• Archives of Plastic Surgery
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• 제47권6호
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• pp.619-621
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• 2020

This article portrays the authors' clinical experience of a complex case of lower extremity reconstruction using a recycled pedicle from 10 years old free latissimus dorsi musculocutaneous flap to supply a new free anterolateral thigh flap for proximal tibia wound defect reconstruction. It provides clinical evidence that muscle neovascularization occurs and supports the dogma peripheral tissue neovascularization. This case stipulates that recycling of pedicle is feasible, when used with appropriate strategy and safety and also provides evidence for the long-term survival of greater saphenous vein grafts in lower extremity reconstruction.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.249-255
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• 2008

Objective : In Moyamoya disease, the primary goal of treatment is to improve collateral circulation through angiogenesis. In the present study, we obtained and sub-cultured bone marrow stromal cells (BMSCs) from rats without a cell-mediated immune response. Then, we injected the labeled BMSCs directly into adjacent temporal muscle during encephalomyosynangiosis (EMS). Three weeks after BMSC transplantation, we examined the survival of the cells and the extent of neovascularization. Methods : We divided 20 rats into a BMSC transplantation group (n=12) and a control group (n=8). Seven days after the induction of chronic cerebral ischemia, an EMS operation was performed, and labeled BMSCs ($1{\times}106^6/100\;{\mu}L$) were injected in the temporal muscle for the transplantation group, while an equivalent amount of culture solution was injected for the control group. Three weeks after the transplantation, temporal muscle and brain tissue were collected for histological examination and western blot analysis. Results : The capillary/muscle ratio in the temporal muscle was increased in the BMSC transplantation group compared to the control group, showing a greater increase of angiogenesis (p<0.05). In the brain tissue, angiogenesis was not significantly different between the two groups. The injected BMSCs in the temporal muscle were vascular endothelial growth factor (VEGF)-positive by immunofluorescence staining. In both temporal muscle and brain tissue, the expression of VEGF by western blot analysis was not much different between the two groups. Conclusion : During EMS in a chronic cerebral ischemia rat model, the injection of BMSCs resulted in accelerated angiogenesis in the temporal muscle compared to the control group.

• 한국안광학회지
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• 제13권4호
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• pp.161-169
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• 2008

목적: 알칼리 화상 후 초기 임상적 손상반응의 진행과 치료를 위한 각막 재생의 이해를 높이기 위하여, 화학적 손상 후 동반하는 다양한 인자에 대한 면역조직화학적 변화를 조사하였다. 방법: 알칼리 화상을 입은 각막의 자가치유과정을 면역형광염색법과 H-E 염색, 그리고 TUNEL assay를 통해 면역조직화학적 측면에서 관찰하였다. 결과: 화상 후 각막의 치유는 진행되었지만 각막기질(stroma)과 내피세포의 세포사는 지속적으로 관찰되었다. 각막가장자리의 혈관신생과 손상된 각막의 ${\alpha}$-SMA의 발현은 알칼리 화상 3일 후부터 나타났으며, 각막기질에서의 콜라젠 III(collagen III)의 형성과 콘드로이친황산(chondroitin sulfate)의 발현은 ${\alpha}$-smooth muscle actin(${\alpha}$-SMA)와 transforming growth factor-${\beta}$(TGF-${\beta}$)의 발현증가와 일치하는 결과를 얻었다. 결론: 각막혼탁을 막기 위해서는 알칼리 화상 후 3일 이내에 혈관신생, 콜라젠 및 콘드로이친황산의 형성을 억제하는데 주력하는 치료가 효과적일 것이라 사료된다. 이 연구는 알칼리 화상을 입은 각막의 치유과정에 있어서의 면역조직화학적 지식을 제공함으로써, 각막의 재생을 촉진하는 치료제의 개발과 이용에 초석이 되리라 사료된다.

• Journal of Veterinary Science
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• 제21권1호
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• pp.10.1-10.12
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• 2020

Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

• Journal of Veterinary Science
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• 제24권1호
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• pp.14.1-14.15
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• 2023

Background: The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported. Objectives: To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects. Methods: In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively. Results: Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon. Conclusions: An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

• 대한두개안면성형외과학회지
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• 제20권1호
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• pp.10-16
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• 2019

Background: Physicians tend to overcorrect when applying the acellular dermal matrix for reconstructive option because of volume decrement problem after absorption comparing with initial volume. However, there are no studies on the exact volume decrement and absorption rate with commercial products in South Korea. To figure out absorption rate of acellular dermal matrix product in South Korea (Megaderm), authors designed this experiment. Methods: Nine mice were used and randomly divided into three groups by the time with sacrificing. The implant (Megaderm) was tailored to fit a cuboid form ($1.0cm{\times}1.0cm$ in length and width and 2.0 mm in thickness). A skin incision was made at anterior chest with blade #15 scalpel with exposing the pectoralis major muscle. As hydrated Megaderm was located upon the pectoralis major muscle, the skin was sutured with Ethilon #5-0. After the surgical procedure, each animal group was sacrificed at 4, 8, and 12 weeks, respectively, for biopsies and histological analysis of the implants. All samples were stained with routine hematoxylin and eosin staining and Masson's trichrome staining and the thickness were measured. A measurements were analyzed using Friedman test. Statistically, the correlation between thicknesses of Megaderm before and after implantation was analyzed. Results: After sacrificing the animal groups at postoperative 4, 8, 12 weeks, the mean tissue thickness values were $2.10{\pm}1.03mm$, $2.17{\pm}0.21mm$, and $2.40{\pm}0.20mm$ (p= 0.368), respectively. The remaining ratios after absorption comparing with after initial hydrated Megaderm were 82.7%, 85.4%, and 94.5%, respectively. In histopathological findings, neovascularization and density of collagenous fiber was increased with time. Conclusion: Author's hypothesis was absorption rate of implant would be increased over time. But in this experiment, there is no statistical significance between mean absorption thickness of implant and the time (p= 0.368). Also it can be affected by graft site, blood supply, and animals that were used in the experiment.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권1호
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• pp.1-10
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• 2008

Purpose: This study was aimed to examine the resorption rate, the healing pattern, and the response of the surrounding tissue after the graft of the acellular dermal matrix ($AlloDerm^{(R)}$) and the autogenous dermis, and to report the clinical result of the use of $AlloDerm^{(R)}$ in order to restore the soft tissue defects. Methods: Twenty mature rabbits, weighing about 3 ㎏, were used for the experimental study. The $10\times10$ mm-size autogenous dermis and the $AlloDerm^{(R)}$ were grafted to the space between the external abdominal oblique muscle and the fascia of the rabbits. And the $AlloDerm^{(R)}$ was grafted to the pocket between the skin and the underlying perichondrium of rabbit ear. The resorption rate of the grafted sites was calculated, and the tissue specimens were histologically examined at 1, 2, 4, and 8 weeks after the graft. The five patients with the cleft-lip nasal deformity and the one patient with the saddle nose deformity, who received the $AlloDerm^{(R)}$ graft to restore the facial soft tissue defects, were reviewed for the clinical study. Results: The resorption rate at 8 weeks after the graft was 21.5% for the autogenous dermis, and 16.0% $AlloDerm^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. However, the neovascularization and the progressive growth of the new fibroblasts were shown in the $AlloDerm^{(R)}$ graft. And the six patients, who received the $AlloDerm^{(R)}$ graft, demonstrated the good stability of the grafts and improved appearance. There were no remarkable complications such as inflammation, rejection, dislocation, and severe absorption in the clinical cases. Conclusion: These results suggest that $AlloDerm^{(R)}$ can be an useful graft material for restoration of soft tissue defects because of the good stability and the tissue response without the remarkable clinical complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.410-417
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• 2006

The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.520-530
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• 2006

Undifferentiated mesencymal stem cells(UMSCs) have been thought to be multipotent cells that can replicate as undifferentiated cells and that have the potential to differentiate into lineages of mesenchymal tissue including the bone, cartilage, fat, tendon, muscle, and marrow stroma. It can be used to sinus lifting, Guided bone regeneration, other bone graft in dental part. The purpose of this study is to evaluate the effect of mesencymal stem cells on sinus augmentation with autogenous bone, fibrin glue mixture in a rabbit model. 8 New Zealand white rabbits were divided randomly into 4 groups based on their time of sacrifice(1, 2, 4 and 8 weeks). First, undifferentiated mesenchymal stem cells were isolated from iliac crest marrow of rabbits and expanded in vitro. cell culture was performed in accordance with the technique described by Tsutsumi et al. In the present study, The animals were sacrificed at 1, 2, 4 and 8 weeks after transplantation, and the bone formation ability of each sides was evaluated clinically, radiologically, histologically and histomorphologically. According to the histological observations, Stem cell group showed integrated graft bone with host bone from sinus wall. At 2 and 4weeks, It showed active newly formed bone and neovascularization. At 8 weeks, lamella bone was observed in sinus graft material area. Radiologically, autobone with stem cell showed more radiopaque than autobone without stemcell. there were significant differences in bone volume between 2 and 4 weeks (p<0.05). In summary, the autobone with stem cells had well-formed, newly formed bone and neovasculization, compared with the autobone without stem cells (esp. 2 weeks and 4 weeks) The findings of this experimental study indicate that the use of a mixture of mesenchymal stem cell yielded good results in osteogenesis and bone volume comparable with that achieved by autogenous bone. Therefore, this application of this promising new sinus floor elevation method for implants with tissue engineering technology deserves further study.

• Molecules and Cells
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• 제40권6호
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• pp.386-392
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• 2017

Periodontal ligament stem cells (PDLSCs) are multipotent stem cells derived from periodontium and have mesenchymal stem cell (MSC)-like characteristics. Recently, the perivascular region was recognized as the developmental origin of MSCs, which suggests the in vivo angiogenic potential of PDLSCs. In this study, we investigated whether PDLSCs could be a potential source of perivascular cells, which could contribute to in vivo angiogenesis. PDLSCs exhibited typical MSC-like characteristics such as the expression pattern of surface markers (CD29, CD44, CD73, and CD105) and differentiation potentials (osteogenic and adipogenic differentiation). Moreover, PDLSCs expressed perivascular cell markers such as NG2, ${\alpha}-smooth$ muscle actin, platelet-derived growth factor receptor ${\beta}$, and CD146. We conducted an in vivo Matrigel plug assay to confirm the in vivo angiogenic potential of PDLSCs. We could not observe significant vessel-like structures with PDLSCs alone or human umbilical vein endothelial cells (HUVECs) alone at day 7 after injection. However, when PDLSCs and HUVECs were co-injected, there were vessel-like structures containing red blood cells in the lumens, which suggested that anastomosis occurred between newly formed vessels and host circulatory system. To block the $SDF-1{\alpha}$ and CXCR4 axis between PDLSCs and HUVECs, AMD3100, a CXCR4 antagonist, was added into the Matrigel plug. After day 3 and day 7 after injection, there were no significant vessel-like structures. In conclusion, we demonstrated the perivascular characteristics of PDLSCs and their contribution to in vivo angiogenesis, which might imply potential application of PDLSCs into the neovascularization of tissue engineering and vascular diseases.