• 대한족부족관절학회지
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• 제15권4호
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• pp.201-206
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• 2011

Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.

• Journal of Chest Surgery
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• 제57권1호
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• pp.99-102
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• 2024

This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.677-685
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• 2015

Background The survival rate of grafted fat is difficult to predict, and repeated procedures are frequently required. In this study, the effects of the freezing period of harvested adipose tissue and the addition of human adipose tissue-derived stem cells (ASCs) on the process of fat absorption were studied. Methods Adipose tissue was obtained from patients who underwent a lipoaspirated fat graft. The fat tissue was cryopreserved at $-20^{\circ}C$ in a domestic refrigerator. A total of 40 nude mice were used. The mice in the experimental group received three different subcutaneous injections in the back: an injection of fresh fat and ASCs, an injection of fat that had been frozen for one month and ASCs, and an injection of fat that had been frozen for two months and ASCs. The control mice received fat grafts without ASCs. The mice were sacrificed at four or eight weeks after the procedure, and the grafted fat tissues were harvested. The extracted fat was evaluated using photographic analysis, volume measurements, and histological examination. Results In the control group, the fat resorption rates four weeks after transplantation in the grafts of fresh fat, fat that had been frozen for one month, and fat that had been frozen for two months were 21.14%, 22.46%, and 42.56%, respectively. In the experimental group, the corresponding resorption rates were 6.68%, 13.0%, and 33.9%, respectively. Conclusions ASCs can increase the fat graft survival rate. The use of ASCs in fat grafting can reduce the need for repeated fat grafts and provide good long term results.

• Journal of Chest Surgery
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• 제42권3호
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• pp.375-379
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• 2009

원위부 대동맥궁에 발생한 대동맥류에 대한 수술을 위해서는 정중흉골 절개술 또는 측방개흉을 통한 수술방법이 있으나 문합 부위의 시야 확보가 용이하지 않은 경우가 자주 있다. 수술 대신 중재시술로 스텐트 그라프트를 삽입하는 방법 또한 가능하지만 동맥류보다 근위부에 충분한 고정 거리를 확보하기 위해서 대동맥궁 분지 일부를 결찰하고 우회로를 조성해야 할 필요가 있다는 제한이 있다. 저자들은 이들 방법의 장점을 취하고자 정중흉골절개술 후 완전 순환 정지 상태에서 대동맥궁을 치환하는 수술 중 외과적 문합 대신 스텐트 그라프트를 이용하여 인조혈관 원위부를 고정하는 방법을 취하여 양호한 결과를 얻은 경험을 보고한다.

• Journal of Chest Surgery
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• 제49권4호
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• pp.298-301
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• 2016

Thoracic endovascular aortic repair (TEVAR) has emerged as an effective therapy for a variety of thoracic aortic pathologies. However, various types of endoleak remain a major concern, and its treatment is often challenging. We report a case of type I endoleak occurring 19 months after zone II hybrid TEVAR. The endoleak was successfully repaired by the frozen elephant trunk technique, without removal of a previous stent graft, combined with ascending aorta and total arch replacement.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.435-448
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• 2006

The purpose of this study was to investigate the effects of ICB(Irradiated frozen allogenic bone, Rocky Mountain Tissue Bank, USA) and MTF(Decalcified freeze-dried bone allograft, Musculoskeletal Transplant Foundation, USA) on the cell proliferation and differentiation of human fetal osteoblasts. Human fetal osteoblasts (hFOB1) were cultured with $10\;ng/m{\ell}$of ICB and MTF. The negatvie control group was cultured with DMSO and positive control group was cultured with BMF ($2\;ng/m{\ell}$). MIT was performed to examine the viability of the cell, and alkaline phosphatase activity was analyzed to examine the mineralization. Calcium accumulation was also evaluated. ICB and MTF did not increase the rate of the cellular proliferation of hFOB1s while they enhanced ALP and calcium accumulation. The expression of osteocalcin (OC) and bone silaloprotein (BSP) increased in hFOB1 treated with ICB and MTF ($10\;ng/m{\ell}$). These results suggest that ICB and MTF stimulate osteoblastic activity of the hFOBl.

• 대한관절경학회지
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• 제11권2호
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• pp.111-116
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• 2007

서론: 전방 십자인대 손상 환자에서 신선 동결 동종 아킬레스건을 이용하여 관절경적 전방 십자인대 재건술을 시행 후 임상적 결과와 이차 관절경 소견을 평가하고자 한다. 대상 및 방법: 1998년 3월부터 2003년 2월까지 전방 십자인대 손상 환자에 대하여 동종 아킬레스건을 이용하여 재건술을 시행 후 1년 이상 추시가 가능하였던 28예를 대상으로 하였다. 평균 연령은 3 1.2세였고, 평균 추시 기간은 16.6개월(범위: $12{\sim}26$개월)이었다. 수술 후 평가는 Lysholm 슬관절 점수, 관절 운동범위, Lachman 및 pivot-shift 검사, KT-1000 관절계를 통한 최대 도수 전위 검사상 차이를 측정하였다. 수술 후 1년 이상 경과 한 환자 중 8례에서 이차 관절경 검사를 하였다. 결과: 최종 추시 시 Lachman 검사는 정상 21례, 1등급 5례, 2등급 2례이었고, 3등급 1례가 있었다. Pivot shift 검사 상 정상 23례(82.1%), 1등급 4례(14.3%), 2 등급 1례(3.6%)로 호전을 보였다. 관절운동 범위에 제한이 있는 경우는 없었다. KT-1000 관절계를 이용한 최대 도수 전위 검사상 수술 전, 후 차이는 수술 전이 평균 6.75 mm였고, 수술 후 최종 추시 시 평균 2.46 mm였다. Lysholm 점수는 수술 전 평균73.5점에서 수술 후 평균 91.6점으로 호전되었다.(p<0.05). 합병증은 전방 십자 인대 재파열 1례, 경골부 이식건 고정부의 상처 감염 1례 있었다. 총 8례에서 이차적 관절경을 시행 할 수 있었으며, 검사에서 활액막 형성의 정도는 우수가 5례, 양호가 1례, 불량이 2례였다. 결론: 전방 십자인대 손상에서 신선 동결 동종 아킬레스건을 이용한 재건술을 시행하여 전방안정성을 회복할 수 있었으며, 2차 관절경 소견에서 양호한 활액막 형성을 확인할 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권4호
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• pp.370-380
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• 1991

This article is intended to study histopathological and immunohistochemical response after autogenous full-thickenss skin graft in rat. 12 male Sprague-Dawley rats were used as the experimental animals. A $1Cm{\times}1Cm$ skin(0.7mm diameter) was taken on the right inguinal area of the rat. Another full-thickeness skin graft($1Cm{\times}1Cm$) was taken from the left inguinal area of the rat. And it was transplanted to the right inguinal area of the rat. The left side wound was closed directly. Light microscopic observation was made at the postoperative $1^{\circ}3^{\circ}8^{\circ}16$ day, after the hematoxylin - Eosin staining of the 4u-thick paraffin embedded specimens and the immunoshitochemical staining of the 10u-thick frozen specimens with mouse anti-rat monoclone antibodies and ABC staining kit. The results were as follows. 1. Electromicroscopic studies revealed interstitial tissue bleeding of transplanted autogenous skin. The response was severe in the 1 day group after operation, moederate in 3 day group, mild in 8 day group, and almost resovled in the 16 days group. 2. Electromicrospic studied also revealed a mild monocyte response in the 3 day and 8 day group. A histiocytic infiltrate was observed. There was a mild response in the 3 day group and moderate response in the 8 day group. 3. Immunohistochmically studies revealed a few pan T cells in the 1 day group, mild appearance of pen T cells and cytotoxic T cells in the 3 day group, a moderate infiltrate of pan T cells and helper T cells in the 8 day group, and total resolution of pan T cells in the 16 day group. 4. According to these finding, a strong inflammatory response was observed around transplanted autogenous skin in the 3 & 8 day groups. In the 16 day group this response had resolved histopathologically and immunohistologically.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.385-392
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• 2008

Purpose: The most effective methods of harvesting, preparing, and injecting autologous fat grafts have been inconsistent and conflicting. With its limitation as resorption in fat grafting, handling various techniques affect adipocyte survival, and is crucial to optimizing its long-term survival. To improve graft survival, re-implantation of cryopreserved adipocytes was developed. In addition, adipocytes do not induce immune rejection in response to non-self lymphocytes in a mixed lymphocyte reaction. The purpose of this study is to analyze the changes in cryopreserved adipocytes so as to determine the most efficient long-term storage period, and to analyze the changes in cryopreserved allografted adipocytes so as to determine the efficacy of cryopreserved adipocytes allografting. Methods: Fat tissues were harvested from the inguinal and retroperitoneal fat pad of mice. After the centrifugation of the harvested fat tissues, they were disintegrated with collagenase. The adipocytes were obtained by centrifugation of the disintegrated fat tissues. The adipocytes were treated as follows: (1) They were examined for weight and then frozen at $-20^{\circ}C$(n=25). For four months, each five frozen samples were taken and examined for weight and histologic changes in the 1st week, the 1st month, the 2nd month, the 3rd month, and the 4th month, respectively. (2) The adipocytes were immediately frozen at $-20^{\circ}C$(n=125). For four months, five frozen samples were taken, and allografted in the same time period as above. Finally, for four months, five cryopreserved allografted adipocytes were taken and examined for histologic changes in the same time period as above. Results: (1) Significant weight changes and histologic findings with inflammatory and destructive changes were observed in the cryopreserved adipocytes in three months. (2) Significant fat necrotic changes in the histologic changes with Hematoxylin and eosin stain were observed in the cryopreserved allografted adipocytes since the first week, independent of the freezing period. Conclusion: The study results show that the adipocytes that were cryopreserved for more than three months underwent obvious weight reductions and necrotic changes, and the adipocytes that were allografted without freezing were viable for four months, but the cryopreserved allografted adipocytes had obvious necrotic changes since the first week regardless of the freezing period.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.199-210
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• 1993

Many surgeons are on the point of bone excision and reconstruction of the bone defects by autograft. xenograft, and allograft in the treatment of begin and malignant tumors of bone. Of all type of bone grafts, we received the autograft as the best ideal bone graft. Of autogenic bone graft, replantation of excised autogenic bone for reconstructiong the bone defects has been the ideal method until now, but early bone healing reponses and tumor cell devitalization after replantation of excised autogenic bone have not been identified for clinical applications. So, to evaluate bone healing response after replantation in rabbit's calvarial bone, we divided the experimental group into three groups. Group 1 is a fresh autogenous bone group. Group 2 is a deep frozen group. Group 3 is freeze-dried demineralized group. Obtained result were as followed: 1. Inflammatory cell infiltration appeared at I week and disappeared at 4 weeks in all experimental group, Especially, severe inflammatory cell infiltration showed in fresh autogenous bone group at 2 weeks. Group 3 is the least showing group on the point of inflammatory cell infiltration. 2. Osteoblastic activity evenly increased upto 4 weeks and maintained to 6 weeks and decreased after this period, especially osteoblastic activity in group 2 is less than group 1 and group 3. We can't discriminate between osteoblastic activity of group 1 and that of group 3. 3. In new bone formation, group 3 was more active than any other groups at early stage, but there were little differences among three experimental groups at later state. 4. Bone resorption around the grafted bone slightly appeared at 1 week and disappeared at 4 weeks in all experimental groups. We can find the more bone resorption in group 2 at 2 weeks than any other groups. We could suggest, as appears from our results, that freeze-dried deminiralized bone graft is the useful bone graft in the clinical applications of excised autogenic bone.