• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.1
• /
• pp.24-31
• /
• 2005

Recently, Platelet rich plasma(PRP) is commonly used because it is now well known that platelets have many functions beyond that of simple hemostasis in aspect of containing autogenous source of several growth factors. It could be responsible for increasing cell mitosis, increasing collagen production, recruiting other cells to the site of injury, initiating vascular ingrowth, and inducing cell differentiation, enhancing bone formation capacity and easily handling to clinician. However, in spite of these clinical advantages, still the theory behind the use of PRP is compelling. This study was to determine preparation techniques used to increase the concentration of platelets and growth factors are all crucial steps in early wound healing of bone graft which may lead to a more rapid and denser bone regenerate. 200 volunteers were sampled and PRP were prepared according to each evaluation item in this study. Higher concentration of platelets have been gained in double centrifugation. 2000 and 2500 rpm showed proper concentration of platelets at first centrifugation and 5000 rpm in second. Timing for 2 minutes was showed good concentration of platelets in high and low centrifugation speed. It was better concentration of platelets in 20 or 30 ml volume during centrifugation. In histomorphologic findings, degrnulated and high concentraion of platelets were found in low centrifugation speed.

• Journal of Chest Surgery
• /
• v.22 no.1
• /
• pp.59-66
• /
• 1989

Coarctation of aorta, a well known congenital cardiovascular defect, can be recognized in the most instances by simple finding of physical examination. This condition shortens life if untreated, but it can be corrected surgically to render the patient functionally normal. It seems relatively rare in Asian. During Six-Year period from January, 1982 through June, 1988, twenty four consecutive operations for the coarctation of the aorta were performed at Yonsei Medical Center. The patients included 14 males and 10 females in the range, 2 months and 34 years old. Associated Cardiac anomalies were patient ductus arteriosus, ventricular septal defect, mitral valve regurgitation, aortic stenosis, double outlet right ventricle, corrected transposition of great vessel, etc. The preoperative main symptoms were frequent URI and dyspnea. Congestive heart failure was the most common symptom at the group younger than 2 year olds. Operative techniques for the coarctation of the aorta were prosthetic patch aortoplasty in 18 patients, resection & vascular graft interposition in 4, resection and end to-end anastomosis in 2. There was no operative death. Four patients had persistent or paradoxical hypertension, and one had postoperative paraplegia.

• Journal of Korean Foot and Ankle Society
• /
• v.4 no.1
• /
• pp.44-47
• /
• 2000

Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

• Journal of Biomedical Engineering Research
• /
• v.13 no.2
• /
• pp.165-174
• /
• 1992

Compliance mismatch across an end-to-end anastomosis was measured In the In vitro experimental setup. A 35mm camera was used and Image process was done in Gould/ DeAnza Image processor. The results showed that compliances of Penrose tubing and synthetic PTFE grafts were In good agreement with the previously reported In vivo data. PTFE grafts exhibited a nonlinear behavior with compliance decreasing with Increasing transmural pressure, whereas the compliance of the Penrose tubing remained relatively constant within the range of the pressures in which data were obtained. The lumen cross sections at the anastomosis were affected by the suture and the mismatch In compliance between the Penrose tubing and vascular grafts. The varla~lons In the lumen dtameter at the anastomosis was more pronounced with increasing transmural pressures. From the present study, it was clearly demonstrated that the compliance of prosthetic grafts Is much lower than that of the arteries. In addition to the hemodynamlc consequences, compliance mismatch across the anastomosis has been known to lead to Increased anastomotlc and suture stresses with resultant suture line dehlscence and false aneurysm formation. Thus, there are good hemodynamic reasons to suppose that Introduction of a less compliant arterial graft Into the arterial circulation wlll be damaging and that grafts should be made to match the elastic behavior of their host arteries as closely possible.

• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1242-1246
• /
• 1997

Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.170-175
• /
• 1999

Objective : Extracranial-intracranial(EC-IC) microvascular anastomosis was performed in 18 patients with hemodynamic cerebral ischemia and traumatic cerebral aneurysm, the aim of this retrospective study was to assess its value in neurosurgical field. Method : Of 18 cases, 17 case were hemodynamic cerebral ischemia and one was traumatic cerebral aneurysm. There were 14 superficial temporal artery(STA)-to-middle cerebral artery(MCA) anastomosis, 3 saphenous vein graft bypass(2 external carotid artery(ECA)-to-MCA, 1main trunk of the STA-to-MCA) and 1 radial artery bypass(ECA-to-MCA). Results : Bypass patency was confirmed by postoperative angiography in all cases except for two cases, postoperative cerebral blood flow of ischemic brain showed significant increased in all cases with good patency through bypass. Conclusion : Revascularization by EC-IC microvascular anastomosis to the ischemic brain eliminated ischemia and was associated with excellent good outcome and good patency rates.

• Journal of Chest Surgery
• /
• v.28 no.1
• /
• pp.73-77
• /
• 1995

We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.1
• /
• pp.60-63
• /
• 2003

Gunshot injuries can range from the most minor to the life-threatening. Multidisciplinary care is required for successful management of patients, In the acute phase, care may involve emergency surgeons, anaesthesists, neurosurgeons, ophthalmic surgeons, vascular surgeons, ENT specialist in addition to the oral and maxillofacial surgeons. Afterwards, definitive treatment of facial gunshot injuries depends ultimately on the abilities and skills of the oral and maxillofacial surgeons, and their appreciation of such injuries. The timing and sequence of the surgical procedures used for reconstruction and rehabilitation of maxillofacial gunshot injuries are crucial to a successful outcome and aesthetic result. If incorrect, they may lead indefinitely to infection, graft rejection, wound dehiscence with consequent multiple revisional operations and complication which will prolong hospital stay and increase treatment costs and morbidity on those patients. We present a gunshot case of a 46-year-old man who tried to commit sucide, and have avulsive and penerating wounds on the face and the neck. We removed the scattered bullets and fragments successfully and the wounds were closed primarily.

• Archives of Plastic Surgery
• /
• v.45 no.3
• /
• pp.253-258
• /
• 2018

Background The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. Methods We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer. Results In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects. Conclusions We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

• Archives of Plastic Surgery
• /
• v.48 no.4
• /
• pp.433-439
• /
• 2021

Acellular dermal matrices (ADM) are a novel graft. The goal of this systematic review is to evaluate the evidence behind differences in human and porcine ADM, irrelevant of manufacturing method, and to determine if there is enough of an evidence base to change clinical practice. An extensive literature search was performed through MEDLINE and Embase with search terms defining a population, intervention and outcome. Title and abstract exclusion were performed with other exclusion criteria. In 191 articles were found after exclusion of duplicates, with only 29 remaining following exclusions. Ten studies were found to have level I and II evidence (I=3, II=8), of which two were histopathological, one was an animal model, one was a systematic review, and six were clinical. The remaining studies were reviewed and considered for discussion, but did not hold high enough standards for medical evidence. Strong clinical evidence already exists for the use of human ADM, but questions of access, cost, and ethics require consideration of a xenograft. Histopathologically, evidence suggests minimal long-term differences between human and porcine ADM, although there is a short acute immune response with porcine ADM. Clinically, there is limited difference in outcomes, with a small range in effect of different ADM preparations. Considering the effectiveness of ADM in wound healing, more high-level research with appropriate statistical analysis to facilitate a future meta-analysis is recommended to justify a transition from human to porcine ADM.