• Title/Summary/Keyword: Graft size

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The Clinical Analysis of Modified B-T Shunt Using 3 mm and 3.5 mm PTFE graft (3mm와 3.5mm PTFF graft를 이용한 변형 B-T 단락술의 임상적 분석)

  • 정성호;윤태진;임한중;민경석;서동만;윤소영;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.716-722
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    • 2000
  • Background: Modified Blalock-Taussig shunt using 3mm or 3.5mm PTFE graft has been performed in patients with small body weight or in candidates for single ventricle palliation. However, there are few reports concerning clinical outcomes in terms of pulmonary artery growth and shunt patency rate after shunt operations using such a small graft. Material and Method: Twenty-five patients rate after shunt operations using 3 or 3.5 mm sized grafts from September 1996 to August 1999. We retrospectively assessed the pulmonary artery growth and the shunt patency rate by reviewing the pre-and post-operative pulmonary angiograms. The risk factors for late death and second shunt operations were also analyzed. To assess the presence of any correlation between body weight and selection of the graft size, regression analysis was done in 81 cases of shunt operations performed during the same period. Result: There were 1(4%) early death and 5(20%) late deaths. The survivors were followed up for an average of 7.34 months. The pulmonary artery index increased significantly from 129$\pm$66$\textrm{mm}^2$/$m^2$ to 213$\pm$114 $\textrm{mm}^2$/$m^2$(p=0.002). The shunt patency rate assessed at postoperative 2, 4, 6 and 8 months were 82.5%, 77%, 73% and 42% respectively with a marked decline between 6 and 8 months. Asplenia was a frequent finding for the patients with late death although the incidence failed to reach statistical significance(p=0.078). Pre-operative diagnosis of PA with VSD was found to be a statistically significant risk factor for a second shunt operation(p=0.01). Body weight(a) at operation and graft size(b) used in the shunt operations revealed strong correlation and could be expressed by the following formula; b=0.128a + 3.233. Conclusion: Adequate growth of pulmonary artery and satisfactory early patency rate could be obtained by modified Blalock-Taussing shunt using 3mm or 3.5mm graft. However, during 6 to 8 months after shunt operations, the patency rate fell sharply, which implicates that close observation and early intervention are mandatory in this period.

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USE OF DEMINERALIZED AND MINERALIZED FREEZE-DRIED ALLOGENIC BONE GRAFT FOR THE CORRECTION OF MAXILLOFACIAL DEFORMITIES; CASE REPORTS (악골결손 재건을 위한 탈회 및 비탈회 동결건조 동종골의 이용)

  • E, Gi-Hyug;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Lee, Byung-Joon;Park, In-Soon;Um, In-Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.371-377
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    • 1996
  • Bone graft has been used to repair one defect caused by disease and trauma, congenital and acquired deformities. Graft materials are autogenous bone, allogenic bone, xenogenic bone, synthetics. Autogenous bone graft is the most superior to other materials for immunologic reaction, compatibility to host tissue, and revascularization. However, autogenous bone graft is required for additional operation and the amount of taking is limited. Autografts are obtained at own expense and also limited in size, shape. In order to compensate these problems, allogenic bone graft has been used increasingly. But allogenic bone graft encounters immunologic complications. Therefore, it has been used after freezing, lyophilization, or demineralization. Allogenic bone processed by only lyophilization includes potential antigenic properties on its surface, therefore it is demineralized to deplete immunologic reaction. Demineralized bone releases BMP and helps the mesenchymal cells transform to the chondroblast to produce cartilage and bone. This reaction is called osteoinducation. Many authors have reported that mineralized lyophilized bone had less antigenicity clinically and favorable bony consideration with host bone. In our department from 1995 to now, we have used banked allogenic bone graft that has been prepared from Wonkwang Bone Bank in 5 cases and mineralized lyophilized bone graft in 2 cases to reconstruct the maxillofacial bone defect after tumor resection and cyst enucleation and cleft alveolus. We will report with literature review that the result is favorable functionally and esthetically.

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Clinical and Radiological Analysis and Results after Anatomical Reduction and Bone Graft for Symptomatic Os Subfibulare (증상을 동반한 비골하 부 골에 대한 임상적 방사선학적 분석과 해부학적 정복술 및 골 이식술 후 결과)

  • Hwang, Pil-Sung;Kim, Do-Young;Park, Yong-Wook;Lee, Sang-Soo;Suh, Dong-Hyun;Kim, Hyong-Nyun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.162-166
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    • 2005
  • Purpose: To analyze the clinical and radiological feature of Os subfibulare and to evaluate the results after anatomical reduction and internal fixation with bone graft for Os subfibulare. Materials and Methods: Forty-two cases, which underwent anatomic reduction and bone graft for Os subfibulare from October 1998 to September 2004 were reviewed. We analysed preopertive symptoms and onset of symptoms and radiologically measured the size and amounts of displacement of Os subfibulare under the inversion stress. Postoperatively we evaluated the clinical results measured by Hasegawa method and evidence of union. Results: Preoperatively there were only pain around the lateral malleolus in 16 cases, only instability of ankle joint in 3 cases, and pain and instability in 23 cases. The age of symptom onset averaged 23 years(range, 13-38 years). Radiographically Os sufibulare anteriorly located from lateral malleolus were in 40 cases, posteriorly situated in 2 cases. The size of Os subfibulare ranged from $1{\times}4\;mm$ to $8{\times}17\;mm$. In 22 cases of inversion stress view, displacement of the Os sbufibulare averaged $1.5{\pm}1.1\;mm$ (0 to 5 mm). The postoperative clinical results were excellent in 41 cases, poor in 1 case. There were complications of 1 case of irritation of sural nerve, 1 case of nonunion. Conclusion: Anatomic reduction and bone graft is effective treatment method for symptomatic Os subfibulare.

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Cross Finger Flap with Reduction Pulp Plasty and Full Thickness Skin Graft (수질부 축소술과 전층 피부이식술을 이용한 교차수지 피판술)

  • Cho, Yong Hyun;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.674-677
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    • 2009
  • Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.

Comparison of healing pattern with or without bone graft after odontogenic cyst enucleation (악골에서 발생한 치성 낭종제거 후 골이식 여부에 따른 치유속도와 양상 비교)

  • Baek, Chae-Hwan;Park, Joon-Hyung;Kim, Gun-Jong;Hong, Jong-Rak;Kim, Chang-Soo;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.515-519
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    • 2010
  • Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

One-year Graft Patency after Coronary Artery Bypass Surgery (관상동맥우회술 후 1년 개존성에 관한 연구)

  • Kim, Gi-Bong;Kim, Hyeon-Jo;Seong, Gi-Ik
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1190-1196
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    • 1997
  • Between July 1994 and August 1995, 78 patients underwent coronary artery bypass graft at Seoul National University Hospital. Coronary angiogram was performed one year after coronary artery bypass graft in 49 patients(62.8%) for evaluation of the graft patency and analysis of the risk factors for graft occlusion. The patency rates of both the internal mammary artery and the radial artery grafts were 100% , although three internal mammary artery grafts(5.0%) were narrowed(string sign). And that of the saphenous vein grafts were 85.2%. Multivariate analysis for the preoperative, operative, and postoperative factors was done between the widely patent and the narrowed internal mammary artery graft groups, and between the patent and the occluded saphenous vein graft groups by the general linear models procedure. Patient's age($\geq$60 years), postoperative intraaortic balloon pump insertion, bleeding, and acute renal failure were found to be the significant risk factors for internal mammary artery graft narrowing, and coronary artery size(< 1.5 mm) was the significant risk factor for the saphenous vein graft occlusion (p<0.05) . This study confirms that the arterial graft is superior to the vein graft at one-year patency rate, and suggests the risk factors for graft occlusion during the first postoperative year. Knowledge of this study may provide a basis for estimating the risk factors for graft occlusion, and thereby modifying surgical strategy and postoperative surveillance.

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Free Vascularized Osteocutaneous Fibular Graft to the Tibia (경골에 시행한 유리 생비골 및 피부편 이식)

  • Lee, Kwang-Suk;Han, Seung-Beom;Lee, Byung-Taek;Kim, Hyeong-Sik
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.1-10
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    • 2002
  • Purpose : To analyze the clinical results of free vascularized osteocutaneous fibula graft to tibial defect combined with soft tissue defect and infection. Materials and Methods : In the retrospective study of 51 consecutive cases of vascularized osteocutaneous fibular graft, the length of the grafted fibula, size of the skin flap, anastomosed vessels, ischemic time of the flap, time for union, hypertrophy of fibula and the complications were evaluated. Results : Initial bony union of the grafted fibula was obtained at 3.74 months after operation, except 4 cases of nonunion and delayed union. The weight bearing without external supports was possible at 18 months after operation in average. The fracture of grafted fibula was most common complication(16 cases). Conclusion : The vascularized osteocutaneous fibula graft provided satisfactory bony union and functional results in the cases not responsible for conventional treatment methods.

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Deep Vein as a Graft Conduit (도관으로 사용된 심부정맥)

  • Yie, Kil-Soo;Cheon, Sung-Bin;Oh, Won-Sub;Ryu, Se-Min;Lee, Bong-Ki;Kim, Hyung-Rae;Kim, Keun-Woo
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.441-446
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    • 2010
  • The ideal graft requires acceptable size, less tissue toxicity, resistance to infection, and long-term durability. Great saphenous veins are gaining popularity as acceptable graft conduits, but they require time to grow in caliber. We report 2 cases of graft bypass and reconstruction using superficial femoral veins to acheive immediate high-flow patency.

Simple Anastomotic Techniques for Coronary Artery Bypass Surgery in Patients with Small Coronary Arteries or a Marked Size Discrepancy Between the Coronary Artery and Graft

  • Lee, Mi Kyung;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.485-488
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    • 2016
  • Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%.

Surface Modification of Colloidal Silica Nanoparticles: Controlling the size and Grafting Process

  • He, Wentao;Wu, Danhua;Li, Juan;Zhang, Kai;Xiang, Yushu;Long, Lijuan;Qin, Shuhao;Yu, Jie;Zhang, Qin
    • Bulletin of the Korean Chemical Society
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    • v.34 no.9
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    • pp.2747-2752
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    • 2013
  • Surface modification of colloidal silica nanoparticles without disrupting the electric double layer of nanoparticles is a major challenge. In the work, silane was employed to modify colloidal silica nanoparticles without inducing bridge flocculation obviously. The effect of pH value of the silica sol, the amount of silane in feed, and reaction temperature on the graft amount and the final size of modified particles was investigated. The increased weight loss by TG and the appearance of $T_2$ and $T_3$ except for $Q_2$ and $Q_3$ signals by CP/MAS $^{29}Si$ NMR of the modified samples verified the successful grafting of silane. The graft amount reached 0.57 mmol/g, which was slightly lower than theory value, and the particle size remained nearly the same as unmodified particles for acidic silica sol at the optimum condition. For alkaline silica sol after modification, aggregates composed of several nanoparticles connected together with silane moleculars as the bridge appeared.