• Title/Summary/Keyword: defect sites

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Tracheal Reconstruction with Perichondrial Graft - An Experimental Study in Rabbits - (연골피막편 이식후 기관 결손부위의 재생에 관한 실험적 연구(제 1 보))

  • 이원상;서장수;이성은;홍원표;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.3-11
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    • 1982
  • Recently through the advancement of medical and surgical managements and the development of low pressure cuffed endotracheal tube, incidence of tracheal stenosis was decreased significantly. Though its incidence was decreased markedly, stenosis was developted unfortunately in the situations such as long term use of respirator, heavy infection, trauma of the trachea and long term intubation etc. Tracheal stenosis had been handled with various methods such as mechanical dilatation, tissue graft techniques, luminal augumentation and end to end anastomosis due to their individual advantages but their effects were not satisfactory. In 1959 Lester had been found the regenerated cartilage from the perichondrium of the rib incidentaly. Since then Skoog, Sohn and Ohlsen were reported chondrogenic potential of perichondrium through the animal experiments. Though many different materials have been tried to rebuild stenosis and gaping defect of trachea, tracheal reconstruction has been a perplexing clinical problems. We choose the perichondrium as the graft material because cartilage is the normal supporting matrix of that structure and it will be an obvious advantage to be able to position perichondrium over a defect and obtain new cartilage there. The young rabbits, which were selected as our experimental animals, were sacrified from two to eight weeks after surgery. The results of our experiment were as follows; 1) In control group, the defect site of trachea was covered with fibrosis and vessels but graft site was covered with hypertrophied perichondrium and vessels. 2) Respiratory mucosa was completely regenerated in defect sites both control and grafted groups. 3) The histologic changes of the grafted sites were as follows: 2 weeks- microvessel dilatation, inflammatory reaction, initiation of fibrosis 4 weeks- decreased microvessel engorgement, submucosal fibrosis, decreased inflammatory reaction immatured cartilage island was noted in the grafted perichondrium (one specimen) 6 weeks- mild degree vascular engorgement submucosal fibrosis. chronic inflamatory reaction cartilage island and endochondrial ossification was noted in the grafted perichondrium (Two specimens) 8 weeks- minute vascular engorgement dense submucosal fibrosis. loss of inflammatory reaction. cartilage island was noted in the grafted perichondrium (two specimens) 4) There was no significant differences in regeneration between active surface in and out groups. 5) We observed immatured cartilage islands and endochondrial ossification in the perichondrial grafted groups where as such findings were not noted in control groups except fibrosis. We concluded that perichondrium was the adequate material for the reconstruction of defected trachea but our results was not sufficient in the aspect of chondrogenic potential of perichondrium. So further research has indicated possibility of chondrogenic potential of perichondrium.

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Usefulness of Venous Graft in Hand Injury (수부 손상에서 정맥이식의 유용성)

  • Lee, Hak-Sung;Kim, Youn-Hwan;Kim, Chang-Yeon;Kim, Jeong-Tae;Ahn, Hee-Chang
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.396-399
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    • 2010
  • Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

Sintering Behavior and Electrical Properties of Strontium Titanate-Based Ceramic Interconnect Materials for Solid Oxide Fuel Cells (고체산화물 연료전지용 Strontium Titanate 세라믹 접속자 소재의 소결 거동 및 전기적 특성)

  • Park, Beom-Kyeong;Lee, Jong-Won;Lee, Seung-Bok;Lim, Tak-Hyoung;Park, Seok-Joo;Song, Rak-Hyun;Shin, Dong-Ryul
    • 한국신재생에너지학회:학술대회논문집
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    • 2010.11a
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    • pp.80.1-80.1
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    • 2010
  • A strontium titanate ($SrTiO_3$)-based material with a perovskite structure is considered to be one of the promising alternatives to $LaCrO_3$-based materials since $SrTiO_3$ perovskite shows a high chemical stability under both oxidizing and reducing atmospheres at high temperatures. $SrTiO_3$ materials exhibit an n-type semiconducting behavior when it is donor-doped and/or exposed to a reducing atmosphere. In this work, $Sr_{1-x}La_xTi_{1-y}M_yO_3$ materials doped with $La^{3+}$ in A-sites and aliovalent transition metal ions ($M^{n+}$) in B-sites were synthesized by the modified Pechini method. The X-ray diffraction analysis indicated that the materials synthesized by the Pechini process exhibited a single curbic perovskite-type structure without any impurity phases, and are tolerant, to some extent, to cation doping. The sintering behaviors of $Sr_{1-x}La_xTi_{1-y}M_yO_3$ in $H_2/N_2$ and air were characterized by dilatometry and microstructural observations. The electrical conduction mechanism and the dopant effect are discussed based on the defect structures and the electrical conductivities measured at various oxygen partial pressures and temperatures.

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BLEEDING CONTROL BY CONTINUOUS WOUND DRAINAGE OF ACTIVE BLEEDING SITES OF TEETH EXTRACTION WOUND IN A PATIENT WITH ADVANCED LIVER CIRRHOSIS : REPORT OF A CASE (중증 간경변증 환자에서 발치창 과도 출혈부의 지속적 배농술을 통한 지혈 : 증례보고)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Ryu, Mi-Heon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.431-436
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    • 2009
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

Successful Epithelialization Using the Buccal Fat Pad Pedicle in Stage 3 Bisphosphonate-Related Osteonecrosis of the Jaw

  • Lee, Sangip;Jee, Yu Jin;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.38-42
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    • 2014
  • Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

Soft Tissue Reconstruction of Finger and Hand Using Arterialized Venous Free Flap (동맥화 정맥 유리 피판술을 이용한 수부와 수지 연부조직 결손의 재건)

  • Kong, Byeong-Seon;Kim, Yong-Jin;Cho, Kwang-Woo
    • Archives of Reconstructive Microsurgery
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    • v.13 no.2
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    • pp.107-116
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    • 2004
  • Flaps are necessary, when important structures such as bone, tendon, nerve and vessel are exposed. Arterialized venous free flap is suited to the coverage of finger and hand because the thickness of venous flap is thin. Authors performed 65 cases arterialized venous free flap for the soft tissue reconstruction of the hand and finger. The size of donor defect were from $1{\times}1cm\;to\;7{\times}12cm$. The mean flap area was $9.1cm^2$. The recipient sites were finger tip in 34 cases, finger shaft in 29 cases and hand in 2 cases. The donor sites were volar aspect of distal forearm in 40 cases, thenar area in 17 cases and foot dorsum in 6 cases. The types of arterialized venous free flap were A-A type in 4 cases and A-V type in 61 cases. The length of afferent vein was from 0.5 cm to 3 cm (mean 1.7 cm) and efferent vein was from 1 cm to 10 cm (mean 2.2 cm). 58 flaps(89.2%) survived eventually. 42 flaps(64.6%) survived totally without any complication. 8 flaps(12.3%) showed the partial necrosis but they were healed without any additional operations. 8 flaps (12.3%) showed the partial necrosis requiring the additional skin graft. We had a satisfactory result by using arterialized venous free flap for the soft tissue reconstruction of finger and hand. We believe that volar aspect of distal forearm, thenar area, foot dorsum are suited as a donor site and the short length of the flap pedicle, the strong arterail inflow affect the survival rate of arterialized venous free flaps.

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Various Use of Perforator Pedicled Flap : First Choice instead of Free Flap and Pedicled Flap (유경 천공지 피판술의 다양한 이용: 유리 피판술 및 유경 피판술을 대신한 1차적 선택)

  • Lee, Ho-Bin;Kim, Yong-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.17 no.2
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    • pp.87-93
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    • 2008
  • Purpose: Because of good blood supply of the pedicled perforator flap and its advantage of not requiring vessel anastomosis compared to pedicled flap, it is widely used recently. The authors intended to report the results of various pedicled perforator flaps which have been performed to reconstruct the soft tissue defects and the utility of the flap. Methods: The study was conducted for 12 cases of pedicled perforator flap which were performed at the plastic surgery department of the current hospital from the period of June, 2005 to August, 2008. Four patients were male and eight patients were female and their age was ranged from 22 to 74 years old with mean age of 42.6 years old. The sites were 1 case on face, 3 cases on chest, 3 cases on back, 4 cases on coccyx, and 1 case on foot. Results: The defect sites of all patients were successfully reconstructed by using the pedicled perforator flap. Although most of the flaps revealed congestion at the early stage after the surgery, they were recuperated within few days. One case of skin flap was reported to be partially necrotized in old age woman who has no reliable perforator. Other than that, all defects were covered successfully and acceptable aethetically. Conclusion: As stated in above, the pedicled perforator flap has many useful advantages than the conventional pedicled flap and various free flap. Unless free flap must be required, the use of pedicled perforator flap is recommended by first choice for soft tissue coverage.

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Clinical study of guided bone regeneration of extracted socket with PLA/PGA membrane and silk fibroin membrane (PLA/PGA 차폐막과 실크 피브로인 차폐막을 이용한 발치와의 골유도재생술의 비교연구)

  • Hwang, Woo-Jin;Jeong, Seong-Nyum;Kim, Yun-Sang;Pi, Sung-Hee;You, Hyung-Keun;Chung, Chong-Pyoung;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.39 no.2
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    • pp.129-138
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    • 2009
  • Purpose: This study was designed to compare the bond regeneratiom effects of treatment using silk fibroin membrane ( Nanogide-S$^{(R)}$ ) resorbable barrier with control group treated by polyactic acid / polylacticglycolic acid membrane(Biomesh$^{(R)}$ ) Methods: 44 severe bone loss on extraction socket from 44 patients were used in this study. In experimental group 22 sites of them were treated by silk fibrin membrane as and the other 22 sites were treated by polyactic acid/ polylacticglycolic acid membrane as a control group. Clinical parameters including recovered bone width, length and radiographic parameter of vertical length were evlauated at base line and 3 months after surgery. Results: 1) Severe bone width, length was significantlly decreased in two group. 2) Bone width, length was significantlly decreased in two group. 3) Decreased bone width, length and radiographic examination differences between group. Conclusions: On the basis of these results, silk fibrin resorbable membrane has similar bone regeneration ability to polyactic acid / polylacticglycolic acid membrane in guided bone regeneration for severe bone loss defect on extraction socket.

Study on the Intrinsic Defects in Undoped GaSb Bulk and MBE-grown GaSb/SI-GaAs Epitaxial Layers for Infrared Photodetectors (적외선검출소자를 위한 GaSb 결정 및 MBE로 성장한 Gasb/SI-GaAs 박막의 진성결함에 관한 연구)

  • Kim, J.O.;Shin, H.W.;Choe, J.W.;Lee, S.J.;Noh, S.K.
    • Journal of the Korean Vacuum Society
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    • v.18 no.2
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    • pp.127-132
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    • 2009
  • We have investigated the intrinsic defects remaining in epitaxial GaSb layers grown on SI-GaAs substrates compared to those in bulk GaSb crystal substrate, which is a basic material of Sb-based strained-layer superlattice infrared photodetectors. From the functional dependence of the band-to-band transition energy of the photomuminescence (PL) spectra observing up to near room-temperature (250 K), the temperature parameters of [$E_o$, $\alpha$, $\beta$] of undoped GaSb crystal are determined by using the Varshni empirical equation describing the temperature variation of the bandgap energy. Additionally to the antisite-Ga ([$Ga_{Sb}$]) with an ionization energy of 29 meV that is well known to a major intrinsic defect in GaSb, epitaxial GaSb layers show a pair of deep states at the emission energy of 732/711 meV that may be related with a complex of two antisite-Ga and antisite-Sb ([$Ga_{Sb}-Sb_{Ga}$]). Based on the analysis of the temperature and the excitation-power dependences of PL, it suggests that excess-Sb substitutes Ga-site by self-diffusion and two anti sites of [$Ga_{Sb}$] and [$Sb_{Ga}$] could form as a complex of [$Ga_{Sb}-Sb_{Ga}$] in GaSb epilayers grown under Sb-rich condition.

Lateral Oropharyngeal Wall Coverage with Buccinator Myomucosal and Buccal Fat Pad Flaps

  • Jung, Bok Ki;Song, Seung Yong;Kim, Se-Heon;Kim, Young Seok;Lee, Won Jai;Hong, Jong Won;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.453-460
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    • 2015
  • Background Reconstruction of oropharyngeal defects after resection of oropharyngeal cancer is a significant challenge. The purpose of this study is to introduce reconstruction using a combination of a buccinator myomucosal flap and a buccal fat pad flap after cancer excision and to discuss the associated anatomy, surgical procedure, and clinical applications. Methods In our study, a combination of a buccinator myomucosal flap with a buccal fat pad flap was utilized for reconstruction after resection of oropharyngeal cancer, performed between 2013 and 2015. After oropharyngectomy, the defect with exposed vital structures was noted. A buccinator myomucosal flap was designed and elevated after an assessment of the flap pedicle. Without requiring an additional procedure, a buccal fat pad flap was easily harvested in the same field and gently pulled to obtain sufficient volume. The flaps were rotated and covered the defect. In addition, using cadaver dissections, we investigated the feasibility of transposing the flaps into the lateral oropharyngeal defect. Results The reconstruction was performed in patients with squamous cell carcinoma. The largest tumor size was $5cm{\times}2cm(length{\times}width)$. All donor sites were closed primarily. The flaps were completely epithelialized after four weeks, and the patients were followed up for at least six months. There were no flap failures or postoperative wound complications. All patients were without dietary restrictions, and no patient had problems related to mouth opening, swallowing, or speech. Conclusions A buccinator myomucosal flap with a buccal fat pad flap is a reliable and valuable option in the reconstruction of oropharyngeal defects after cancer resection for maintaining functionality.