• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.286-290
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• 2021

Objectives: The use of fat grafts in maxillofacial sculpturing is currently a common technique. Unlike fillers, autologous fats unite with facial tissues, but long-term results may still be unsatisfactory. Sharing long-term follow-ups can be helpful in making outcomes more predictable. Materials and Methods: The data from patients who were admitted from 2014 to 2016 for fat augmentation were collected. In all cases, fat grafts were injected by blunt cannula using a tunneling technique in different planes. A fan shape order for the malar, periorbital, nasolabial fold, mandibular angle and body, and perioral area was established. Results: Autologous fat was used for different sites of the maxillofacial regions. Of 15 patients, two patients were not satisfied due to fat graft resorption. For this, further injections were performed six months after the first injection using preserved fat grafts. One patient continued to be dissatisfied. There were no other complications related to fat transplants. Conclusion: Fat transplantation is a safe, reliable, and non-invasive method for facial contour and facial soft tissue defect restoration. Additional methods such as mesenchymal stem cells along with fat injection increase the survival rate of transferred fat.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.84-90
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• 2021

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

• 대한정형외과학회지
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• 제56권6호
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• pp.472-483
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• 2021

광범위 회전근개 파열의 치료는 일반적인 회전근개 파열에서와 같이 단순 봉합술을 시행하는 경우도 있으나 최근 패치의 개발이 활발해지면서 이를 이용한 봉합술 또한 시행되고 있다. 여러 종류의 패치의 성분에 대하여 이해하는 것은 패치를 이용한 봉합술 시행 시 종류의 선택에 도움을 줄 수 있으며, 광범위 회전근개 파열에 대한 보다 나은 치료를 위하여 단순 봉합술과 패치를 이용한 봉합술 사이의 임상 결과 비교, 그리고 패치의 종류에 따른 수술 후 결과 비교에 대한 최근까지의 연구결과 동향을 파악할 필요가 있다. 따라서 여기서는 광범위 회전근개 파열 환자에서 패치의 종류에 따른 치료 결과에 대한 다양한 연구들의 결과를 비교하여 보고자 한다.

• Korean Journal of Radiology
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• 제1권4호
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• pp.215-218
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• 2000

Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess.

• 한국산림과학회지
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• 제75권1호
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• pp.19-24
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• 1986

우리나라 남부지역(南地部域)에 있어서 관상(觀償) 및 조경수(造景樹)로서 이용(利用) 가치(價値)가 높은 목서류(木犀類)의 증식(增殖)에 관(關)하여 연구(研究) 결과(結果)를 요약(要約)하면 다음과 같다. 1) 쥐똥나무를 대목(臺木)으로 사용(使用)하여 접목(接木)을 해 본 결과(結果) 그 활착율(活着率)은 금목서(金木犀) 63% 은목서(銀木犀)가 60%로 나타났다. 2) 접목묘(接木苗)에 있어서 최초발순(最初發荀)은 접목일(接木日)로부터 28일(日)째 시작(始作) 되었고 신장(伸長)은 3차생장(次生長)까지 하였으며 그 신장(伸長) 비율(比率)은 금목서(金木犀) 63%, 은목서(銀木犀)가 59%로 나타났다. 3) 삽목상별(揷木床別)로 발근율(發根率)을 조사(調査)한 결과(結果) perlite와 Vermiculite 1:1 비율(比率)의 혼합상(混合床)이 가장 효과적(効果的)이 었으며 그 성적(成績)은 금목서(金木犀) 93%, 은목서(銀木犀)가 90%로 가장 양호(良好)하였다. 4) 삽목(揷木)에 의(依)한 묘목생장(苗木生長)은 녹지삽목(綠枝揷木)이 휴면지삽목(休眠枝揷木)보다 발근율(發根率)이 높은 것으로 나타났다. 5) 접목묘(接木苗)에 있어서 신장생장(伸長生長)은 7월(月)과 9월(月)에 왕성(旺盛)한 생장(生長)을 나타내었으며 10월중(月中)이 신초생장(新梢生長)이 중지(中止)되었다. 6) 금목서(金木犀)의 접목(接木) 묘고(苗高)와 근원경간(根元徑間)에 정(正)(+)의 상관(相關)을 나타내었고 동시(同時)에 직선적(直線的) 관계(關係)($r=0.70^{**}$)가 성립(成立)되었으므로 안정(安定)된 생장(生長)을 하였다고 볼 수 있다.

• Journal of Chest Surgery
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• 제53권6호
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• pp.339-345
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• 2020

Background: Iliac artery aneurysm is frequently found in patients undergoing surgical repair of an abdominal aortic aneurysm. The use of commercial bifurcated grafts is insufficient for aorto-biiliac replacement with complete iliac artery aneurysm resection. We evaluated the effectiveness of handmade composite grafts for this purpose. Methods: A total of 233 patients underwent open surgery for abdominal aortic aneurysm between 2003 and 2019, including 155 patients (67%) treated with commercial grafts and 78 patients (33%) treated with handmade composite grafts. Their operative characteristics, postoperative outcomes, and late outcomes were retrospectively reviewed. Results: The early mortality rate did not differ significantly between the groups. On average, the handmade composite graft technique took approximately 15 minutes longer than the commercial graft technique (p=0.037). Among patients who underwent elective surgery, no significant differences between the conventional and composite groups were observed in the major outcomes, including red blood cell transfusion volume (2.8±4.7 units vs. 3.1±4.7 units, respectively; p=0.680), reoperation for bleeding (2.7% vs. 3.1%, respectively; p>0.999), bowel ischemia (0% vs. 1.6%, respectively; p=0.364), and intensive care unit stay duration (1.9±6.6 days vs. 1.6±2.4 days, respectively; p=0.680). The incidence of target vessel occlusion also did not differ significantly between groups. Conclusion: The increased technical demand involved with handmade composite grafting did not negatively impact the outcomes. This technique may be a viable option because it overcomes problems associated with commercial grafts.

• Journal of Periodontal and Implant Science
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• 제26권4호
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• pp.967-987
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• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.225-231
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• 2017

Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.291-297
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• 2007

Purpose: Platelet-rich plasma(PRP) contains protein growth factors, which are actively secreted by platelets to promote wound healing. However, it is not clear whether the injection of PRP into the autologous fat grafts increases the survival rate and the degree of angiogenesis. Methods: New Zealand White rabbit ears were injected fat with PRP, saline, insulin or isoproterenol (n=8/each group) for observation of the survival and degree of angiogenesis of the injected fat. The volume of the harvested fat and the degree of angiogenesis from dorsum of rabbit ears were evaluated 4, 8, and 12 weeks after the autologous fat graft. The degree of angiogenesis was measured with microvascular density (MVD) counts. Results: The volume of harvested fat decreased in a time-dependent manner after autologous fat grafts, but the decrease rate in volume of harvested fat was slower in PRP-injected group compared to that of other control groups. The difference in the volume of the harvested fat between PRP-injected group and other control groups became significant from 4 weeks after the autologous fat graft, and was maintained up to 12 weeks. However, there was no significant difference between PRP-injected group and insulin-injected group 8 and 12 weeks after the autologous fat graft. On the contrary, MVD counts increased in a time-dependent manner after autologous fat grafts. The MVD counts were significantly higher in PRP-and insulin-injected groups than in other control groups from 4 weeks after the autologous fat graft, and these differences were maintained up to 12 weeks. There was no correlation between mean platelet numbers and the volume of harvested fat. Conclusion: The present study demonstrates that PRP-injection into autologous fat grafts increases the survival rate and the degree of angiogenesis. Thus, PRP injection with autologous fat grafts would be a promising tool for maintaining the volume of the grafted fat.

• 한국산림과학회지
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• 제78권2호
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• pp.189-197
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• 1989

호두나무(Julans sinensis)의 접목묘(接木苗) 생산(生産)을 위(寫)하여 생장(生長)이 왕성(旺盛)한 유조직(幼組織)을 접합(接合)시키는 방법(方法)으로 종자(種子)에서 발아(發芽)된 유경(幼莖)을 태목(台木)으로 하고 접수(接穗)는 신초녹지(新稍綠枝)로 하여 영지(露地)에서 유경녹지접목(幼莖綠枝接木)을 실시(實施)하여 얻은 결과(結果)를 요약(要約)하띤 다음과 같다. 1. 태목(台木)의 유경(幼莖)을 비대(肥大)하게 육성(育成)코자 plastic 원통(圓筒)을 설치(設置)하고 파종복토량(播種覆土量)은 6cm높이로 하는 것이 유경(幼莖)굵기를 10.0mm까지 키우는데 효과(効果)가 있었다. 2. 접수(接穗)는 경화이전(硬化以前)의 유지(柔枝)로 정아(頂芽)가 달린 결과지(結果枝) 및 도장지(徒長枝) 8-12cm 깊이로 사용(使用)할 때 90%의 높은 활착율(活着率)을 얻었다. 3. 유경녹지접목(幼莖綠枝接木) 시기(時期)는 5월(月)20일(日)이 적기(適期)이고 접목활착율(接木活着率)은 평균(平均) 86.0% 높게 나타났다. 4. 접목묘(接木苗)의 초기발순(初期發荀)은 접목일(接木日)로부터 25일(日) 후(後) 6월(月)15일(日)에 전체(全體) 72% 활착(活着)하였다. 5. 접목묘고생장(接木苗高生長)은 7월말(月末)로 완료(完了)하고 비대생장(肥大生長)은 10월말(月末)까지 계속(繼續)하였다. 6. 묘고(苗高)와 근원직경간(根元直徑間)의 정(正)의 상관(相關)(r=0.276**)이 있었다. 7. 휴안지접목(休眼枝接木)은 2년간(年間)에 걸쳐 생산(生産)하나 유경녹지접목묘(幼莖綠枝接木苗)는 작업방법(作業方法)이 쉽고 당년(當年)에 생산(生産)되므로 경제적(經濟的)인 효과(効果)을 얻을 수 있었다.