• Title/Summary/Keyword: 이식술

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The Quantitative Analysis by Digital Subtraction Radiography on the Effect of Platelet Rich Plasma Combined with Synthetic Bone Graft on Grade II Furcation Involvement (2급 치근 이개부 치료 시 합성골 이식 및 혈소판 농축 혈장의 골재생 효과에 대한 디지털 공제술의 정량적 분석)

  • Oh, Ji-Soo;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.31 no.2
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    • pp.465-475
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    • 2001
  • The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with and without porous resorbable calcium carbonate($Biocoral^{(R)}$)in humans by digital subtraction radiography. 15 teeth(control group) were treated with porous resorbable calcium carbonate($Biocoral^{\(R)}$), and 15 teeth(test group) were treated with porous resorbable calcium carbonate($Biocoral^{(R)}$) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program(5% significance level). The results were as follows: 1. In test group, the radiolucency in 3 months after surgry were significantly increased than 1 month after surgery(p<0.05). 2. In test group, there were no significant difference between 1 month after surgery and 6 months after surgery(p>0.05). 3. In test group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. In control group, the radiolucency in 3 months and 6 months after surgery were significantly increased than 1 month after surgery(p<0.05). 5. In control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 6. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.

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Cross Finger Flap with Reduction Pulp Plasty and Full Thickness Skin Graft (수질부 축소술과 전층 피부이식술을 이용한 교차수지 피판술)

  • Cho, Yong Hyun;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.674-677
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    • 2009
  • Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.

Heart Valve Replacement With Ionescu-Shiley Valves: Report Of 265 Cases (IonescuShiley 판막 사용 심장판막이식술[265례 보고])

  • Lee, Yung-Kyoon;Kim, Sam-Hyun
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.369-380
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    • 1981
  • In this department 504 cases of valve replacement were done since 1968 to the end of October 1981. Since October 31, 1978 to the end of October 1981 ,333 Ionescu-Shiley bovine pericardial xenograft bioprosthetic cardiac valves were replaced in 265 patients. There were 149 males and 116 female. Ages ranged from 2 to 63 years with 25 cases under 15 years of age. Among 265 cases of Ionescu valve replacement there were 157 MVR, 36 VAR, 6 TVR, 45 MVR+ AVR, 16 MVR+TVR and 5 MVR+AVR+TVR cases with mortality of 5.7%, 8.3%, 16.7%, 8.9%, 18.8% and 20% for each group respectively. Over all mortality rate in 265 Ionescu valve replacement cases was 7.9% with 21 total deaths. Main causes of operative deaths were due to LCOS in 7, bleeding in 5, arrhythmia in 3, air embolism in 2,and heart block in 2 cases. There were 12 late complications with 6 deaths. Over all long-term survival rate was 89.8%. MVR showed the highest long-term survival rate with 92.4%, and MVR+AVR+TVR the lower with 80% lower with 80%.Average follow-up period was 14 month duration. Twenty five congenital anomaly cases were operated with Ionescu-valve replacement that consisted of 7 VSD+AI, and 5 Ebstein anomaly cases with over all operative mortality of 16% and late mortality of 14.3% among 21 operative survivors. There were 25 Ionescu valve replacement cases in pediatric patients under the age of 15 years, with 4 operative deaths. Fourteen MVR, 7 AVR, and 3 TVR cases were found. Even though long-term follow-up study was short in postoperative period with total of 33~.0 months among 244 operative survivors ranging one to 36 months, the late survivors showed beneficial long-term results two thromboembolic episodes in 244 patients were found. More cases and longer term follow-up study are warranted for valve replacement in pediatric and TVR cases with Ionescu-valves which have advantageous hemodynamic structures compared with other bio-prosthetic heart valves.

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Pharyngoesophageal Reconstruction Using Free Jejunal Graft (유리공장이식편을 이용한 인두 및 경부식도 재건술)

  • 김효윤
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.140-147
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    • 1994
  • Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

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Surgical Treatment of Main Pulmonary Artery Aneurysm with Patent Ductus Arteriosus -A Case Report- (동맥관개존증에 동반된 주폐동맥류의 수술치험 - 수술치험 1례)

  • 김대식;이성주;권오우;김창회;채성수;오성철
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1270-1275
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    • 1996
  • Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.

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A Case of Refractory Vitiligo Treated with Non-cultured Epidermal Cell Suspension Transplantation Using Suction Blister Method (흡입수포를 이용한 비배양표피세포이식술로 치료한 난치성 백반증 1예)

  • Eun, Sung Hye;Jung, Yu Seok;Lee, Hanna;Lee, Ji Hae;Kim, Gyong Moon;Bae, Jung Min
    • Korean journal of dermatology
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    • v.56 no.9
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    • pp.552-555
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    • 2018
  • Vitiligo is a commonly acquired cutaneous depigmentation disorder that affects 0.5~1% of the population worldwide. While phototherapy is the primary treatment for vitiligo, surgical methods can be used for treating patients who are refractory to conventional treatments. Herein, we present the case of a 14-year-old Korean girl who developed vitiligo after hematopoietic stem cell transplantation for the treatment of acute lymphoblastic leukemia. She had multiple depigmented patches on her lower legs that did not respond to narrow-band ultraviolet B phototherapy for 7 months. The depigmented patches were successfully treated by transplantation of non-cultured epidermal cell suspension from the epidermal roof of the suction blister in the right inner thigh. No adverse event, such as secondary infection or scarring in both the donor and recipient sites, was noted. We recommended that non-cultured epidermal cell suspension transplantation using the suction blister method would be a safe and effective option for the treatment of refractory vitiligo.

An Improved Online Algorithm to Minimize Total Error of the Imprecise Tasks with 0/1 Constraint (0/1 제약조건을 갖는 부정확한 태스크들의 총오류를 최소화시키기 위한 개선된 온라인 알고리즘)

  • Song, Gi-Hyeon
    • Journal of KIISE:Computer Systems and Theory
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    • v.34 no.10
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    • pp.493-501
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    • 2007
  • The imprecise real-time system provides flexibility in scheduling time-critical tasks. Most scheduling problems of satisfying both 0/1 constraint and timing constraints, while the total error is minimized, are NP-complete when the optional tasks have arbitrary processing times. Liu suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on uniprocessors for minimizing the total error. Song et at suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on multiprocessors for minimizing the total error. But, these algorithms are all off-line algorithms. In the online scheduling, the NORA algorithm can find a schedule with the minimum total error for the imprecise online task system. In NORA algorithm, EDF strategy is adopted in the optional scheduling. On the other hand, for the task system with 0/1 constraint, EDF_Scheduling may not be optimal in the sense that the total error is minimized. Furthermore, when the optional tasks are scheduled in the ascending order of their required processing times, NORA algorithm which EDF strategy is adopted may not produce minimum total error. Therefore, in this paper, an online algorithm is proposed to minimize total error for the imprecise task system with 0/1 constraint. Then, to compare the performance between the proposed algorithm and NORA algorithm, a series of experiments are performed. As a conseqence of the performance comparison between two algorithms, it has been concluded that the proposed algorithm can produce similar total error to NORA algorithm when the optional tasks are scheduled in the random order of their required processing times but, the proposed algorithm can produce less total error than NORA algorithm especially when the optional tasks are scheduled in the ascending order of their required processing times.

Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Mid-term Results of the Ross Procedure (Ross 술식의 중단기 성적)

  • Kang Seong-Sik;Jung Sung-Ho;Lee Sang-Gwon;Joo Suk-Jung;Song Hyun;Song Meong-Gun;Lee Jae-Won
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.23-28
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    • 2005
  • Ross procedure is ideal aortic valve replacement method with several merits of hemodynamic superiority and durability without the need of anticoagulation. Based upon this presumption, we studied its procedure performed in our hospital and tried to get the mid-term results Material and Method: From Jan 1999 to Oct 2001, 22 patients underwent the Ross procedure. The mean age of experimented (including 17 men and 5 women) was $30.9{\pm}8.1(17\~44)$. The diagnosis before the surgery had shown 20 as accompanied with AR and the rest 2 as with ASR. The follow-up period ranged from 0.6 to 40.6 months, mean of $38.9{\pm}1.6\;months,\;and\;follow-up\;rate\;was\;100{\%}$. Result. There was no operative death and two late deaths, one of whom was cardiac originated and the other, non-cardiac relate The survival rate was $94.1{\pm}5.7{\%}$(40.6 months). Postoperatively there were 2 exploration for bleeding, 3 low cardiac output patients. The pulmonary autograft technique was root replacement in 14 and inclusion technique in 8. Pulmonary homografts were used at the pulmonary position in all cases. There was no patient with significant aortic regurgitation. Conclusion: These showed that the mortality and morbidity of the Ross procedure were acceptable and postoperative AR was not significant. However, further long-term follow-up will be necessary for the improvement of the function of pulmonary autograft and homograft.