• Title/Summary/Keyword: Combined graft

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Combined Treatment of Stromal Vascular Fraction and Ablative Fractional CO2 Laser for Hypertrophic Foot Scar

  • Kim, Dong Gyu;Park, Eun Soo;Kim, Seok Hwan
    • Medical Lasers
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    • v.8 no.2
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    • pp.90-93
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    • 2019
  • The treatment of keloid and hypertrophic scars (HTSs) remains one of the most difficult challenges, with a high recurrence rate regardless of the method of treatment. The latest trend in scar management is a combined approach using multiple modalities that are individualized to the patient and that would provide successful results for keloid and HTSs. There are previous reports that stromal vascular fraction (SVF) is effective for scar remodeling. Based on these reports, we introduced the concept of a combination treatment using SVF injection and fractional ablative CO2 laser. In this report, we present a 21-year-old woman who was involved in a car accident. A defect on her foot was covered with a skin graft, but the scars became elevated, which turned out to be HTSs. She was treated with a fractional ablative CO2 laser for five sessions. A month later, SVF injection and fractional ablative CO2 laser were conducted simultaneously. The result of a year's follow-up showed a flattened scar with resolution of pigment deposition. In conclusion, the combination treatment for HTSs with SVF injection and ablative fractional CO2 laser is one of the modalities to achieve an excellent outcome for treating HTS.

A Case of Orthognathic Surgery in Congenital Alveolar-Palatal cleft patient (구순 및 구개열을 가진 상악 후퇴증 환자의 교정-외과적 치험 1례)

  • Park, Jae-Hyun;Lee, Myung-Jin;Lee, Chang-Kon;Kim, Jong-Sub;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.189-196
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    • 1992
  • Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

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Healing Effects of Demineralized Freeze - Dried Bone Allograft and Deproteinized Bovine Bone Mineral on Periodontal Fenestration Defect in Rats (탈회 동결 건조골과 탈단백 우골의 백서 치조골 천공결손에 대한 치유 효과)

  • Shin, Joong-Ho;Kwon, Young-Hyuk;Park, Jun-Bong;Herr, Yeek
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.73-91
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    • 2001
  • The present study was performed to compare effects of demineralized freeze-dried bone allograft(DFDBA) with deproteinized bovine bone mineral(DBBM) on periodontal fenestration defect in rats. Twelve adult male rats weighing 500 to 540 grams were used in this study. Periodontal fenestration defects were surgically created with tapered fissure bur(${\Phi}1mm$) at the left side of buccal surface of the mandible. The defect size was from anterior border of the first molar to anterior of the ascending ramus mesiodistally and from just below the alveolar crest to apically 1.5-2mm area apicocoronally with 2mm in depth. Rats were divided into control group, test group I and II. Four defects were assigned to the test group I grafted with DBBM and other 4 defects were assigned to the test group II grafted with DFDBA. The rest of defects were the negative control group. At 10 days and 35 days after surgery, 12 rats were sacrificed through intracardiac perfusion and specimens were obtained prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. In the control group, new bone, osteoid, dense connective tissue were observed in the defects at 10 days. new bone formation was not found but loose connective tissue was formed in the defect and fibrous encapsulation of graft materials was shown in two test groups at 10 days. 2. In all groups, new bone formation was shown in the defect at 35 days. And in the control group, bone formation increased at 35 days than at 10 days. 3. In the test group I and II at 35 days, graft materials were combined with new bone and joined host bone. There was very close contact between new bone, graft materials, and host bone with no gaps. 4. In the test group I and II, new bone formation was similar to that in the control group but not exeeded. In conclusion, in the test group I new bone formation was similar to that in the test group II at 35 days, but there was infiltration of inflammatory cells at 10 days. DFDBA and DBBM were considered as the biocompatible graft materials and effective in the regeneration of new bone.

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Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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A cumulative survival rate of implants installed on posterior maxilla augmented using MBCP after 2 years of loading: A retrospective clinical study (MBCP를 이용하여 거상된 상악 구치부에 식립한 임플란트의 기능 후 2년 누적 생존율 - 후향적 임상 연구)

  • Kim, Min-Soo;Lee, Ji-Hyun;Jung, Ui-Won;Kim, Chang-Sung;Choi, Seong-Ho;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.669-678
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    • 2008
  • Purpose: The purpose of this study was to evaluate 2 years cumulative survival rate of implants on augmented sinus area using MBCP, mixture of MBCP and ICB, and mixture of MBCP and autogenous bone by means of clinical and radiologic methods. Materials and Methods: In a total of 37 patients, 41 maxillary sinuses were augmented and 89 implant fixtures were installed simultaneously or after a regular healing period. The patients were divided in 3 groups: MBCP only, MBCP combined with ICB, MBCP combined with autogenous bone. After delivery of prosthesis, along 2 years of observation period, all implants were evaluated clinically and radiologically. And the results were as follows. Results: The results of this study were as follows. 1. A 2 year cumulative survival rate of implants placed with sinus augmentation procedure using MBCP was 97.75%. 2. Survival rate of implants using MBCP only was 97.62%, MBCP and ICB was 100%, MBCP and autogenous bone was 95%. There was no statistically significant difference between 3 groups. 3. Only 2 of 89 implants were lost before delivery of prosthesis, so it can be regarded as an early failure. And both were successfully restored by wider implants. Conclusion: It can be suggested that MBCP may have predictable result when used as a grafting material of sinus floor augmentation whether combined with other graft(ICB, autogenous bone) or not. And the diameter, length, location of implants did not have a significant effect on 2 year cumulative survival rate.

Additional use of autogenous periosteal barrier membrane combined with regenerative therapy in the interproximal intrabony defects: case series (치간부 골내낭의 치주재생치료에서 골막이식의 부가적 사용 증례)

  • Kim, Hyun-Joo;Kim, Hyung-min;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.230-237
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    • 2017
  • Regenerative therapy in an interproximal intrabony defect is a challenge due to unaesthetic appearance after surgery. In this article, we introduce a case series of additional use of autogenous periosteal barrier membrane combined with bovine bone mineral and enamel matrix derivative (EMD) in interproximal periodontal intrabony defects to overcome an aforementioned shortcoming. During the periodontal regenerative surgery, autogenous periosteal membrane was additionally adopted besides xenograft material and EMD. Clinical and radiographic examinations were performed before surgery and 6 months after surgical treatment. All clinical parameters were improved and the intrabony defects were resolved on the radiography 6 months after surgery. Moreover, soft tissue esthetics such as the contour of interdental papilla was better than that of conventional regenerative therapy. Periodontal regenerative therapy using several graft materials and bioactive materials was effective in the treatment of periodontal intrabony defect. Moreover, using of autogenous periosteal barrier membrane combined with xenograft and EMD has additional effect for the treatment of an interproximal intrabony defect in terms of augmentation of interdental soft tissue volume.

Complete Transposition of Great Arteries Combined with VSD and Pulmonic Stenosis (S.D.D.) -One Case Report- (대혈관전위증 (S.D.D.) 치험 1례)

  • 강면식
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.207-214
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    • 1979
  • This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.

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Anomalous Arterial Supply to the Serratus Anterior Muscle (전방거근으로 분지되는 혈관경의 해부학적 변이 증례보고)

  • Goh, Tae Buhm;Lee, Jong Wook;Koh, Jang Hyu;Seo, Dong Kook;Choi, Jai Koo;Jang, Young Chul
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.487-490
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    • 2008
  • Purpose: The latissimus dorsi flap and the serratus anterior flap have been used as combined flaps to reconstruct extensive defects. Because these two muscles are usually supplied by the subscapular-thoracodorsal vessels, the two flaps can be based on vascular pedicle that is long and anatomically reliable. In this case, we reported that serratus anterior possessed an anomalous arterial supply totally independent from the subscapular pedicle while raising combined latissimus dorsi and serratus anterior flap. Methods: A 35-year-old male with extensive soft tissue defect in the left perineum and thigh visited. Muscle defects of the medial thigh were observed, and femoral nerve and vessels were exposed. Combined latissimus dorsi and serratus anterior free flap was raised to reconstruct defect. On raising flaps, artery supplying the serratus anterior muscle originated from the axillary artery directly, was lying on the undersurface of the serratus anterior muscle. Results: Because two flap pedicles had no communication and latissimus dorsi muscle was large enough to cover soft tissue defect, we transferred only latissimus dorsi free flap with 1 : 3 meshed skin graft. Patient had limb salvage and satisfactory functional outcome. Conclusion: There are many variations of arterial pedicles of flaps. However, most of these variations remain within known anatomical consistence, thus is an indicator in planning the dissection of the vessels. According to documents, arterial pedicle to the serratus muscle not originated from the thoracodorsal artery is rarely reported, and in most of these cases, the arteries are originated from the subscapular artery. Thus pedicle directly originated from the axillary artery to serratus muscle is a very rare variation in its vascular anatomy.

Surgical Treatment of Pulmonary Atresia with VSD - A Report of 2 Cases - (심실중격결손증을 동반한 폐동맥 폐쇄증 [Pulmonary Atresia] 의 외과적 치료-2예 보고-)

  • 강면식
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.780-785
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    • 1987
  • Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

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Effects of High-Intensity Ultrasound & Supercritical Nitrogen on PP-MA Reactive Extrusion

  • Sohn, Chang-Hee;Shim, Dong-Chul;Lee, Jae-Wook
    • Proceedings of the Polymer Society of Korea Conference
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    • 2006.10a
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    • pp.369-369
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    • 2006
  • Compatibilizers contribute to many processes in polymer industry, such as manufacturing polymer blends and composites. They are usually designed to be block or graft form which is combined in polar and non-polar parts in the first synthesis process level, for example, the general form of maleic anhydride (MA) as a compatiblizer is a grafted counterpart. However, the process of making the compatibilizer is related to the first synthesis level and it has some problems, such as high cost, poor processability, limitation on use and properties, and so on. So, in order to improve its poor processability and overcome the limitation on use, we developed compatibilizers which have various chemical forms by high intensity ultrasound and super critical fluid nitrogen in polymer melt reactive extrusion.

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