• Title/Summary/Keyword: Repair technique

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The Effect of Placing Biomembrane cover following Microfracture on Cartilage Repair: Comparison with Conventional Microfracture Technique in a Prospective Randomized Trial (미세골절술 후 생체막 덮개가 연골 재생에 미치는 영향 : 고식적인 미세골절술과의 전향적 비교 연구)

  • Son, Kwang-Hyun;Kim, Jin-Ho;Kwak, Kyu-Sung;Park, Jang-Won;Yoon, Kyoung Ho;Min, Byoung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.83-91
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    • 2011
  • Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

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EVALUATION OF ANGIOGENIC PHENOTYPES IN CULTURED HUMAN PERIOSTEAL-DERIVED CELLS UNDER HIGH-DOSE DEXAMETHASONE (고용량의 Dexamethasone 존재하에서 골막기원세포에서 발현되는 혈관신생인자의 평가)

  • Park, Bong-Wook;Choi, Mun-Jeong;Ryu, Young-Mo;Lee, Sung-Gyoon;Hah, Young-Sool;Kim, Deok-Ryong;Cho, Yeong-Cheol;Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.217-224
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    • 2008
  • Angiogenesis plays an important role in bone development and postnatal bone fracture repair. Vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptors (VEGFRs) have been thought to be primarily involved in promoting angiogenesis. It is well known that VEGF and its receptors have been reported to play an important role in the regulation of the interaction between angiogenesis and osteogenesis during bone repair processes. Dexamethasone, a potent synthetic glucocorticoid, promotes phenotype markers of osteoblast differentiation, such as ALP and osteocalcin. It stimulates in vitro osteogenesis of human bone marrow osteogenic stromal cells. Dexamethasone has been reported to suppress VEGF gene expression in some cells. However, our previous study demonstrated VEGF quantification increased in a time-dependent manner in periosteal-derived osteogenesis under dexamethasone. So, the purpose of this study was to examine the angiogenic phenotypes in cultured human periosteal-derived cells under high-dose dexamethasone. Periosteal-derived cells were cultured using a technique previously described. After passage 3, the periosteal-derived cells were further cultured for 28 days in an osteogenic inductive culture medium containing ascorbic acid, ${\beta}$-glycerophosphate and high-dose dexamethasone, We evaluated the expression of VEGF isoforms, VEGFR-1, VEGFR-2, and neuropilin-1, ALL VEGF isoforms ($VEGF_{121},\;VEGF_{165},\;VEGF_{189}$, and $VEGF_{206}$) expression was observed by RT-PCR analysis. VEGFR-1, VEGFR-2 and neuropilin-1 expression increased up to day 14, particularly during the early stage of mineralization. Our results suggest the involvement of direct VEGFs/VEGFRs system on periosteal-derived cells during early mineralization phase under high-dose of dexamethasone. These also suggest that VEGF might act as an autocrine growth molecule during osteoblastic differentiation of cultured human periosteal-derived cells.

Evaluation of clinical outcomes of implants placed into the maxillary sinus with a perforated sinus membrane: a retrospective study

  • Kim, Gwang-Seok;Lee, Jae-Wang;Chong, Jong-Hyon;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.50.1-50.6
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    • 2016
  • Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

Developing a water discharge anchor & trap bolt to prevent basic salt from penetrating to harbor structures (해수 염기 침투방지를 위한 항만구조물 보수보강용 물배출 앵커 및 트랩볼트 개발에 관한 연구)

  • Ock, Jong-Ho;Moon, Sang-Deok;Lee, Hwa-Sun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.535-541
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    • 2018
  • Most construction methods for the repair and reinforcement of old reinforced concrete harbor structures involve a process of applying a fiber complex or fiber complex panel just like wallpaper to the bottom of structures, such as slabs or beams. On the other hand, these techniques result in the sealing of repaired and reinforced portions of the structures by the fiber products, preventing moisture, such as rainwater entering the structures through the upper surfaces of the slabs or beams from being released, and causing the entire concrete covering of the structures to be peeled off in the long run. To prevent this, it is necessary to develop a technique to protect the basic salt from the sea water from penetrating into the structures while expelling the water absorbed in the structures swiftly. This study attempted to solve the problem by modifying the anchor bolts currently used to repair and reinforce the port structure. That is, by drilling holes into the body of anchor bolts and modifying the caps of the bolts to produce a structure that would let the water flow like a toilet trap, the moisture inside of the structure could be drained through the holes in the anchor bolts. The water discharge anchor bolts developed were tested and observed for 6 months; the water was discharged in 73% of the anchors (200 anchor installation, 145 anchors).

Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury (둔상에 의한 흉부대동맥 손상에서 TEVAR에 관한 임상연구)

  • Ku, Gwan Woo;Choi, Jin Ho;Choi, Min Suk;Park, Sang Soon;Sul, Young Hoon;Go, Seung Je;Ye, Jin Bong;Kim, Joong Suck;Kim, Yeong Cheol;Hwang, Jung Joo
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.232-240
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    • 2015
  • Purpose: Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury. Methods: Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014. Results: Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was $105.64{\pm}24.60mm\;Hg$, and the mean heart rate was $103.64{\pm}20.02per$ minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was $21.82{\pm}16.37hours$. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur. Conclusion: Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.

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A Methodology of Seismic Damage Assessment Using Capacity Spectrum Method (능력 스펙트럼법을 이용한 건물 지진 손실 평가 방법)

  • Byeon, Ji-Seok
    • Journal of the Earthquake Engineering Society of Korea
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    • v.9 no.3 s.43
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    • pp.1-8
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    • 2005
  • This paper describes a new objective methodology of seismic building damage assessment which is called Advanced Component Method(ACM). ACM is a major attempt to replace the conventional loss estimation procedure, which is based on subjective measures and the opinions of experts, with one that objectively measures both earthquake intensity and the response ol buildings. First, response of typical buildings is obtained analytically by nonlinear seismic static analysis, push-over analyses. The spectral displacement Is used as a measure of earthquake intensity in order to use Capacity Spectrum Method and the damage functions for each building component, both structural and non-structural, are developed as a function of component deformation. Examples of components Include columns, beams, floors, partitions, glazing, etc. A repair/replacement cost model is developed that maps the physical damage to monetary damage for each component. Finally, building response, component damage functions, and cost model were combined probabilistically, using Wonte Carlo simulation techniques, to develop the final damage functions for each building type. Uncertainties in building response resulting from variability in material properties and load assumptions were incorporated in the Latin Hypercube sampling technique. The paper also presents and compares ACM and conventional building loss estimation based on historical damage data and reported loss data.

Chitosan-alginate Gel Modified Poly (L-Lactic-co-ε-Caprolactone) (PLCL) as a Scaffold for Cartilage Tissue Engineering (변형된 키토산 알지네이트 겔 poly (L-Lactic-co-ε-Caprolactone) 지지체의 연골 조직 재생 평가)

  • Sutradhar, Bibek Chandra;Hwang, Yawon;Choi, Seokhwa;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.224-230
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    • 2015
  • This study was designed in the fabricated poly (L-Lactic-co-${\varepsilon}$-Caprolactone) (PLCL) scaffold using chitosan-alginate hydrogel, which would be more suitable to maintain the biological and physiological functions continuing three dimensional spatial organizations for chondrocytes. As a scaffold, hydrogels alone is weak at endure complex loading within the body. In this study, we made cell hybrid scaffold constructs with poly (L-Lactic-co-${\varepsilon}$-Caprolactone) (PLCL) scaffold and hydrogels to make a three-dimensional composition of cells and extracellular matrix, which would be a mimic of a native cartilage. Using a particle leaching technique with NaCl, we fabricated a highly-elastic scaffold from PLCL with 85% porosity and $300-500{\mu}m$ pore size. A mixture of bovine chondrocytes and chitosan-alginate gel was seeded and compared with alginate as a control on the PLCL scaffold. The cell maturation, proliferation, extracellular matrix synthesis, glycosaminoglycans (sGAG) production and collagen type-II expressions were better in chondrocytes seeded in chitosan-alginate hydrogel than in alginate only. These results indicate that chondrocytes with chitosan-alginate gel on PLCL scaffolds provide an appropriate biomimetic environment for cell proliferation and matrix synthesis, which could successfully be used for cartilage repair and regeneration.

Long term results in the unilateral cleft lip repair by Mulliken's method (Mulliken 방법을 이용한 일측성 구순열의 장기 추적 결과)

  • Kim, Seok-Kwun;Moon, In-Sun;Lee, Chang-Ho;Heo, Jung;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.174-182
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    • 2009
  • Purpose: The Mulliken's method is a one of the very excellent technique to correction of the unilateral cleft lip. It could decrease the need of additional operation and second operation by the early simultaneous correction of unilateral cleft lip and nasal deformity, at a time. Numerous procedures were advocated for the correction of nasal deformity, but with general dissatisfaction of the results, it became obvious that no one procedure is the ideal one. The authors have been operating on unilateral cleft lip by Mulliken's method and long term follow - up of postoperative result was evaluated. Methods: The authors have done long term follow - up of result in the 75 cases unilateral cleft lip patient, during 1 ~ 7 years. That was repaired by simultaneous correction of cleft lip and nasal deformity by Mulliken's method at the period from June, 1997 to December, 2007. The patients were unilateral complete cleft lip 39 cases, unilateral incomplete cleft lip 36 cases. In the severe complete cleft lip cases, lip adhesion operation was done before definite operation. The mean age of unilateral cleft lip operation was 3.2 months. Five anthropometric parameters, which were upper lip, cutaneous lip and vermilion mucosa height, nasal tip protrusion, columella length were measured by Sliding Vernier Caliper. The anthropometric analysis was performed preoperative and postoperative at 6 months, 3, 5 and 7 years and the results were com pared with those of age - matched, normal children. T - tests were used to analyze the differences between the measurements. Results: Long - term postoperative results were evaluated by anthropometrically. Most patients showed adequate growth of upper lip height, vermilion mucosa height and columella length. But nasal tip protrusion was relatively short compare with normal value. Incomplete cleft lip group was nearly normal growth results than complete cleft lip group. Conclusion: In conclusion, we could make harmonious Cupid's bow, natural philtrum and lip, appropriate nasal shape by Mulliken's method. But nasal tip protrusion was under the normal values on complete and incomplete group. And incomplete group was more good results than complete group. We have experienced repair of cleft lip by Mulliken's method with 75 cases of unilateral cleft lip patients and conclude that it was very useful and good method.

Effect of Cytosine Arabinoside, 3-Aminobenzamide and Hydroxyurea on the frequencies of radiation-induced micronuclei and aneuploidy in human lymphocytes (DNA 회복 저해제 Cytosine Arabinoside, 3-Aminobenzamide 및 Hydroxyurea가 방사선에 의해 유도된 소핵과 이수성에 미치는 영향)

  • Cho, Yoon-Hee;Kim, Yang-Jee;Kang, Chang-Mo;Ha, Sung-Whan;Chung, Hai-Won
    • Journal of Radiation Protection and Research
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    • v.30 no.4
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    • pp.209-219
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    • 2005
  • This study was carried out to examine the effect of the DNA repair inhibitors, Cytosine Arabinoside(Ara C), 3-Aminobenzamide(3AB) and Hydroxyurea(HU) on the frequencies of radiation-induced micronuclei(MNi) and aneuploidy. Irradiated lymphocytes(1-3Gy) were treated with DNA repair inhibitors, Ara C, 3AB and HU for 3 hours and CBMN assay - FISH technique with DNA probe for chromosome 1 and 4 was performed. The frequencies of x-ray induced MNi and aneuploidy of chromosome 1 and 4 were increased in a dose-dependent manner. Ara C, 3AB and HU enhanced the frequencies of radiation-induced MNi and the frequencies of radiation-induced aneuploidy of chromosome 1 and 4 were enhanced by HU and Ara C while no effect was observed by 3AB. The frequency of radiation-induced aneuploidy of chromosome 1 was higher than that of chromosome 4. These results suggest that there are different mechanisms involved in the formation of MNi and aneuploidy by radiation.

Mandibular reconstruction with a ready-made type and a custom-made type titanium mesh after mandibular resection in patients with oral cancer

  • Lee, Won-bum;Choi, Won-hyuk;Lee, Hyeong-geun;Choi, Na-rae;Hwang, Dae-seok;Kim, Uk-kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.35.1-35.7
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    • 2018
  • Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. Case presentation: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors' clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors' clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. Conclusions: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.