• Clinical Pain
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• v.19 no.1
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• pp.8-15
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• 2020

Objective: To compare the therapeutic efficacy of the bone marrow aspirate concentrate (BMAC)- platelet-rich plasma (PRP) complex with hyaluronic acid in patients with knee osteoarthritis. Method: Thirty-four patients with knee osteoarthritis participated in this study. Seventeen patients in the study group underwent BMAC and PRP extraction followed by intra-articular injection of BMAC-PRP complex within affected knee. Seventeen patients in the control group underwent intra-articular injection of hyaluronic acid. Knee injury, osteoarthritic outcome score (KOOS), and EuroQol-5D (EQ-5D) questionnaire were evaluated before, one month, three months, and six months after the injection. Results: There were statistically significant temporal differences in total KOOS scores in both BMAC-PRP and HA groups. However, there were no significant group difference in the study period. In the Sports and Recreational Function Scale, there was statistically significant improvement in the BMAC-PRP group compared to the HA group at three months (p=0.041). There were no side effects or complications in both groups. Conclusion: Intra-articular injection of BMAC-PRP showed better functional recovery in the OA at three months and this can be an alternative treatment in terms of functional recovery in the OA in addition to the decrease of pain.

• Journal of Life Science
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• v.26 no.11
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• pp.1345-1354
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• 2016

Alopecia areata (AA) is a common and tissue-specific autoimmune disease of hair follicle resulting in the loss of hair on the scalp and elsewhere on the body. Hair follicles is a unique organ because it has its own immune system and hormonal milieu and has a different immune state at each hair cycle stage. The collapses of anagen-dependent hair follicle immune privilege arise autoimmune attack, inducing ectopic MHC class I expression in the hair follicle epithelium and autoantigen presentation to autoreactive CD8+T cells, which results in AA. Clinical and experimental studies have pointed that psychological stress may also influence the hair follicle immune/hormone systems and contribute to the induction of AA. The key pathogenesis of AA is associated with immune privilege guardians (including ACTH, ${\alpha}-MSH$, and $TGF-{\beta}$), natural killer group 2D-positive (NKG2D+) cells (including NK and CD8+T cells), and stress hormones (including CRH and substance P). Effective treatments for AA are still demanded. One of the future targets of treatment will be the modification of hair follicle immune privilege including stress. Recent studies have reported that JAK inhibitors and immunomodulators used in other autoimmune disease, such as psoriasis, atopic dermatitis, and rheumatoid arthritis, Tregs, platelet-rich plasma therapy, statins, and prostaglandin anaolgues are effective for AA. Here the article reviews the recent understanding in the pathogenesis associated with perifollicular endocrine/immunology and new treatments of AA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.113-122
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• 2007

Purpose: Platelet-rich plasma (PRP) is known to accelerate and/or enhance hard and soft tissue healing and regeneration. As such, PRP has been used in various clinical fields of surgery. Recently there have been several attempts to use PRP in the field of tissue engineering. However, some controversies still exist on exact mechanism and benefits of PRP. Therefore various animal experiments are necessary to reveal the effect of the PRP. However, even if animal experiment is performed, the efficacy of the experiment could not be validated due to absence of an animal PRP model. The purpose of this study is to establish rat PRP model by comparing several PRP fabricating methods, and to assay growth factor concentration in the PRP. Materials and methods: Rat blood samples were collected from nine SD rat (body weight: 600-800g). PRP was prepared using three different PRP fabricating methods according to previously reported literatures. (Method 1: 800 rpm, 15 minute, single centrifuge; Method 2: 1000 rpm, 10 minute, double centrifuge; Method 3: 3000 rpm, 4min and 2500 rpm, 8 min, double centrifuge). Platelet counts were evaluated in an automated machine before and after PRP fabrications. In terms of growth factor assay, prepared PRP were activated with 100 unit thrombin and 10% calcium chloride. Growth factor (PDGF-BB, VEGF) concentrations on incubation time were determined by sandwich-ELISA technique. Results: An average of 3ml (via infraorbital venous plexus) to 15ml (via celiac axis) the rat blood could be collected. By using Method 3 (3000 rpm, 4 min and 2500 rpm, 8 min, double centrifugation), around 1.5ml of PRP could be prepared. This method allowed us to concentrate platelet 3.77-fold on average. PDGF-BB concentration (mean, 1942.10 pg/ml after 1 hour incubation) and VEGF concentration (mean, 952.71 pg/ml after 1 hour incubation) in activated PRP were higher than those in untreated blood. Also PDGF-BB showed constant concentration during 4-hour incubation, while VEGF concentration was decreased after 1 hour. Conclusion: Total 11,000 g minute separation and condensation double centrifuge method can produce efficient platelet-rich plasma. Platelet-rich plasma activated with thrombin has showed higher concentrations of growth factors such as PDGF-BB and VEGF, compared to the control group. Platelet-rich plasma model in a rat model was confirmed in this study.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.65-72
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• 2011

Purpose: We evaluated the complications of allograft reconstruction after a bone tumor resection, and reviewed literatures to overcome such complications. Materials and Methods: We retrospectively reviewed clinical records and radiographs of fifteen patients in whom reconstruction with allograft after bone tumor resection. Results: Eight patients were men and seven were women with a mean age of 27.1 years (1-56 years) and a mean follow-up period of 89.5 months (33-165 months). All postoperative complications related to the allograft were recorded. Twenty patients (80.0%) obtained a radiologic bony union at a mean of 8.35 months (4-12 months). The mean Musculoskeletal Tumor Society score was 73.5% (46.6-93.0%). Nine patients (60.0%) experienced one event and 3 (20.0%) patients experienced multiple events during the follow-up period. Recorded events were infection (3), fracture (2), nonunion (2), limb length discrepancy (2) and varus deformity (2). The mean event free survival period was 60.8 months (6-144 months). The mean allograft survival period was 80.2 months and the 5 year survival rate of the allografts was 83.0%. Conclusion: In order to overcome complications, the combination of an allograft and vascularized fibular graft is highly recommended. In the near future, the tissue engineering technique, the application of the stem cell and PRP, could reduce the complication of allograft such as resorption and nonunion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.498-510
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• 2001

Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.158-164
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• 2008

Purpose : Recently, various materials were developed for enhancing bone formation capacity. Platelet rich plasma(PRP) is an autologous source with several growth factors and obtained by sequestering and concentrating platelets by gradient density centrifugation. This study was to evaluate the effect of PRP on healing of grafted bone. Materials and methods : Two blood samples were obtained and analysed for measuring platelet counts of normal blood and PRP. In experimental group, two defects of mandibular bone, 10mm in diameter and 4.0mm deep, were created in the mandible and immediately grafted with autogenous bone chips mixed with PRP. In control group, same bone defects were prepared and grafted with autogenous bone chips. Gelform was used for carrier of PRP. 2 weeks, 4 weeks, 8 weeks later, each group was evaluated with histologi-cal and histomorphometric analyses. Results : According to histological observation, experimental group was showed more anastomosing newly-formed woven bone having osteoblastic activation than control group. According to histomorphometric analysis, there were 9.11% more newly-formed bone volume in experimental group than control group at 2 weeks, 7.91% more at 4 weeks, 20.08% more at 8 weeks. Conclusion: Our results demonstrated PRP in autogenous bone graft could enhance the bone formation.