• Title/Summary/Keyword: 재건술

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AN EXPERIMENTAL STUDY OF $GUIDOR^{(R)}$ BARRIER MEMBRANE ABOUT BONE PROMOTION AROUND DENTAL IMPLANTS PLACED INTO EXTRACTION SOCKET IN DOGS (성견의 Implant 주위에 $GUIDOR^{(R)}$ BARRIER MEMBRANE 사용후 골신생에 관한 실험적 연구)

  • Yang, Myeong-Cheol;Jin, Woo-Jeong;Shin, Hyo-Keun;Kim, Oh-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.135-143
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    • 1996
  • The aim of this study was to evaluate bone promotion of bioreabsorbable guided tissue regeneration for generating new bone adjacent to osseointegrated implants in dogs. Third premolars were extracted in dgo mandibles. Cylindrical HA-coated implants were placed into extracted sockets in dogs. And test sites were protected by $GUIDOR^{(R)}$ matrix barrier. But control sites were not protected by membrances. The sites were examined clinically, radiologically, and histologically after 1, 2, and 4 months to assess bone regeneration. The results obtained were as foolows : 1. There were the good healing and the stability of $GUIDOR^{(R)}$ matrix barrier in experimental site during the healing period. 2. Complete resorption of $GUIDOR^{(R)}$ matrix barrier was clinically observed about 4 months postoperatively. 3. The woven bone changed to mature bone with a normal cortical plate and mature, resting periosteum after 4 months. 4. In experimental site, there was a significantly greater bone promtion than observed in control site. 5. $GUIDOR^{(R)}$ matrix barrier was useful for the preparation of immediate dental implants.

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Vaginal Reconstruction with Modified Singapore Flap in MRK Syndrome Patients (MRK증후군 환자에서 변형 Singapore피판술을 이용한 질 재건)

  • Kim, Do-Hoon;Pyon, Jai-Kyong;Mun, Goo-Hyun;Bang, Sa-Ik;Oh, Kap-Sung;Lim, So-Young
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.616-620
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    • 2011
  • Purpose: Mayer-Rokitansky-Kuster syndrome (MRK) is second common cause of primary amenorrhea. It is a syndrome of vaginal aplasia and Mullerian duct anomaly. Vaginal aplasia varies from agenesis of whole vagina to aplasia of upper 2/3. For reconstructing vagina, various methods are introduced. Gracilis myocutaneous flap was the first attempt in that the flap is used in vaginal reconstruction. Various flap-based vaginal reconstruction methods have been introduced. Modified Singapore flap (pedicled neurovascular pudendal thigh fasciocutaneous flap) is one of those methods that used posterior labial artery as pedicle, and pudendal nerve branch as sensory root. As its donor lies on inguinal crease that is easily hidden and there are benefits on sexual intercourse by early sensory recovery, authors think that modified Singapore flap is effective for young MRK syndrome patients. Methods: Eight patients underwent surgery between 2008 and 2010. The flap was designed on both groin area with external pudendal artery branch as a pedicle. All flaps were fixated in pelvic cavity with absorbable suture, and additional compression on neovaginal wall was supplied by polyvinyl alcohol sponge ($Merocel^{(R)}$). Results: All patients were successfully reconstructed without flap related complications such as congestion or partial flap loss. The average size of the flap (each side) was 69.34 $cm^2$. Polyvinyl alcohol sponge ($Merocel^{(R)}$) was inserted into neovagina for 5 days on every patient. One case of rectal laceration was occurred while making pelvic pocket by OBGY team. Other complications such as lumen narrowing, wound contracture or vaginal prolapsed were not reported during 8 months of follow up. Conclusion: Modified Singapore flap is a sensate fasciocutaneous flap that is thinner than other myocutaneous flap such as VRAM, and more durable over skin graft. Therefore this is a good choice for vaginal reconstruction in MRK syndrome. And known complications of Modified Singapore flap could be reduced with careful procedure and mild compression techniques.

The Infection Rate in Case of Cranioplasty According to Used Materials and Skull Defect Duration (두개골 성형술의 사용 재료와 수술 시기에 따른 감염율)

  • Kim, Young-Woo;Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyung-Suck;Kim, Jae-Gun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.216-220
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    • 2001
  • Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

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Lecompte Procedure in Complex Congenital Heart Diseases (선천성 복잡 심기형에서의 Lecompte 술식의 유용성 및 임상적용에 관한 연구)

  • Kim, Yong-Jin;Kim, Kyung-Hwan;Lee, Suk-Jae;Song, Hyun;Oh, Sam-Se;Lee, Jeong-Ryul;Rho, Joon-Ryang;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.660-667
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    • 1998
  • Background: This study is to evaluate the effectiveness and application of Lecompte procedure as a treatment for various complex cardiac anomalies with pulmonary outflow tract obstruction. Methods: Between July 1988 and December 1997, 44 patients underwent Lecompte procedure in Seoul National University Children's Hospital. The male to female ratio was 24 to 20 and the mean age was 29.2 months(range, 3 to 83). Of these patients, 28(63.6%) had transposition of great arteries with ventricular septal defect and pulmonary stenosis(or pulmonary atresia), 14(31.8%) had double outlet right ventricle with pulmonary stenosis(or pulmonary atresia), and so on. The principles of the technique are 1) extension of the ventricular septal defect or conal resection, 2) construction of a intracardiac tunnel connecting the left ventricle to the aorta, and 3) direct connection, without a prosthetic conduit, of the pulmonary trunk to the right ventricle. Results: There were 3 in-hospital deaths and their causes were sustained hypoxia, myocardial failure, and sepsis, respectively. There was 1 late death due to sepsis. Reoperations were performed in 6 patients who had pulmonary outflow tract obstructions(4 cases), residual muscular ventricular septal defect(1 case), and recurrent septic vegetation(1 case). The cumulative survival rates by the Kaplan-Meier method were 92.7%, 92.7%, and 92.7% at 1, 2, and over 4 years. The reoperation free survival rates were 92.7%, 92.7%, and 70.2% at 1, 3, and over 5 years. Among the risk factors for the operative death, aortic cross clamping time had statistical significance(p<0.05) and all the risk factors for the recurrent pulmonary stenosis such as age, pulmonary artery index, and materials used for the pulmonary outflow tract reconstruction had no statistical significance(p>0.05). Conclusions: Our review suggests that Lecompte procedure is an effective treatment modality for various complex cardiac anomalies with pulmonary outflow tract obstruction. Repair in early age is possible and the rates of mortality and morbidity are also acceptable.

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Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • Lee, Sub;Kim, Han-Woong;Kang, Hyoung-Seok;Bae, Chi-Hoon;Jheon, Sang-Hoon;Kwon, Oh-Choon;Ahn, Wook-Su
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.672-679
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    • 2001
  • Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

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Serum Lmmunoglobulin G and M Level after Xenograft Valve or Valved Conduit Implantation (이종 조직판막 도관 혹은 판막 이식술 직후 면역 글로불린 항체 G, M의 혈중 농도 변화)

  • Kwak, Jae-Gun;Yoo, Jae-Suk;Yoon, Sun-Hee;Kim, Woong-Han;Kim, Kyung-Hwan;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.223-228
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    • 2008
  • Background: The aim of this study is to confirm that peripheral blood sampling for measuring of serum immunoglobulin can predict immunological changes after xenograft implantation. Material and Method: Between March 2006 and January 2007, 19 patients were enrolled (10 xenograft implantation group, 9 control group). Through 3 peripheral blood samples, we measured changes in serum immunoglobulin G and M levels preoperatively, and 2 and 10 days postoperatively. Result: In both groups, serum immunoglobulin levels showed similar changes-they decreased 2 days postoperatively, then increased up to the baseline levels 10 days postoperatively. However, this postoperative change of immunoglobulin G and M was not significantly different in absolute value or pattern between the 2 groups (Ig G; p-value=0.393, Ig M; p-value=0.193). Conclusion: We could not predict immunological changes after xenograft implantation by measuring serum immunoglobulin levels by simple blood sampling. Direct checking of ${\alpha}$-Galactose antibody may confirm an immunological reaction after xenograft implantation.

EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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The Factors Influencing the Systemic Action of Dimethoate (O.O-dimethyl-S-(N-methylcarbamoylmethyl) phosphorodithioate) to the Rice Seeds and Phytotoxic Effects (수도종자에의 Dimethoate 침투력 및 발아저해에 관여하는 요인에 관한 연구)

  • Choi Seung Yoon
    • Korean journal of applied entomology
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    • v.9 no.2
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    • pp.57-74
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    • 1970
  • These experiments were conducted to investigate the :actors influencing the systemic action of Dimethoate (O,O-dimethyl-S-(N-methylcarhamoylmethyl) photphorodithioate) to rice seeds and the phytotoxic effects on the seed germination. Dimethoate $(Roxion^{(R)})$ $40\%$ emulsion was used. The varieties tested were Jinheung. Nongkwang,Suwon #82, Norm #6, Paltal, Shirogane, Suseong, Pungkwang, Shin #2, Fujisaka #5, Kwanok, and Jaekeun. The permeated Dimethoate was extracted from the treated seeds by chloroform and quantities were determined by Spectrophotometer. The phytotoxicity was evaluated from the effects on the germination of the treated seeds which were kept in an incubator. The oxygen consumption was measured by Warburg Manometer at $30^{\circ}C$ for 60 minutes. Indices of KOH disintegration of seeds and chemical composition of the seeds were also determined. The results obtained were as followings; 1) The amount of permeated Dimethoate in the seeds showed remarkable differences with varieties. The amount of Dimethoate per 100 grains was greater as in the ascending order of Suseong, Kwanok, Nongkwang, Jinheung, Paltal, Fujisaka #5, Suwon #82, Norm #6, Shirogane, Shin #2, Pungkwang and Jaekeun. 2) It was observed that the total amount of Dimethoate in the seeds(mg./100 grains) were greater among the varieties with large grain than those with small grains, while reverse cases were true in the amount of Dimethoate in a gramme of seeds, probably because of the greater surface areas In a small grains for a gramme weight. 3) There was no significant correlation between the permeated amount of Dimethoate and amount of absorbed water by the seeds when the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours. 4) The permeability of Dimethoate to seeds significantly increased in the prolonged soaking periods, higher concentration, and higher temperature. 5) When the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours at $15^{\circ},\;20^{\circ},\; 20^{\circ},\; and \;30^{\circ}C$, the permeated amount of Dimethoate were increased at higher temperature. It seems to be that the more active penetration of Dimethoate was involved at the higher temperature. 6) The phytotoxic effects of Dinethoate on the seed germination varied with the varieties. An descending order of varietal tolerance of seeds was as followings: Jinheung, Fujisaka #5, Suwon #82, Paltal, Nongkwang, Jaekeun, Shin #2, Kwanok, Shirogane, Pungkwang, Suseong, and Norm #6. 7) There was a positive correlation between the amount of Dimethoate permeated into the seeds (mg./gram. of seeds) and phytotoxicity of seeds. 8) The Phytotoxic effects of Dimethoate showed close correlation with the degree of KOH disintegration of seeds, average germination periods, and oxygen respiration of seeds. 9) It was observed that higher protein contents of the seeds decreased the phytotoxic effects of Dimethoate. 10) Relatively high negative correlation between the degree of KOH disintegration of seeds and crude protein content of the seeds was observed. 11) The average germination period was delayed for about 2 days when the seeds were treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$. 12) The oxygen consumption of the seeds treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$ was greatly decreased when compared with that of the normal seeds. 13) The amount of oxygen consumption of the seeds (in 24 hours after 24 hours water soaking) was negatively correlated with the average germination periods of the seeds.

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SINUS FLOOR GRAFTING USING CALCIUM PHOSPHATE NANO-CRYSTAL COATED XENOGENIC BONE AND AUTOLOGOUS BONE (칼슘포스페이트 나노-크리스탈이 코팅된 골이식재와 자가골을 병행 이용한 상악동 거상술)

  • Pang, Kang-Mi;Li, Bo-Han;Alrashidan, Mohamed;Yoo, Sang-Bae;Sung, Mi-Ae;Kim, Soung-Min;Jahng, Jeong-Won;Kim, Myung-Jin;Ko, Jea-Seung;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.3
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    • pp.243-248
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    • 2009
  • Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.

Assessment of the permanent canine bone support after secondary bone graft In UCLP patients (편측성 순구개열 환자에서 이차 골이식후 맹출된 영구 견치의 치조골 지지도에 관한 연구)

  • Park, Ki-Tae
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.601-610
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    • 2001
  • The purpose of this retrospective study was to evaluate the level oi alveolar bone support of the erupted Permanent canine through the reconstructed cleft region compared to the contralateral canine on the non-cleft side. This study was limited to children with complete unilateral cleft lip and palate who underwent secondary alveolar iliac bone gvaft and the apices of the erupted canine roots were closed at the time of evaluation. With these criteria the study included 21 children whose average age at the time of bone graft reconstruction was 9.8 years, with a minimum of 12.4 years of age at the time of the evaluation. The study was limited to the use of iliac cancellous bone as the autograft material for reconstruction of the alveolar cleft. Cranial bone graft and other autogenous bone sources were excluded. The periapical radiographs were used to evaluate alveolar bone level of each canine. The percentages of root supported by the bone were established by dividing the amount of root covered with the bone by the anatomic root length. The canine oi the non-cleft side was used as an internal control and the canine on the cleft side was used as an experimental. There was a statistically significant difference in the alveolar bone support ratio between the control ($92.9\%$) and experimental canines ($8.7\%$). An average of $95\%$ level of alveolar bone support was achieved for the experimental canine in comparison to the control canine. Neither the presence of lateral incisor, nor the stage of root development of the canine at the time of the bone graft appeared to have affected the alveolar bone support ratio of the canine after the secondary bone graft.

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