Is Diabetes a Contraindication to Lower Extremity Flap Reconstruction? An Analysis of Threatened Lower Extremities in the NSQIP Database (2010-2020)

Amy Chen,Shannon R. Garvey,Nimish Saxena,Valeria P. Bustos,Emmeline Jia,Monica Morgenstern,Asha D. Nanda,Arriyan S. Dowlatshahi,Ryan P. Cauley Korean Society of Plastic and Reconstructive Surge 2024 Archives of Plastic Surgery Vol.51 No.2

Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

Gender Norms, Peer Culture and the Gender Gap

Amy Hsin,I-Chien Chen 한국사회학회 2018 한국사회학회 심포지움 논문집 Vol.2018 No.5

Functional rehabilitation of children with post surgical oro nasal fistula using obturators: Case reports with ten year follow up

Pratibha Kukreja,Amy Yi-Ling Chen Asia Association for Disability and Oral Health 2020 대한장애인치과학회지 Vol.16 No.1

Oronasal fistulas (ONF) present as the most common complication after cleft palate surgery. Various methods of closure have been described, depending upon site, size and tissue available. However, in certain situations, nonsurgical management is required to correct the functional deficits due to ONF.The clinical reports presented here describe the management of ONF in two paediatric patients due to flap necrosis. A fixed type of obturator with bands on upper primary second molar teeth has been described. A ten year long follow up has been presented. This paper highlights the importance of multidisciplinary approach and long term follow up for non-surgical management of ONF.

Phylogenetic and Morphological Identification of the Novel Pathogen of Rheum palmatum Leaf Spot in Gansu, China

( Yan Wang ),( Amy O. Charkowski ),( Cuiyun Zeng ),( Tiantian Zhu ),( Huizhen Wang ),( Honggang Chen ) 한국균학회 2016 Mycobiology Vol.44 No.2

A new leaf spot disease was observed on leaves of Rheum palmatum (Chinese rhubarb) in Northwest China (Gansu Province) starting in 2005. A Septoria-like fungus was isolated and completion of Koch’s postulates confirmed that the fungus was the casual agent of the leaf spot disease. Morphology and molecular methods were combined to identify the pathogen. The fungus produced conidiomata pycnidia and the conidia were 2~5 septate, 61.2~134.1 μm in length and 3.53~5.3 μm in width, which is much larger than the known Spetoria species that infects Polygonaceae species. Phylogenic analysis of the internal transcribed spacer region confirmed that this Septoria-like fungus is within the Septoria genus but distinct from known Septoria species. Together, these morphological and phylogenetic data support that the R. palmatum infecting Septoria strain is a newlydescribed plant pathogenic species.

Ginsenoside Rg3 in combination with artesunate overcomes sorafenib resistance in hepatoma cell and mouse models

Ying-Jie Chen,Jia-Ying Wu,Yu-Yi Deng,Ying Wu,Xiao-Qi Wang,Amy Sze-man Li,Lut Yi Wong,Xiuqiong Fu,Zhi-Ling Yu,Chun Liang 고려인삼학회 2022 Journal of Ginseng Research Vol.46 No.3

Sorafenib is effective in treating hepatoma, but most patients develop resistance to it. STAT3signaling has been implicated in sorafenib resistance. Artesunate (ART) and 20(R)-ginsenoside Rg3 (Rg3)have anti-hepatoma effects and can inhibit STAT3 signaling in cancer cells. This study aimed to evaluatethe effects of Rg3 in combination with ART (Rg3-plus-ART) in overcoming sorafenib resistance, and toexamine the involvement of STAT3 signaling in these effects. Methods: Sorafenib-resistant HepG2 cells (HepG2-SR) were used to evaluate the in vitro anti-hepatomaeffects of Rg3-plus-ART. A HepG2-SR hepatoma-bearing BALB/c-nu/nu mouse model was used to assessthe in vivo anti-hepatoma effects of Rg3-plus-ART. CCK-8 assays and Annexin V-FITC/PI double stainingwere used to examine cell proliferation and apoptosis, respectively. Immunoblotting was employed toexamine protein levels. ROS generation was examined by measuring DCF-DA fluorescence. Results: Rg3-plus-ART synergistically reduced viability of, and evoked apoptosis in HepG2-SR cells, andsuppressed HepG2-SR tumor growth in mice. Mechanistic studies revealed that Rg3-plus-ART inhibitedactivation/phosphorylation of Src and STAT3 in HepG2-SR cultures and tumors. The combination alsodecreased the STAT3 nuclear level and induced ROS production in HepG2-SR cultures. Furthermore, overactivation of STAT3 or removal of ROS diminished the anti-proliferative effects of Rg3-plus-ART, andremoval of ROS diminished Rg3-plus-ART's inhibitory effects on STAT3 activation in HepG2-SR cells. Conclusions: Rg3-plus-ART overcomes sorafenib resistance in experimental models, and inhibition of Src/STAT3 signaling and modulation of ROS/STAT3 signaling contribute to the underlying mechanisms. Thisstudy provides a pharmacological basis for developing Rg3-plus-ART into a novel modality for treatingsorafenib-resistant hepatoma.

Family History of Cancer and Head and Neck Cancer Risk in a Chinese Population

Huang, Yu-Hui Jenny,Lee, Yuan-Chin Amy,Li, Qian,Chen, Chien-Jen,Hsu, Wan-Lun,Lou, Pen-Jen,Zhu, Cairong,Pan, Jian,Shen, Hongbing,Ma, Hongxia,Cai, Lin,He, Baochang,Wang, Yu,Zhou, Xiaoyan,Ji, Qinghai,Zho Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: The aim of this study was to investigate whether family history of cancer is associated with head and neck cancer risk in a Chinese population. Materials and Methods: This case-control study included 921 cases and 806 controls. Recruitment was from December 2010 to January 2015 in eight centers in East Asia. Controls were matched to cases with reference to sex, 5-year age group, ethnicity, and residence area at each of the centers. Results: We observed an increased risk of head and neck cancer due to first degree family history of head and neck cancer, but after adjustment for tobacco smoking, alcohol drinking and betel quid chewing the association was no longer apparent. The adjusted OR were 1.10 (95% CI=0.80-1.50) for family history of tobacco-related cancer and 0.96 (95%CI=0.75-1.24) for family history of any cancer with adjustment for tobacco, betel quid and alcohol habits. The ORs for having a first-degree relative with HNC were higher in all tobacco/alcohol subgroups. Conclusions: We did not observe a strong association between family history of head and neck cancer and head and neck cancer risk after taking into account lifestyle factors. Our study suggests that an increased risk due to family history of head and neck cancer may be due to shared risk factors. Further studies may be needed to assess the lifestyle factors of the relatives.

Prevalence and Factors Associated with Oral Pre-Malignant Lesions in Northeast Thailand

Juntanong, Narongrit,Siewchaisakul, Pallop,Bradshaw, Peter,Vatanasapt, Patravoot,Chen, Sam Li-Sheng,Yen, Amy Ming-Fang,Chen, Tony Hsiu-Hsi,Promthet, Supannee Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

Background: Oral cavity cancer (OCC) is one of the most common cancers worldwide. No studies have reported on the prevalence and epidemiologic risk factors of oral premalignant lesions (OPLs) in Thailand. The purpose of this study was to investigate the prevalence of OPLs and associated factors in Roi Et Province, Thailand. Materials and Methods: To investigate the prevalence of OPLs, a cross-sectional descriptive study was conducted in which 2,300 subjects over 40 years of age were recruited and screened for the prevalence of OPLs. To identify factors associated with OPLs, a matched case-control study was used in which the subjects were 102 cases with OPL and 102 matched controls without OPLs. The studies were conducted in Roi Et Province during the period 1 February, 2014, to 30 April, 2014, and the data were collected by the use of a structured interview questionnaire and by extraction of information from medical records. Data analyses involved the use of descriptive statistics, McNemar's test, and conditional logistic regression. Results: The overall prevalence of OPLs was 3.8%, and no-one was diagnosed with more than one type of OPL. The factors found to be associated with a statistically significant higher risk of an OPL were betel nut chewing, smoking, and alcohol consumption. The associations with these factors were strong, especially for betel nut chewing and smoking. Conclusions: The habits of betel nut chewing, smoking, and alcohol use are confirmed as factors associated with OPLs in a population of Roi Et Province, Thailand. Campaigns to reduce such risk healthy behaviour are needed, but whether any actual decrease will prevent the eventual transformation of an OPL into an OCC remains an open question.

Sustainable synthesis and characterization of a bisphenol A-free polycarbonate from a six-membered dicyclic carbonate

Wang, Pengrui,Park, Ji Hoon,Sayed, Mahmoud,Chang, Tae-Sun,Moran, Amy,Chen, Shaochen,Pyo, Sang-Hyun The Royal Society of Chemistry 2018 Polymer chemistry Vol.9 No.27

<P>A bisphenol A (2,2-bis(4-hydroxyphenyl)propane, BPA)-free polycarbonate (PC) from a six-membered di-cyclic carbonate, di-trimethylolpropane di-cyclic carbonate (DTMPC), was developed as a new type of PC by ring opening homo-polymerization. The polymerization was controlled by using metal-free organic-based catalyst systems. The results indicated that the conversion rate depends on the basicity of the catalyst in the order of 1,5,7-triazabicyclo[4.4.0]dec-5-ene (TBD), 1,8-diazabicyclo[5.4.0]undec-7-ene (DBU), 4-dimethylaminopyridine (DMAP), and triethylamine (TEA) from high to low. Over 99% conversion of DTMPC was obtained at 130 °C within 15 min by TBD, DBU and DMAP. The resulting PC as a homo-polymer showed high optical transparency and hardness, low swelling property in organic solvents, and thermal stability at temperatures as high as 200 °C. A high cell viability and cyto-compatibility of C3H 10T1/2 cells seeded directly on the surface of PC films were obtained. This implied that PC is a viable material for biomedical and consumer products applications where safety is an important consideration.</P>