• The Journal of the Korean dental association
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• v.55 no.1
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• pp.30-41
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• 2017

Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.136-147
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• 2009

Statement of problem: Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Implantium^{(R)}$ implant, which features a sandblasted and acid-etched surface and internal connection with microthreads. Material and methods: 106 $Implantium^{(R)}$ implants placed in 38 patients at Yonsei University Hospital were examined to determine the effect of various factors on implant success and marginal bone loss, through clinical and radiographic results during a 6 to 30 month period. Results: 1. Out of a total of 106 implants placed in 38 patients, one fixture was lost, resulting in a 99.1% cumulative survival rate. 2. Among the 96 implants which were observed throughout the study period, the survival rates were 97.0% in the maxilla and 100% in the mandible. The survival rate in the posterior regions was 98.9% and 100% in the anterior regions. 3. The mean bone loss during the first year after prosthesis placement was 0.17 mm, while the mean annual bone loss after the first year was 0.04 mm, which was statistically less than during the first year(P<.05). 4. There was no significant difference in marginal bone loss according to age during the first year(P>.05), but after the first year, the mean annual bone loss in patients above 50 years was significantly greater(P<.05) compared with patients under 50 years. 5. No significant difference in marginal bone loss was found according to the following factors: gender, jaw, location in the arch, type of implant(submerged or non-submerged), presence of bone grafts, type of prostheses, and type of opposing dentition(P<.05). Conclusion: Based on these results, the sole factor influencing marginal bone loss was age, while factors such as gender, jaw, location in the arch, type of implant, presence of bone grafts, type of prostheses and type of opposing dentition had no significant effect on bone loss. In the present study, the success rate of the $Implantium^{(R)}$ implant with a SLA surface and internal connection with microthreads was satisfactory up to a maximum 30 month period, and the marginal bone loss was in accord with the success criteria of dental implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.249-255
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• 2011

Purpose: Placement of endosseous implants in the atrophic maxilla is often restricted because of the lack of supporting bone. In this article, augmentation of the maxillary sinus floor with deproteinized bovine bone to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. Methods: The procedure was used in 200 patients (839 implants), using deproteinized bovine bone. The mean follow-up was 28.5 months. No inflammation of the bone grafts nor of the maxillary sinus occurred. The patients received implant supported overdentures or bone-anchored bridges. Results: The survival rate of implant restoration of this study was 97.6%. The total average of marginal bone loss in radiographs was $0.20{\pm}0.38$ mm. Insufficient primary stability, bony quality, and infection were thought to be associated factors in the failed cases. Conclusion: This study documented that deproteinized bovine bone, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of a endosseous implant.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.575-583
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• 2013

Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. Conclusions The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.182-192
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• 2017

Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.278-286
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• 2023

Objectives: This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. Materials and Methods: One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. Results: The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. Conclusion: These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

• Horticultural Science & Technology
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• v.30 no.2
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• pp.129-136
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• 2012

This study was conducted to develop an efficient mass propagation method for the mature $Prunus$ $yedoensis$ Matsumura (43 to 58 years old). Cutting was conducted depending on cutting time, auxin treatments (IBA and NAA treatments mixed with talc powder), and cuttings position on shoots in a plastic house equipped with a fog system without heating. Rooted cuttings were transplanted to a nursery bed, and their growth characteristics were investigated in order to check whether the cuttings are successful or not for roadside tree planting. The average rooting rate was highly significant ($P$ < 0.0001) in all treatments: cutting on June 1st (61.4%) was more than two times greater in rooting rate than that on August 1st (23.6%); IBA 1,000 $mg{\cdot}L^{-1}$ (90.8%) and IBA 500 $mg{\cdot}L^{-1}$ (89.2%) showed much greater rooting rates than those of the other treatments; upper part of the cuttings treated with IBA 1,000 $mg{\cdot}L^{-1}$ showed the highest rooting rate, 96.7%. The interactions among treatments in the average rooting rate were also significant. There were significant differences ($P$ < 0.0001) among the auxin treatments in the survival rate of leafed cuttings transplanted to a nursery bed. The average survival rate was 46.5%, and IBA 1,000 $mg{\cdot}L^{-1}$ treatment was the highest in leafed cuttings 79.2%, but most of leafless cuttings were dead. There were significant differences ($P$ < 0.0001) among the cuttings, grafts, and in the seedlings height, diameter at root collar, the number of roots, branches, and leaves, etc., and the cuttings was the best. We can expect a possibility of mass propagation of improved $P.$ $yedoensis$ Matsumura and a high planting survival rate through the transplanting of cuttings to a nursery bed in which the cuttings should be the following conditions: cutting in June to July, use of the upper part of cuttings, IBA treatment, and rooting in August in a cutting-greenhouse equipped with a fog system.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.16-24
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• 2019

Background: Optimal graft selection for coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) dysfunction remains debatable. We report an analysis of our experiences of isolated CABG in patients with severe LV dysfunction and the impact of graft strategy on long-term outcomes. Methods: We analyzed 209 patients with severe LV dysfunction (ejection fraction [EF] <30%) who underwent primary isolated CABG. Of these, 169 were revascularized with a bilateral internal thoracic arterial (ITA) graft (BITA group) and 40 were revascularized with a single ITA graft (SITA group). The mean follow-up duration was $22{\pm}32$ months. Results: There were 18 early deaths (8.6%). Overall survival at 5 years was 66.7%. The rate of freedom from cardiac-related death at 5 years was 74.1%, and was significantly higher in patients who underwent off-pump CABG (p=0.005) and in the BITA group (p=0.023). Multivariate analysis demonstrated that old age (hazard ratio [HR], 2.548; 95% confidence interval [CI], 1.134-5.762; p=0.024), off-pump CABG (HR, 0.245; 95% CI, 0.090-0.661; p=0.006), and BITA grafts (HR, 0.333; 95% CI, 0.146-0.757; p=0.009) were correlated with cardiac mortality. Conclusion: CABG in patients with severe LV dysfunction (EF <30%) showed reasonable long-term outcomes. The rate of freedom from cardiac-related death was significantly higher in patients who underwent off-pump CABG and in the BITA group. Off-pump BITA grafting strategies can be accepted as a viable primary option in patients with severe LV dysfunction if performed by an experienced surgeon.