• Title/Summary/Keyword: 이식술

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Free Jejunal Transfer for Benign and Malignant Esophageal Disease -7 Cases Reports (유리 공장이식 술을 이용한 식도 질환의 외과적 치료)

  • 신호승;옥창석
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1392-1397
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    • 1996
  • Over the past two years the free jejunal transfer have been used in 7 consecutive patients to restore alimentary tract continuity artier the resection of esophagus. Six patients had squamous cell carcinomas and one had esophageal stricture . The patients underwent partial esophagectomy with modified radicAl neck dissection or mediastinal Iymph node dissection. The microvascular anastomosis was performed to the neck vessels in 4 patients and to the in ercostal vessels in 3 patients. Postoperative complications were graft necrosis in one patient, and a temporary anastomotic leakage with spontaneous closure in one patient. Reconstruction of the esophagus was successful in 6 of 7 patients. We emphasize that esophagectomy followed by transplantation of a free jejunal transfer is suitable for esophageal carcinoma or intractable esophageal stricture, and involvement of the midesophagus is not a contraindication to the use of the free Jejunal transfer.

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Free Flap Transplantation to the Injured Foot (족부 손상에 시행한 유리조직 이식술)

  • Lee, Jun-Mo;Song, Yun-Sang;Hwang, Byung-Yun
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.59-64
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    • 1997
  • The aims of free tissue transplantation to the injured foot are to cover the exposed blood vessels, nerves, muscles, tendons and bones, to clear up infection, to lessen the morbidity, to shorten the hospitalization, and to prepare for further surgical procedures when no local or transpositioning flaps are available. Authors have carried out free flap transplantation in 13 cases of crushing injury, osteomyelitis and electrical burn in the foot at Chonbuk National University Hospital from June 1992 through May 1996. The results were as follows : 1. 9 cases of 13 (69%) were sustained from the traffic accident. 2. The dorsalis pedis free flap transplantation has been performed most frequently in 5 cases (38.5%), followed gracilis muscle flap in 4 cases(30.7%), rectus abdominis muscle flap in 2 cases(15.4%), latissimus dorsi muscle flap and upper arm flap in 1 each. 3. 6 muscle flaps were covered with split thickness skin graft 20 days after microsurgical anastomosis. 4. All of 13 cases were survived after microsurgical procedure and showed excellent coverage in the foot.

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Recurrent Osteofibrous Dysplasia Treated with Wide Extraperiosteal Resection and Vascularized Fibular Graft -A Case Report- (광범위 골막외 절제 후 유리 생비골 이식술로 치료한 재발성 골섬유성 이형성증 -1예 보고-)

  • Ok, In-Young;Chung, Yang-Guk;Kim, Hyung-Min;Kang, Hyun-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.47-51
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    • 2006
  • Osteofibrous dysplasia is a rare bone tumor arising in patient younger than 10 years. Because of the frequent local recurrences after intralesional curettage and even after wide extraperiosteal resection, it is difficult to treat. Recurred lesions often showed increased disease activities. We experienced a case of osteofibrous dysplasia arisen in tibia. We treated the recurrent lesion occurred after two times of curettages and bone grafts with wide extraperiosteal segmental resection and reconstruction with free vascularized fibular graft. Here we report the case with review of the related literatures.

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Partial Left Ventriculectomy as a Bridge to Cardiac Transplantation in a Patient of End-Stage Heart Failure -Case Report- (말기 심부전 환자에서 심장이식의 교량으로서 좌심실 축소술 - 중례보고 -)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.672-674
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    • 2002
  • A 40-years-old male with dilated cardiomyopathy(DCMP) and end-stage heart failure had undergone partial left ventriculectomy(PLV) in July 1997 and then underwent cardiac transplantation in January 1999. Three months later he showed increased ejection fraction (EF) from 26% to 42.6%, decreased left ventricular end diastolic diameter(LVEDD) from 71mm to 45mm, cardiac output(CO) 3.95 L/min and cardiac index(CI) 2.28 L/min/m$^2$echocardiographically. Eight months later, left ventriclular end diastolic and systolic diameters increased to 56 and 51 mm respectively and EF decreased to 17% in echocardiographic follow-up. He had been on maximum medication until he underwent cardiac transplantation 18 months after the PLV. Consecutive myocardial biopsies (1, 3 and 6 month later) showed ISHLT (international society of heart and lung transplantation) class la and the treatment for rejection was not needed until now on. We report a partial left ventriculectomy as a successful bridge to cardiac transplantation in a patient with DCMP and end-stage heart failure.

Transient Calcification of Autogenous Grafted Patellar Tendon in Anterior Cruciate Ligament Reconstruction - A Case Report - (슬관절 전방 십자 인대 재건술 후 발생한 이식 건의 일과성 석회화 - 증례 보고 -)

  • Chung, Hyun Kee;Choi, Choong Hyeok;Kim, Jong Heon;Kim, Jae Young
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.30-34
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    • 1999
  • We report the case of a 30-year-old man who was presented with transient calcification on the graft shortly after anterior cruciate ligament(ACL) reconstruction using a autogenous bone patellar tendon. The patient underwent ACL reconstruction with two incisional technique and six month later, calcific density was seen radiologically around the graft. On postoperative 13 months follow-up radiographic films, the calcific density disappeared. After two months of operation, Lachman and pivot shift test were negative and one millimeter side to side difference was detected in KT-1000 with 20 Ibs strength. But 6 months after the reconstruction, mild anterior instability was detected with the calcific density around the grafted tendon. However the anterior stability was recovered according to the disappearance of calcific density.

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ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft (전방 십자 인대 재건술: 골-슬개건-골 자가이식물)

  • Koh, Hae-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.102-108
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    • 2005
  • The incidence of anterior cruciate ligament tears is increasing as a result of the increasing participation of individuals of all ages in high-risk sports. Endoscopic anterior cruciate ligament reconstruction using autogenous central third bone-patellar tendon-bone graft is the most commonly used method. With regard to BPTB graft as the go]d standard in ACL reconstruction, there are no data that refute this claim to date. Author reviewed the biomechanical properties, donor site morbidity and selection of the bone-patellar tendon-bone graft and described the surgical technique of endoscopic ACL reconstruction using BPTB autograft.

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Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Graft Selection in ACL Reconstruction (전방 십자 인대 재건술에서 이식건 선택)

  • Lee Dong-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.92-99
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    • 2003
  • The prevalence of anterior cruciate ligament (ACL) injury is continuously increased due to sports activities and traffic accident. Simultaneously ACL reconstruction operations are on the increase. Several kinds of autografts and allografts are used in ACL reconstruction. Although ACL reconstruction using an autogenous bone-patellar tendon-bone graft is the good standard, it might have potential morbidity, anterior knee pain and minimal extension loss. To minimize the complications and disadvantages on each graft and to select appropriate graft for each patient, it is necessary to understand the unique characteristics of each graft for biomechanical aspect, morbidity and disadvantage. Selecting the appropriate graft depends on numerous factors including surgeon's preference and experience, patient's activity level and age, extent of ligament injury, tissue availability, and patient's selection for graft .

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Chondrosarcoma of Proximal Tibia Trated by Allograft - A Case Report - (동종골 이식술로 치료한 경골 근위부에 발생한 연골 육종 - 증례 보고 -)

  • Jung, Gu-Hee;Kim, Jae-Do;Chung, So-Hak;Cha, Sang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.165-170
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    • 2006
  • We reported a case of chondrosarcoma in proximal tibia in a 44-year-old man. MR images demonstrated a $3.5{\times}20$ cm sized bone tumor. In reconstruction of resected proximal tibia, we used the allograft bone and soft tissue defects were covered by medial gastrocnemius rotation flap and skin graft. There were no local recurrence and distant metastasis and any complication such as secondary infection, nonunion, metal failure at the time of the last follow-up. There was no limitation of knee motion through the appropriate rehabilitaion programs.

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Operative Treatment of Symptomatic Os Acromiale (견봉 골의 수술적 치료)

  • Ji, Jong-Hun;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Moon, Chang-Yun
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.123-130
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    • 2008
  • Os acromiale is the rare shoulder disease and its treatment is controversial. Despite conservative treatments for 6 months include medication, exercise, physical therapy and subacromial steroid injections, operative treatment for uncontrolled symptomatic Os acromiale is considered the treatment of choice. Operative treatment includes excision, arthroscopic or open reduction and internal fixation with a bone graft. Open reduction with tension band wiring and a bone graft is now the preferred treatment. We experienced 8 patients with symptomatic Os acromiale from March, 2001 to March, 2006. The average patient's age was 45 years and the man and women ratio were 2: 6. All 8 cases of symptomatic Os acromiale of the mesoacromion were treated with open reduction and internal fixation using tension-band wiring. The preoperative ASES($47.3\pm24.4$) and UCLA ($16.6\pm5.8$)scores were improved to $88.8\pm7.3$ and $31.5\pm1.9$, respectively, at the 2 year follow up. The overall UCLA score showed 1 excellent result and 7 good results. We think that symptomatic Os acromiale is a specific disease entity, and open reduction and internal fixation using tension-band wiring with K-wire is a good treatment modality.