Dermal nipple-areola complex flap method in female to male gender affirming surgery

Subcutaneous mastectomy plays a major role in female to male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola complex (NAC) flap, with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularisation. This case report describes how the novel approach may potentially be applied as an alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The technique is simple, provides an aesthetically appealing outcome and presumably poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or resizing of the NAC where required.

Preface

2021 International Conference on Electron Devices and Applications (ICEDA 2021) was held online during August 14-16, 2021. Due to the evolving public health concerns and travel advisories issued for the avoidance of non-essential travel in view of COVID-19, the conference ICEDA 2021 has been held virtually with about 37 guests hosted on Zoom video conference platform. It was a fully synchronized online conference that had live Q&A, participants jointly listened to presentations, and attended other live events associated with the conference. The conference program was organized in 5 sessions, with 7 plenary and 37 specialized papers presented. Scientists from China, Russia, Thailand took part in the scientific forum. Each plenary speech lasted for 30 minutes, including 5 minutes for Q&A while for other sessions, there was 15 minutes for each presentation, including 2 minutes for Q&A. The interaction session was real experience to the participants and they had good exposure with foreign researchers, students and other delegates. The objective of ICEDA was to provide a platform for engineers, scientists and industrial partners to discuss and disseminate recent research findings in wide aspects of theoretical, experimental, and practical electron devices and applications fields. Professionals, experts, and scholars from various engineering disciplines were invited to share experiences, innovations, achievements and knowledge. The conference brought together academics, researchers, and practitioners with the aim of bridging the gap between theory and practice in all electron devices aspects. All papers in this proceeding were subject to peer-review by conference committee members and international reviewers. The papers were selected for the proceedings based on quality and relevance to the conference. We express our gratitude to the Organising Committee for its valuable contribution to this successful edition of ICEDA 2021. W e also express our sincere gratitude to all people who contributed to the review process and did all their best to enhance the scientific merit and quality of the Proceedings. We are also grateful to the authors for their contributions, to the speakers and participants of the ICEDA 2021. W e wish to extend our warmest welcome to all interested participants to the next ICEDA 2022. Prof. Wei Lei Southeast University, China List of titles ICEDA Committees, Statement of Peer Review are available in this Pdf.

Innovative techniques of left atrial exposure in minimally invasive mitral valve repair

Various atrial retractors have been developed to achieve optimal exposure of mitral valve in minimally invasive surgery. We introduce our technique of only using retraction sutures to expose mitral valve. This method is simple, efficient, and provides good exposure of the left atrium without causing traumatic injury.

Superior mediastinal tumour excision through upper partial sternotomy and chamberlain incision

Superior mediastinal mass excision can be performed by various approaches such as partial sternotomy, mini trapdoor incision, anterior cervical transsternal approach and lateral thoracotomies. However, adequate exposure especially of superior surface seems to be difficult. Total four patients of superior mediastinal mass were admitted in the department of cardiothoracic and vascular surgery, Safdarjung hospital, New Delhi between June 2019 to May 2021. All of them were operated by upper partial sternotomy with right or left chamberlain extension of incision. It is safe and effective in terms of exposure with early recovery as well as cosmesis. Hence, we advocate the use of upper partial sternotomy with left or right chamberlain incision which provides good exposure in addition to ease of patient position, vascular control and emergency institution of cardiopulmonary bypass.

First molar extractions related to molar-incisor hypomineralization (MIH) in a special need patient: case report

Although most orthodontists avoid extractions, treating patients with biprotrusion traditionally involves removing teeth. In the current case report, a 15-year-old deaf patient had a Class II molar and canine relationships, 8 mm overjet and 3mm overbite, 3 mm of a discrepancy between U/L midline, crowding in both arches (3 mm in the upper and 7 mm in the lower). The first right upper molar (16) and the first right and left lower molars (36 and 46) were severely MIH affected. Extraction of the first four molars was proposed, since a large amount of space was required and three of the four molars were very compromised with severe MIH. Tooth 26 was extracted to maintain the symmetry of the arch and because the extraction of a premolar would not allow for alignment associated with class II correction of canines on the left side. During the closure of the extraction spaces, upper and lower third molars eruption was observed, in an appropriate position. Facial analysis shows us the coincidence of the upper midline with the face and good exposure of the incisors in the smile. There was considerable reduction of overjet and dental protrusion, enabling passive lip sealing. A perfect fit of the Class I superior teeth was not obtained since the patient considered that the treatment was already very good and did not want to collaborate with hygiene and the use of orthodontic appliances for more time.

PETROGENETIC MODELING OF THE GRANITIC ROCKS IN AND AROUND LODHMA, DIST RANCHI, JHARKHAND, INDIA

The Lodhma area, in the Ranchi district, constitutes the central segment of Chotanagpur Granite Gneissic Complex ( CGGC) and falls in the northeastern segment of Survey of India toposheet number 73E/4. The CGGC is mainly composed of variants of granitic rocks, amphibolites and metasedimentaries. The granitic rocks find good exposure in the area. They comprise predominantly of granite gneisses, crystalline massive granites and migmatites showing noticeable variations in mineralogy, texture, structure and associations. The regional strike of the lithounits of the area show almost E-W trend. However ambient structural controls have brought about local changes in the strike direction. The area has witnessed at least three phases of deformations which is reflected by three generations of folds, which are generally isoclinals. Petrogenetic characterization of granitic rocks and its variants in the area has been attempted using various geochemical tools involving major/ trace element studies and Niggli values. S –type parentage of these Granites have been established on the basis of distribution behavior of various chemical components present in it, thereby indicating role of pelitic schists in the generation of anatectic melt, which ultimately crystallized into granites. S-type lineage of these granites has also been further cemented with the help of several well established binary and ternary variation diagrams

Microsurgical Resection of Dorsal Pontine Cavernous Malformation: The Telovelar Approach Augmented by the Tonsillouvular Fissure Exposure: 2-Dimensional Operative Video

Surgical approaches to lesions of the fourth ventricle (FV) have been modified over the years to reduce the complications associated with splitting the inferior cerebellar vermis (ICV) and disrupting the brainstem and critical surrounding structures.1-4 Two common approaches to lesions of this region include the transvermian approach (TVA) and telovelar approach (TeVA).2 The TVA was initially considered the conventional route of access to lesions of the FV1 but has been associated with significant risks, including possible gait ataxia and dysarthria.3 The TeVA is advantageous, as it involves dissection along natural clefts and division of non-neural tissue and provides good exposure of the superolateral recess with modest exposure of the rostral FV. The TeVA approach can be augmented by opening the tonsilouvular fissures (TUFs). This added dissection allows greater lateral and superior exposure with less need for retraction. In this operative video, we demonstrate a case in which we augmented the TeVA with a TUF dissection to access a dorsal pontine cavernous malformation. We performed a midline suboccipital craniotomy with a C1 posterior laminectomy. TUF dissection was followed by division of the tela choroidea (TC), which allowed for more lateral exposure of the FV and excellent visualization of the cavernous malformation without the need to traverse neural tissue. TeVA augmented by TUF dissection provided adequate access to the dorsal pons for complete resection of the cavernous malformation. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication. Anatomic images provided by courtesy of © The Rhoton Collection. http://rhoton.ineurodb.org/. Video © Mayo Foundation for Medical Education and Research, 2021. Used with permission.

Physiological Profiles of Hair and Scalp Conditions in Korea Population: Servey, Hairological Expert-Diagnosis and New Diagnostic Device

Many devices have been widely used to diagnose various skin and scalp disorders. However, existing devices may show few results of measurement contents or inaccuracy of results or inconvenience of use. In this study, two hundreds and forty Korea participants from whole South Korea were enrolled, conducted servey by self-questionnaire, diagnosed scalp type by hairological expert and diagnosed systemically hair and scalp conditions by APM PRO200 device. As the results, women is 70.7% and <20 ages were 99 (41.3%). The most subjects treated with shampoo 1 time per day (65.4%) and didn’t have the dyeing (80.0%). The most frequent was A scalp type (41.7%) in hairological expert-diagnosis. The subjects of 46.3% had mild damage of hair cuticle, good exposure of sclap’s vessel (87.1%), good hair density (78.3%), hair loss status of W type (68.3%), sensitive hair pore status (26.3%), good hiar thickness (91.7%), bad corneous of scalp (47.5%) and scalp status (22.9%) status in diagnosis by APM PRO200 device. In anaysis of relationship between self-questionnaire and physiological profiles of hair and scalp conditions diagnosed by APM PRO200 device, exposure of scalp’s vessel, hair loss status and hair pore status showed significant difference by sex and cuticle status, hair density, hair pore status, corneous of scalp and scalp status showed significant difference by age. Therefore, the diagnosis of hair and scalp conditions can be really facilitated by the APM PRO200 device.

INFLUENCE OF ANAMBRA BROADCASTING SERVICE SLOGAN “DOBE ANAMBRA OCHA” ON AWKA RESIDENTS’ ATTITUDE TOWARDS ENVIRONMENTAL SANITATION

This study entitled Influence of Anambra Broadcasting Service Slogan “Dobe Anambra Ocha” on Awka Residents’ Attitude towards Environmental Sanitation investigatedwhether residents of Awka Metropolishas answered the clarion call contained in the slogan meant to sensitise them to keep their environment clean at all times. Specific objectives of the study among others are to: assess respondents’ frequency of exposure to ABS slogan “Dobe Anambra Ocha;” ascertain whether the ABS slogan “Dobe Anambra Ocha” is effective in sensitizing the residents about environmental sanitation; find out the respondents’ attitude towards the ABS slogan “Dobe Anambra Ocha;” determine whether the ABS slogan “Dobe Anambra Ocha” has helped residents in maintaining good environmental sanitation. The study was anchored on the Theory of Planned Behaviour (TPB). The survey research design was used in carrying out the study. A sample size of 399 was selected from the population of Awka Metropolis using the Taro Yamani’s sample size determination formula. The questionnaire was the instrument used in collecting data for the study. Data generated from the study were presented in statistical table with frequency and simple percentage used in analyzing the data. Results of the analysis showed among others that: 74.9 percent of the respondents had very good exposure to the ABS slogan “Dobe Anambra Ocha”, 73.6 percent attested to the effectiveness of the slogan in sensitizing the residents to keep their environment clean at all times, the respondents had a very positive attitude towards the ABS slogan “Dobe Anambra Ocha”. The study recommended among others that: Credible information is required to attract the needed response in a radio health campaign, such as with the ABS slogan “Dobe Anambra Ocha.” Messages aired continually and consistently can reach many or more persons and are capable of changing the attitude of the residents to comply with safety measures as required. It means that programming/slogan is of essence in order to reach the intended target audience with the required and relevant message. ABS should intensify the campaign/slogan to ensure that the remaining audiences who still have negative attitude towards “Dobe Anambra Ocha” heed the message to keep their environment clean.

The Dermal Nipple-Areola-Complex Flap Method in Female-to-Male Gender Affirming Surgery

Background:Subcutaneous mastectomy (SCM) plays a major role in female-to-male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola-complex (NAC) flap with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularization.Methods:Through a horizontal incision, a superior thoracic full skin flap was elevated at the dissection plane for mastectomy. The mastectomy was continued inferiorly, creating an inferior flap including the NAC. The surface of the inferior flap was deepithelialized, secluding the NAC, which allowed the inferior dermal flap to be inserted posterior to the superior flap. A circular defect was created in the superior flap, into which the NAC was sutured.Results:The surgery delivered satisfactory results with an aesthetically pleasing masculine appearance and a high level of patient satisfaction. We were able to place the horizontal scars inferiorly along the pectoral muscles, which enabled some camouflage. Additionally, the inferior flap provided a uniform filling effect to the chest, further contributing to the male aesthetic. There were no NAC complications.Conclusion:The dermal NAC flap method could be applied as an excellent alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The method is simple, provides an aesthetically appealing outcome, and poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or reduction of the NAC where required.