• Title/Summary/Keyword: grafting technique

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Clavicle Nonunion: Matchstick Bone-grafting and Osteosynthesis

  • Park, Yong Bok;Yoo, Jae Chul;Park, Geun Min;Kum, Dong Ho;Tauheed, Mohammed;Jeong, Jeung Yeol
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.33-38
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    • 2016
  • Background: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management. Methods: From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3-4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score. Results: All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7-32 months). The mean follow-up period was 20.1 months (8-56 months), and the mean duration until union was 11.2 weeks (8-16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was $3.3{\pm}2.6mm$ (1-18 mm); and the difference in clavicular length between operative and non-operative site was $5.9{\pm}6.9mm$. Conclusions: Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.

Introduction of Specific Interaction of Hydroxyapatite/Polylactide Composites (수산화인회석과 폴리락타이드 복합체에서 상호작용력의 도입)

  • Kang, Jin-Kyu;Lim, Jun-Heok;Moon, Myong-Jun;Lee, Won-Ki;Kim, Mi-Ra;Lee, Jin-Kook
    • Polymer(Korea)
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    • v.33 no.1
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    • pp.13-18
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    • 2009
  • To increase mechanical properties of the hydroxyapatite/poly (L-lactide) (HA/PLLA) composite which was a potential bone substitute material, HA was modified by the surface grafting with D-lactide (DLA) and the formation of stereocomplexes between components was introduced. The composite films were prepared by the solvent-nonsolvent technique to minimize the precipitation of HA during drying. The structure and properties of the composites were investigated by thermal gravimetric analysis (TGA), differential scanning calorimeter, and scanning electron microscopy, and mechanical property measurements. TGA results showed that the amount of DLA grafted on the HA surfaces (g-HA) was 6 wt%. The obtained g-HA exhibited better dispersity in an organic solvent than HA. The formation of stereocomplexes in the composites was confirmed by the change in melting temperature. The mechanical properties of g-HA/PLLA composites were increased, compared to the HA/PLLA composites.

The Clinical Study on the Root Coverage Effects with Free Standing Connective tissue Graft (독립된 결합조직 이식술로 치은퇴축 치료시 치근 피개에 관한 임상적 연구)

  • Park, Cheol;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.30 no.3
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    • pp.651-661
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    • 2000
  • A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of $5.9{\pm}0.97mm$ from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is $4.2{\pm}1.15mm$ and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being $7.4{\pm}1.65mm$.

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The Study of Micro Crack Detection in Dissimilar Metal Weld Using a Variable Ultrasound Infrared Thermography (가변초음파 적외선열화상을 이용한 이종접합용접부의 미세균열 검출 연구)

  • Park, Jeong-Hak;Park, Hee-Sang;Choi, Man-Yong;Kwon, Koo-Ahn
    • Journal of the Korean Society for Nondestructive Testing
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    • v.35 no.3
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    • pp.215-220
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    • 2015
  • As a nondestructive inspection technology currently in use, infrared thermography has gradually expanded its application range to industry. The method detects only defect areas by grafting ultrasound on a technique of detecting infrared energy emitted from all objects with absolute temperature of 0 K and converting this energy into thermography for inspection. Ultrasound infrared thermography has merits including the ability to inspect a wide area in a short time without contacting the target object. This study investigated the applicability of the technique for defect detection using variable ultrasound excitation inspection methods on samples of Terfenol-D, a magnetostrictive material with a tunable natural resonant frequency.

Dermis Graft for Wound Coverage: A Preliminary Report (창상피복을 위한 진피이식술의 예비보고)

  • Yoon, Tae-Hwan;Han, Seung-Kyu;Kim, Jung-Bae;Ki, Woo-Kyung
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.267-270
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    • 2005
  • The two major concerns in skin grafting are poor color match at the recipient site and donor site morbidity. To overcome the limitations of the classic skin graft, we have used dermis graft-deepithelialized split thickness skin graft-for coverage of small to medium sized wounds. The important aspects of this methods involve the immediate return of epidermis to the donor site to overcome donor site morbidity and restoration of the epidermis at the recipient site by neo epithelization from the adjacent skin. From April of 2001 to July of 2003, the dermis graft was applied to 32 patients. Simultaneously, the regular split thickness skin graft procedure was performed in 33 patients. We compared the healing time in all patients. The scar condition was also evaluated at 2 to 12 months after operation. The entire dermis grafts were reepithelialized in 15.5 days. The skin grafted wounds were healed by 11.8 days. Regarding the donor sites, donor sites of dermis graft healed within 7.5 days. On the contrary those of regular skin graft required 12.8 days. The donor sites of the dermis graft were also superior to those of skin graft in scar quality and patient satisfaction. The dermis graft technique for wound coverage compares favorably to regular skin graft technique in both recipient and donor sites aesthetically and functionally.

Apicoectomy of maxillary anterior teeth through a piezoelectric bony-window osteotomy: two case reports introducing a new technique to preserve cortical bone

  • Hirsch, Viola;Kohli, Meetu R.;Kim, Syngcuk
    • Restorative Dentistry and Endodontics
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    • v.41 no.4
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    • pp.310-315
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    • 2016
  • Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.

MANDIBULAR BONE REGENERATION USING AUTOGENOUS SKIN-DERIVED PRECURSOR CELLS WITH A MIXED DEMINERALIZED BONE AND FIBRIN GLUE SCAFFOLD IN MINIATURE PIGS (미니돼지에서 자가 피부유래 전구세포와 탈회골 및 피브린 스케폴드를 이용한 하악골 골결손부의 골재생에 대한 연구)

  • Byun, June-Ho;Choi, Mun-Jeong;Choi, Young-Jin;Shim, Kyoung-Mok;Kim, Uk-Kyu;Kim, Jong-Ryoul;Park, Bong-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.3
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    • pp.198-206
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    • 2009
  • Purpose: The aims of this study were to assess the in vitro co-culturing pattern of isolated skin-derived precursor cells (SKPs) with a mixed demineralized bone (DMB) and fibrin glue scaffold and to evaluate in vivo osteogenesis after transplantation of autogenous SKPs with a these mixed scaffold in the animal's mandibular defects. Materials and Methods: We isolated SKPs from the ears of adult 4 miniature pigs. The isolated SKPs were co-cultured with a mixed DMB and fibrin glue scaffold in a non-osteogenic medium for 1, 2, and 4 weeks. Histological characteristics of in vitro co-cultured cells and scaffold were evaluated. $1{\times}10^7\;cells/100\;{\mu}l$ of autogenous porcine SKPs were grafted into the mandibular defects with a DMB and fibrin glue scaffold. In the control sites, only a scaffold was grafted, without SKPs. After two animals each were euthanized at 2 and 4 weeks after grafting, the in vivo osteogenesis was evaluated with histolomorphometric and osteocalcin immunohistochemical studies. Results: Homogeneously shaped skin-derived cells were isolated from porcine ear skin after 3 or 4 weeks of primary culture. In vitro osteogenic differentiation of SKPs was observed after co-culturing with a DMB and fibrin glue scaffold in a non-osteogenic medium. Von Kossa-positive bone minerals were also noted in the co-cultured medium at 4 weeks. As the culture time progressed, the number of observable cells increased. Trabecular new bone formation and osteocalcin expression were more pronounced in the SKP-grafted group compared to the control group. Conclusion: These findings suggest that autogenous SKP grafting with a DMB and fibrin glue scaffold can serve as a useful alternative to bone grafting technique.

Maxillary sinus floor elevation using autogenous skin-derived mesenchymal stem cells in miniature pigs (미니돼지에서 자가 피부유래 간엽성 줄기세포를 이용한 상악동저 거상술)

  • Byun, June-Ho;Kang, Eun-Ju;Maeng, Geun-Ho;Rho, Gyu-Jin;Kang, Dong-Ho;Lee, Jong-Sil;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.87-93
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    • 2010
  • Introduction: In our previous studies, we isolated porcine skin-derived mesenchymal stem cells (pSDMSCs) from the ears of adult miniature pigs and evaluated the pluripotency of these pSDMSCs based on expressions of transcription factors, such as Oct-4, Sox-2, and Nanog. Moreover, the characteristic of mesenchymal stem cells was revealed by the expression of various mesenchymal stem cell markers, including CD29, CD44, CD90, and vimentin. The aim of this study was to evaluate in vivo osteogenesis after maxillary sinus lift procedures with autogenous pSDMSCs and scaffold. Materials and Methods: The autogenous pSDMSCs were isolated from the 4 miniature pigs, and cultured to 3rd passage with same methods of our previous studies. After cell membranes were labeled using a PKH26, $1{\times}10^{7}$ cells/$100{\mu}L$ of autogenous pSDMSCs were grafted into the maxillary sinus with a demineralized bone matrix (DBM) and fibrin glue scaffold. In the contralateral control side, only a scaffold was grafted, without SDMSCs. After two animals each were euthanized at 2 and 4 weeks after grafting, the in vivo osteogenesis was evaluated with histolomorphometric and osteocalcin immunohistochemical studies. Results: In vivo PKH26 expression was detected in all specimens at 2 and 4 weeks after grafting. Trabecular bone formation and osteocalcin expression were more pronounced around the grafted materials in the autogenous pSDMSCs-grafted group compared to the control group. Newly generated bone was observed growing from the periphery to the center of the grafted material. Conclusion: The results of the present study suggest that autogenous skin-derived mesenchymal stem cells grafting with a DBM and fibrin glue scaffold can be a predictable method in the maxillary sinus floor elevation technique for implant surgery.

The Comparison of Clinical Outcomes of Off-pump versus On-pump Coronary Artery Bypass Grafting in Diabetes Patients (당뇨 환자에서 시행한 Off-pump CABG와 On-pump CABG의 비교 연구)

  • 송석원;임상현;홍순창;조수진;장병철;강면식;신혜란;유경종
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.553-558
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    • 2004
  • Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CAB G) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. Material and Method: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. Result: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. Conclusion: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.

Off-Pump Coronary Artery Bypass Grafting (심폐바이패스없이 시행하는 관상동맥우회술)

  • Kim, Ki-Bong;Lim, Hong-Gook;Huh, Jae-Hak;Ahn, Hyuk;Ham, Byung-Moon
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.38-44
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    • 2000
  • Background: We analyzed the result of the "Off-Pump" Coronary Artery Bypass grafting (OPCAB) performed to minimize inflammatory responses to cardiopulmonary bypass and myocardial ischemia during the aortic cross-clamp period. Material and Method : The preoperative diagnosis operative procedure mortality complication and postoperative course of the 50 patients who underwent OPCAB between January 1998 and September 1998 were analyzed. There were 34 males and 16 females with mean age of 60$\pm$9 years. Preoperative clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and postinfarction angina in 3(6%) patients. Preoperative angiographic diagnoses were three-vessel disease in 25(50%) two-vessel disease in 5(10%) one-vessel disease in 7(14%) and left main disease in 13(26%) patients. There were elective operation in 37 cases and urgent operation in 13 cases. Result: The mean number of grafts was 3.2$\pm$1.2 per patient. Grafts used were unilateral internal thoracic artery in 43 greater saphenous vein in 37 radial artery in 7 bilateral internal thoracic arteries in 4 and right gastroepiploic artery in 2 cases Forty sequential anastomoses were performed in 18 cases. Vessels accessed were left anterior descending artery in 48 diagonal branch in 41 obtuse marginal branch in 30 right coronary artery in 24 posterior descending artery in 9 ramus intermedius in 5 and posterolateral branch in 5 anastomoses. Predischarge coronary angiography performed in 44 patients demonstrated the patency rate of 89.5%(128/143) Operative mortality was 2%(1/150) Postoperative complications were arrhythmia in 5 graft occlusion that needed reoperation in 4. perioperative myocardial infarction in 2 femoral artery thromboembolism developed after the application of IABP in 1 postoperative transient delirium in 1 peripheral compression neuropathy in 1 case. Sixteen patients(32%) were extubated at the operating room and the other patients were extubated at the mean 13$\pm$20 hours after the operation. Mean duration of stay in intensive care unit was 49$\pm$46 hours. Thirteen patients(26%) required blood transfusions perioperatively and the amount of perioperative blood transfusion was mean 0.70$\pm$1.36 pack/patient. Conclusion: OPCAB is suggested to be the ideal technique with less postoperative complication less hospitalization time and less cost.less cost.

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