Austin D. Chen

Sliding-strip microfluidic device enables ELISA on paper

This article describes a 3D microfluidic paper-based analytical device that can be used to conduct an enzyme-linked immunosorbent assay (ELISA). The device comprises two parts: a sliding strip (which contains the active sensing area) and a structure surrounding the sliding strip (which holds stored reagents—buffers, antibodies, and enzymatic substrate—and distributes fluid). Running an ELISA involves adding sample (e.g. blood) and water, moving the sliding strip at scheduled times, and analyzing the resulting color in the sensing area visually or using a flatbed scanner. We demonstrate that this device can be used to detect C-reactive protein (CRP)—a biomarker for neonatal sepsis, pelvic inflammatory disease, and inflammatory bowel diseases—at a concentration range of 1–100 ng/mL in 1000-fold diluted blood (1–100 µg/mL in undiluted blood). The accuracy of the device (as characterized by the area under the receiver operator characteristics curve) is 89% and 83% for cut-offs of 10 ng/mL (for neonatal sepsis and pelvic inflammatory disease) and 30 ng/mL (for inflammatory bowel diseases) CRP in 1000-fold diluted blood respectively. In resource-limited settings, the device can be used as a part of a kit (containing the device, a fixed-volume capillary, a pre-filled tube, a syringe, and a dropper); this kit would cost ~

The Impact of Hering's Law in Blepharoptosis: Literature Review.

0.50 when produced in large scale (>100,000 devices/week). This kit has the technical characteristics to be employed as a pre-screening tool, when combined with other data such as patient history and clinical signs.

Abstract: Surgical Site Infection in Immediate Breast Reconstruction: Does Chemotherapy Timing Make a Difference?

AbstractThe aim of this literature review is to examine Hering’s law, a well-documented phenomenon in blepharoptosis patients, with 10% to 20% noted in cases of unilateral ptosis. Predominantly presenting as contralateral eyelid drop postoperatively, it poses a challenge for eyelid surgeons in the pursuit of symmetry and appropriate eyelid height. Proper preoperative evaluation is of utmost importance, consisting of one of either lifting test, covering test, or phenylephrine test. A deeper understanding of Hering’s law further provides adequate information for optimal management of ptosis. In regard to ptosis etiology, congenital ptosis does not appear to have a distinct relation to positive Hering’s law, commonly associated with a low incidence, when compared with acquired ptosis. Ptosis in the dominant eye seems to be related to a higher incidence of the phenomenon than ptosis in the nondominant eye, with statistical significance in studies ranging from P < 0.001 to P = 0.09. This can be explained as an innate response for increased innervation to regain the field of vision. Both ptosis severity and levator function appear to be of lesser importance than ptosis etiology, with minimal incidence of Hering’s law in congenital ptosis regardless of these factors. It is, however, noted that ptosis severity has direct association with contralateral eyelid position in acquired ptosis, whereas there is a lack of studies for levator function. In the event of preoperative contralateral eyelid drop, surgeons should consider simultaneous surgery instead of delayed surgery for bilateral ptosis (P = 0.002). For unilateral ptosis, although reoperation is done per patient request, it may be more appropriate to first wait for roughly 2 weeks and reassess for self-regulation to a normal eyelid position.

The love surrounding the first skin graft in Taiwan: "British skin" that will stay in Taiwanese hearts.

We aim to analyze the impact of chemotherapy timing on surgical site infections (SSI) after immediate breast reconstruction (IBR).

Abstract: The Impact of Resident Post Graduate Year Involvement in Body Contouring Procedures

There is a painting that looks like a representation of a simple surgical procedure. However, it holds a warm story of the love surrounding the first skin graft made by Dr. David Landsborough III for a Taiwanese child in 1928. He harvested the donor skin from his wife, Marjorie Landsborough, to save a poor boy. Although the grafted skin could not grow onto the wound, the graft of love was permanently imprinted on Taiwanese Peoples hearts. The first Taiwanese recipient of MD, PhD degree, Dr. Tsung-Ming Tu invited an artist to recreate and draw the surgical procedure to immortalize the unforgettable love and memory of Dr. Landsborough III. The painting hanging on the hospital wall portrays an important professional role model for every student and health care provider. The life story of this medical missionary in Formosa from 1895 to 1936 contributed greatly to the development of medical care in Taiwan. It is hoped that this story, outlining great love and selflessness, can be glorified and remembered for the world to appreciate for generations to come.

National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program

CONCLUSION: It is undeniable that Plastic Surgeons play a role in the propagation of the opioid epidemic and it is our moral obligation to implement strategies to curb our contribution. We have shown that knowledge deficits do exist among trainees and that trainees are significantly less comfortable than their attending counterparts with opioid prescribing and patient management. Therefore, the implementation of more thorough post-operative pain management education in residency may be a cogent strategy in mitigating the opioid crisis.

Abstract: Syndactyly: National Analysis of Trends in Epidemiology and Surgical Management from 1997–2012

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005–2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

Abstract: Institutional Diversity in Academic Plastic Surgery: A Collaborative Solution to Resource Limitations

Ten patients in the neurofibroma group and seven in the schwannoma groups responded to a post-operative survey. There were no significant differences for any responses. Both groups reported improvement in post-operative quality of life (p=0.7806), no regret with surgery (p=1.000), and a positive proclivity towards proceeding with surgery for potential future peripheral nerve tumors (p=0.8029).

Abstract: Referrals of Plastic Surgery Patients to Integrative Medicine Centers: A Review of Resource Utility

RESULTS: From 2000–2013 the proportion of female surgeons among all female physicians has remained constant at 12–13%. The ratio of femaleto-male surgeons and residents has increased over time in all surgical specialties. While females outnumber males in one surgical specialty (obstetrics and gynecology), the female-to-male ratio in neurosurgery, orthopedic surgery, and thoracic surgery is 1:10 or higher. This discrepancy is lower among resident physicians (1:6 or lower). Presently, the female-to-male ratio of practicing surgeons in plastic surgery is approximately 1:5 with a smaller discrepancy among plastic surgery residents (integrated: 1 to 1.5; independent: 1 to 3.0). The proportion of Asian female surgeons has increased across all specialties.

Abstract: Predictors of Hospital Costs in the Self-Pay Rhytidectomy Patient: Analysis of 1,890 Patients

INTRODUCTION: The evaluation and management of emergency department (ED) consults is an essential competency in plastic surgery residency. Trainees usually perform these duties under indirect attending supervision. However, no formal curriculum exists to prepare trainees for the requirements of on-call coverage and there is minimal literature on the frequency and nature of ED consults requiring plastic surgery evaluation. The purpose of this study is to determine the most common consults and procedures necessitating ED plastic surgery management in an effort to prepare trainees, prior to on-call coverage, in the core diagnostic and procedural skills required in the ED.