscopy, immunofluorescence, quantitative polymerase chain reaction, and complete sequencing, including unbiased, next-generation sequencing. We identified 3 additional cases of HPyV6 or HPyV7 skin infections. Expression of T antigen and viral capsid was abundant in lesional skin. Dual immunofluorescence staining experiments confirmed that HPyV7 primarily infects keratinocytes. High viral loads in lesional skin compared with normal-appearing skin and the identification ...
Plastic and Reconstructive Surgery, 2017
Plastic and reconstructive surgery, Jan 16, 2016
Keloids represent a challenging problem for plastic surgeons and patients. Surgical excision rema... more Keloids represent a challenging problem for plastic surgeons and patients. Surgical excision remains the definitive treatment for immediate lesion debulking. However, post-excisional recurrence rates are reported to be 45% - 100%. We present a series of 5 patients undergoing excision of keloids and a staged reconstructive approach using a dermal regeneration substrate and epidermal grafting to minimize recurrence and donor site morbidity. Keloids were completely excised down to normal subcutaneous tissue or perichondrium. A bilaminar dermal regeneration matrix (Integra, Integra Lifesciences Corp.) was approximated to the entire wound, with the silicone lamina oriented superficially. Reconstruction was delayed for at least 21 days to allow for neo-dermal ingrowth. The silicone lamina was then removed, and an epidermal skin graft was harvested from the thigh using an epidermal graft harvesting system (CelluTome, KCI Inc.) and secured to the neo-dermis with non-occlusive dressing (Tega...
I 2009 deltok Norge for første gang i Commonwealth Funds internasjonale helsesystemundersøkelse. ... more I 2009 deltok Norge for første gang i Commonwealth Funds internasjonale helsesystemundersøkelse. Målet med undersøkelsen er å danne grunnlag for nytenkning om helsepolitikk og gi beslutningstakere nødvendig informasjon for å fatte informerte og ansvarlige beslutninger om helsetjenestesystemet i sitt land. •Undersøkelsen ble gjennomført våren 2009 i elleve land: USA,
viser sammenlikninger av helsesystemer og deres resultater pa en rekke dimensjoner. OECD har bruk... more viser sammenlikninger av helsesystemer og deres resultater pa en rekke dimensjoner. OECD har brukt ulike indikatorer som er valgt basert pa betydningen for langsiktig kurs og om de er tilgjengelige og sammenliknbare. Vi onsker med denne rapporten a belyse viktige trekk ved den norske helsetjenesten sett i forhold til OECD, spesielt pa omrader der Norge klart skilte seg ut fra andre OECD-land. Resultat og diskusjon: OECD-rapporten viser generelt bade gunstige helsevaner og god helsetilstand i Norge, med hoyere forventet levealder og lavere sykelighet og dodelighet enn OECD-gjennomsnittet. Samtidig har norsk helsetjeneste de nest hoyeste helseutgiftene per innbygger etter USA og hoyest andel av helseutgiftene som gar til pleie og omsorg. Mens norsk helsetjeneste har vist den storste reduksjonen i sykehusdodelighet pa grunn av hjerneslag, er overlevelse etter fem ar ved brystkreft, livmorhalskreft, tykktarmskreft og endetarmskreft i Norge omtrent pa OECD-gjennomsnittet. Pa mange andre omrader i helsetjenesten har vi ikke palitelige resultatindikatorer. (fortsetter pa baksiden) Norsk helsetjeneste sammenliknet med andre OECD-land
2014 IEEE 3rd Global Conference on Consumer Electronics (GCCE), 2014
Depth from Defocus (DFD) is known as the technology which is able to estimate depth in the scene ... more Depth from Defocus (DFD) is known as the technology which is able to estimate depth in the scene by a monocular camera without any additive devices. Using this advantage of DFD, we improved the speed of Auto Focus (AF). To apply DFD to AF, it is necessary to capture 2 images that have a small amount of “difference in focal positions” (we call DiFP). In this paper, we show the performance of the depth estimation when the DiFP is changed, and verify that Low Pass Filter is a good solution to get robust depth.
Eplasty, 2012
Adjunct acellular dermal matrices (ADM) are thought to improve esthetic outcomes of breast recons... more Adjunct acellular dermal matrices (ADM) are thought to improve esthetic outcomes of breast reconstruction but the existing evidence is largely anecdotal. In this study, we provide comparative data on esthetic outcomes of expander-implant breast reconstruction with and without ADM. Chart review was performed on a consecutive series of expander-implant reconstructions by the senior author. Demographic, oncologic, surgical, and photographic data were obtained for each patient. Photographic data were scored using a 3-point (0-1-2) breast-specific esthetic scale by 3 blinded, independent reviewers not involved in patient care. ADM-assisted breast reconstructions had significantly higher scores than the non-ADM reconstructions for breast mound volume (1.38 vs 1.11; P = .0102), breast mound placement (1.57 vs 1.39; P = .0217), and the inframammary fold (1.39 vs 1.23; P = .0458). ADM may improve breast volume, placement, and inframammary fold definition. These specific findings may help pla...
Eplasty, 2012
Relative value units (RVUs) were developed as a quantifier of requisite training, knowledge, and ... more Relative value units (RVUs) were developed as a quantifier of requisite training, knowledge, and technical expertise for performing various procedures. In select procedures, increasing RVUs have been shown to substitute well for increasing surgical complexity and have been linked to greater risk of complications. The relationship of RVU to outcomes has yet to be examined in the plastic surgery population. This study analyzed nearly 15,000 patients from a standardized, multicenter database to better define the link between RVUs and outcomes in this surgical population. The American College of Surgeons' National Surgical Quality Improvement Program was retrospectively reviewed from 2006 to 2010. A total of 14,936 patients undergoing primary procedures of plastic surgery were identified. Independent risk factors for complications were analyzed using multivariable logistic regression. A unit increase in RVUs was associated with a 1.7% increase in the odds of overall complications an...
Journal of plastic surgery and hand surgery, 2013
Traditional nipple reconstruction relies on local flap techniques. However, there are several pro... more Traditional nipple reconstruction relies on local flap techniques. However, there are several problems associated with local flap reconstruction including loss of projection, widening of the base width, and difficulty working around the mastectomy scar. This study presents a variation of traditional local flap nipple reconstruction, which is termed the weave technique. Rather than using two flaps to create base width, the weave technique uses one. By controlling the base width, this may serve to sustain long-term projection. Second, filling the inside of the nipple with the second flap may contribute to longer term projection. Because there is no third flap, it is easier to orient the nipple with respect to the mastectomy scar. To date, the senior author has used this method to reconstruct 55 nipples in 40 patients, with 415 days (range 191-733) mean follow-up time. This includes 45 (82%) nipple reconstructions after tissue expander-implant reconstruction. The use of this technique ...
Journal of plastic surgery and hand surgery, 2013
Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a... more Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a post-mastectomy option often used as a salvage procedure for a failed tissue expander (TE). The patient is traditionally placed in the lateral decubitus position for flap dissection and is re-prepped and re-draped in the supine position for placement of the tissue expander. A new generation of anatomically-shaped, tabbed tissue expanders are increasingly being used in place of traditional untabbed expanders. The innovative suture tabs allow for more predictable and controlled expander placement while the patient is in the lateral decubitus position, eliminating the need to reposition the patient intraoperatively. The objective of this study was to evaluate the use of tabbed tissue expanders in latissimus dorsi breast reconstruction, with respect to total operative time, complication rates, and aesthetic outcomes. The outcomes of 34 LD breast reconstruction procedures with tissue expande...
Plastic and Reconstructive Surgery - Global Open
Background: Lipoabdominoplasty has evolved over the last 6 decades through contributions from num... more Background: Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery. Methods: The authors review historical perspective and provide a contemporary examination of trends in lipoabdominoplasty. Results: In 1967, Pitanguy popularized abdominoplasty (without liposuction) as a technique for augmenting ventral hernias repairs and subsequently for aesthetic improvement of the abdomen. After the introduction of suction assisted lipectomy by Illouz in 1983, abdominoplasty became a central tool in a diverse armamentarium of anterior and lateral abdominal wall contouring procedures. Liposuction was initially utilized with mini-abdominoplasty in order to improve contour. Subsequently, Matarasso advanced the safe combination of liposuction with full abdominoplasty. Additionally, he systematized the variety of cutaneous undermining, excision, and liposuction procedures utilized in abdominal contouring as indicated by the degree of skin laxity and musculofascial diastasis. Lockwood advocated high lateral tension closure of the superficial fascial system of the abdomen to improve the contour of the hips and flanks. Saldanha advanced selective undermining and anterior abdominal wall perforator preservation to minimize wound healing and seroma complications associated with lipoabdominoplasty procedures. Conclusion: In abdominal contour surgery, surgeons can rely on classic techniques and algorithms that have withstood the test of time while modifying their approaches with advances backed by compelling and rigorously obtained evidence.
Journal of Reconstructive Microsurgery, 2022
Background Accurate assessment of regional lymph node basins is critical for oncological manageme... more Background Accurate assessment of regional lymph node basins is critical for oncological management of breast cancer. The internal mammary lymph node (IMLN) basin directly drains the medial pole of the breast, but biopsy is not commonly performed. While the axillary sentinel lymph node sample remains the standard of care, the majority of patients who have been found to have a positive IMLN biopsy have simultaneously had negative axillary sentinel lymph nodes. This study prospectively examines routine IMLN biopsy during microsurgical breast reconstruction. Methods An IRB-approved study of routine IMLN biopsies in 270 consecutive patients who underwent microsurgical breast reconstruction was performed from July 1, 2018, to June 1, 2021. Recorded data included unilateral or bilateral breast reconstruction, unilateral or bilateral IMLN sampling, patient demographics, disease stage, and pathologic findings of IMLN. Results The majority of patients, 240 of 270 patients (88.9%), had bilate...
2017 Fifteenth IAPR International Conference on Machine Vision Applications (MVA), 2017
Depth from Defocus (DFD) is known as a technology which is able to estimate depth by a monocular ... more Depth from Defocus (DFD) is known as a technology which is able to estimate depth by a monocular camera, without any additive devices. However, it has to get two blurred images with different focused distance sequentially so that subjects or the camera itself can move in the short interval of consecutive shots. Conventional DFD is intolerant to such image shift especially in the weak texture part. In this paper, a new evaluation function for DFD is shown in order to achieve the motion robustness in frequency domain. The Conventional DFD algorithm is modified considering the image shift, and in the derived formula both shift and phase components vanished. As for DFD technology, the formula is insensitive to the image shift because the defocus blur appears only in the amplitude part. As a result, we also confirmed that our algorithm overcomes conventional methods especially for the real life with rapidly moving subjects.
Journal of Animal Science, 2021
The use of probiotics may be an effective strategy in sustainable pig production. The objective o... more The use of probiotics may be an effective strategy in sustainable pig production. The objective of this experiment was to examine the effects of Lactobacillus fermentum LfQi6 (LF) on sow and litter performance. First parity, gestating sows (UNL Resource Population Rep x DNA Genetics Duroc; n = 28) were allotted one of two treatment groups. Treatment groups consisted of a control group (CTL) fed a standard gestation and lactation diet for the duration of the study, while the experimental group was fed CTL supplemented with 10^10 CFU LF per day from d 80 of gestation through lactation. Individual piglet body weights (BW) were recorded weekly. LF sows tended to enter the farrowing crates lighter than the control sows (209.93 vs 200.91kg; P = 0.0794). LF sows had a smaller loin eye area when compared to CTL sows (6.24 vs 5.86 cm2; P = 0.0374) when entering the farrowing crates. However, LF sows tended to lose less loin area per day when in the crate (0.025 vs 0.012 cm2/d; P = 0.078); re...
Journal of Animal Science, 2021
The use of probiotics may be an effective strategy in sustainable pig production. The objective o... more The use of probiotics may be an effective strategy in sustainable pig production. The objective of this experiment was to examine the effects of Lactobacillus fermentum (LF) on nursery pig performance. Weaned pigs (n = 70; average initial BW 6.464 kg) were randomly allotted to 1 of 3 treatments, forming 6 replicates per treatment. Treatments included: 1) pigs fed a standard nursery diet (NRC 2012); CTL; 2) pigs fed CTL with the addition of 10^10 CFU LF per day for phase 1 (wk 2 and 3; LF1); and 3) pigs fed CTL with the addition of 10^10 CFU LF per day for phase 1 and phase 2 (wk 2 thru 5). A common diet was fed during adaptation (wk 1) and during a wash out phase (wk 6). Individual piglet BW were recorded weekly along with pen feed disappearance. No differences were observed in BW by the end of phase 1; at the end of phase 2 the pigs fed LF had a lower BW than the others (19.38, 19.22, 17.3 kg; P = 0.031). This was associated with a reduced feed efficiency seen in week 5 (0.679, 0.6...
The Breast Journal, 2020
Introduction: Clinical significance of internal mammary (IM) lymph node biopsy during microvascul... more Introduction: Clinical significance of internal mammary (IM) lymph node biopsy during microvascular free flap breast reconstruction remains controversial. Some microsurgeons may choose to biopsy an IM lymph node during routine IM vessel dissection. The authors reviewed the results of IM lymph node biopsy during autologous breast reconstruction. Methods: A retrospective chart review of patients who underwent autologous breast reconstruction during a seven-year period (January 2010 to January 2017) was performed. Patient demographic data, disease staging, flap details, pathology reports, and adjuvant treatment were evaluated. Results: A total of 230 patients with a mean age of 52.1 (SD 9.3) underwent IM lymph node biopsy (n = 297). Single IM lymph node was removed in 169 patients, 2 nodes were removed in 56 patients, 3 nodes in 4 patients, and 4 nodes in a single patient. Histopathologic analysis demonstrated presence of IM lymph node metastasis in 16 patients (7.0%). Thirteen patients were found to have metastatic IM lymph nodes in the setting of immediate reconstruction. Three patients were found to have metastatic IM lymph nodes in the setting of delayed. Five out of 16 patients (31.3%) had negative axillary sentinel lymph node biopsy and IM lymph nodes were the only site of nodal metastases. All five of these patients were upstaged accordingly and received adjuvant therapy based on the discussion at the multidisciplinary breast tumor conference. Conclusions: Opportunistic internal mammary lymph node sampling during autologous breast reconstruction can be performed with minimal morbidity and has significant impact on the disease staging and adjuvant treatment.
Dermatology Online Journal, 2020
Journal of Cutaneous Pathology, 2021
International journal of dermatology, Aug 2, 2017
References 1 Wolf R, Orion E, Matz H. The baboon syndrome or intertriginous drug eruption: a repo... more References 1 Wolf R, Orion E, Matz H. The baboon syndrome or intertriginous drug eruption: a report of eleven cases and a second look at its pathomechanism. Dermatol Online J 2003; 9: 2. 2 H€ ausermann P, Harr T, Bircher AJ. Baboon syndrome resulting from systemic drugs: is there strife between SDRIFE and allergic contact dermatitis syndrome? Contact Dermatitis 2004; 51: 297–310. 3 Weiss JM, Mockenhaupt M, Sch€ opf E, et al. Reproducible drug exanthema to terbinafine with characteristic distribution of baboon syndrome. Hautarzt 2001; 52: 1104–1106. 4 € Ozkaya E. Current understanding of Baboon syndrome. Expert Rev Dermatol 2009; 4: 163–175. 5 Miyahara A, Kawashima H, Okubo Y, et al. A new proposal for a clinical-oriented subclassification of baboon syndrome and a review of baboon syndrome. Asian Pac J Allergy Immunol 2011; 29: 150–160.
Journal of the American Academy of Dermatology, Jan 28, 2016
Human polyomavirus (HPyV)6 and HPyV7 are shed chronically from human skin. HPyV7, but not HPyV6, ... more Human polyomavirus (HPyV)6 and HPyV7 are shed chronically from human skin. HPyV7, but not HPyV6, has been linked to a pruritic skin eruption of immunosuppression. We determined whether biopsy specimens showing a characteristic pattern of dyskeratosis and parakeratosis might be associated with polyomavirus infection. We screened biopsy specimens showing "peacock plumage" histology by polymerase chain reaction for HPyVs. Cases positive for HPyV6 or HPyV7 were then analyzed by immunohistochemistry, electron microscopy, immunofluorescence, quantitative polymerase chain reaction, and complete sequencing, including unbiased, next-generation sequencing. We identified 3 additional cases of HPyV6 or HPyV7 skin infections. Expression of T antigen and viral capsid was abundant in lesional skin. Dual immunofluorescence staining experiments confirmed that HPyV7 primarily infects keratinocytes. High viral loads in lesional skin compared with normal-appearing skin and the identification ...
Plastic and Reconstructive Surgery, 2017
Plastic and reconstructive surgery, Jan 16, 2016
Keloids represent a challenging problem for plastic surgeons and patients. Surgical excision rema... more Keloids represent a challenging problem for plastic surgeons and patients. Surgical excision remains the definitive treatment for immediate lesion debulking. However, post-excisional recurrence rates are reported to be 45% - 100%. We present a series of 5 patients undergoing excision of keloids and a staged reconstructive approach using a dermal regeneration substrate and epidermal grafting to minimize recurrence and donor site morbidity. Keloids were completely excised down to normal subcutaneous tissue or perichondrium. A bilaminar dermal regeneration matrix (Integra, Integra Lifesciences Corp.) was approximated to the entire wound, with the silicone lamina oriented superficially. Reconstruction was delayed for at least 21 days to allow for neo-dermal ingrowth. The silicone lamina was then removed, and an epidermal skin graft was harvested from the thigh using an epidermal graft harvesting system (CelluTome, KCI Inc.) and secured to the neo-dermis with non-occlusive dressing (Tega...
I 2009 deltok Norge for første gang i Commonwealth Funds internasjonale helsesystemundersøkelse. ... more I 2009 deltok Norge for første gang i Commonwealth Funds internasjonale helsesystemundersøkelse. Målet med undersøkelsen er å danne grunnlag for nytenkning om helsepolitikk og gi beslutningstakere nødvendig informasjon for å fatte informerte og ansvarlige beslutninger om helsetjenestesystemet i sitt land. •Undersøkelsen ble gjennomført våren 2009 i elleve land: USA,
viser sammenlikninger av helsesystemer og deres resultater pa en rekke dimensjoner. OECD har bruk... more viser sammenlikninger av helsesystemer og deres resultater pa en rekke dimensjoner. OECD har brukt ulike indikatorer som er valgt basert pa betydningen for langsiktig kurs og om de er tilgjengelige og sammenliknbare. Vi onsker med denne rapporten a belyse viktige trekk ved den norske helsetjenesten sett i forhold til OECD, spesielt pa omrader der Norge klart skilte seg ut fra andre OECD-land. Resultat og diskusjon: OECD-rapporten viser generelt bade gunstige helsevaner og god helsetilstand i Norge, med hoyere forventet levealder og lavere sykelighet og dodelighet enn OECD-gjennomsnittet. Samtidig har norsk helsetjeneste de nest hoyeste helseutgiftene per innbygger etter USA og hoyest andel av helseutgiftene som gar til pleie og omsorg. Mens norsk helsetjeneste har vist den storste reduksjonen i sykehusdodelighet pa grunn av hjerneslag, er overlevelse etter fem ar ved brystkreft, livmorhalskreft, tykktarmskreft og endetarmskreft i Norge omtrent pa OECD-gjennomsnittet. Pa mange andre omrader i helsetjenesten har vi ikke palitelige resultatindikatorer. (fortsetter pa baksiden) Norsk helsetjeneste sammenliknet med andre OECD-land
2014 IEEE 3rd Global Conference on Consumer Electronics (GCCE), 2014
Depth from Defocus (DFD) is known as the technology which is able to estimate depth in the scene ... more Depth from Defocus (DFD) is known as the technology which is able to estimate depth in the scene by a monocular camera without any additive devices. Using this advantage of DFD, we improved the speed of Auto Focus (AF). To apply DFD to AF, it is necessary to capture 2 images that have a small amount of “difference in focal positions” (we call DiFP). In this paper, we show the performance of the depth estimation when the DiFP is changed, and verify that Low Pass Filter is a good solution to get robust depth.
Eplasty, 2012
Adjunct acellular dermal matrices (ADM) are thought to improve esthetic outcomes of breast recons... more Adjunct acellular dermal matrices (ADM) are thought to improve esthetic outcomes of breast reconstruction but the existing evidence is largely anecdotal. In this study, we provide comparative data on esthetic outcomes of expander-implant breast reconstruction with and without ADM. Chart review was performed on a consecutive series of expander-implant reconstructions by the senior author. Demographic, oncologic, surgical, and photographic data were obtained for each patient. Photographic data were scored using a 3-point (0-1-2) breast-specific esthetic scale by 3 blinded, independent reviewers not involved in patient care. ADM-assisted breast reconstructions had significantly higher scores than the non-ADM reconstructions for breast mound volume (1.38 vs 1.11; P = .0102), breast mound placement (1.57 vs 1.39; P = .0217), and the inframammary fold (1.39 vs 1.23; P = .0458). ADM may improve breast volume, placement, and inframammary fold definition. These specific findings may help pla...
Eplasty, 2012
Relative value units (RVUs) were developed as a quantifier of requisite training, knowledge, and ... more Relative value units (RVUs) were developed as a quantifier of requisite training, knowledge, and technical expertise for performing various procedures. In select procedures, increasing RVUs have been shown to substitute well for increasing surgical complexity and have been linked to greater risk of complications. The relationship of RVU to outcomes has yet to be examined in the plastic surgery population. This study analyzed nearly 15,000 patients from a standardized, multicenter database to better define the link between RVUs and outcomes in this surgical population. The American College of Surgeons' National Surgical Quality Improvement Program was retrospectively reviewed from 2006 to 2010. A total of 14,936 patients undergoing primary procedures of plastic surgery were identified. Independent risk factors for complications were analyzed using multivariable logistic regression. A unit increase in RVUs was associated with a 1.7% increase in the odds of overall complications an...
Journal of plastic surgery and hand surgery, 2013
Traditional nipple reconstruction relies on local flap techniques. However, there are several pro... more Traditional nipple reconstruction relies on local flap techniques. However, there are several problems associated with local flap reconstruction including loss of projection, widening of the base width, and difficulty working around the mastectomy scar. This study presents a variation of traditional local flap nipple reconstruction, which is termed the weave technique. Rather than using two flaps to create base width, the weave technique uses one. By controlling the base width, this may serve to sustain long-term projection. Second, filling the inside of the nipple with the second flap may contribute to longer term projection. Because there is no third flap, it is easier to orient the nipple with respect to the mastectomy scar. To date, the senior author has used this method to reconstruct 55 nipples in 40 patients, with 415 days (range 191-733) mean follow-up time. This includes 45 (82%) nipple reconstructions after tissue expander-implant reconstruction. The use of this technique ...
Journal of plastic surgery and hand surgery, 2013
Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a... more Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a post-mastectomy option often used as a salvage procedure for a failed tissue expander (TE). The patient is traditionally placed in the lateral decubitus position for flap dissection and is re-prepped and re-draped in the supine position for placement of the tissue expander. A new generation of anatomically-shaped, tabbed tissue expanders are increasingly being used in place of traditional untabbed expanders. The innovative suture tabs allow for more predictable and controlled expander placement while the patient is in the lateral decubitus position, eliminating the need to reposition the patient intraoperatively. The objective of this study was to evaluate the use of tabbed tissue expanders in latissimus dorsi breast reconstruction, with respect to total operative time, complication rates, and aesthetic outcomes. The outcomes of 34 LD breast reconstruction procedures with tissue expande...