• Title/Summary/Keyword: Autologous

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Incidental finding of subclavian artery occlusion and subsequent hypoplastic internal mammary artery as a candidate recipient vessel in DIEP flap breast reconstruction

  • Seong, Ik Hyun;Woo, Kyong-Je
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.599-602
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    • 2019
  • We report a case of autologous breast reconstruction in which a thoracodorsal vessel was used as a recipient vessel after a hypoplastic internal mammary vessel was found on preoperative computed tomography (CT) angiography. A 46-year-old woman with no underlying disease was scheduled to undergo skin-sparing mastectomy and breast reconstruction using a deep inferior epigastric artery perforator flap. Preoperative CT angiography showed segmental occlusion of the right subclavian artery with severe atherosclerosis and calcification near the origin of the internal mammary artery, with distal flow maintained by collateral branches. The thoracodorsal artery was selected to be the recipient vessel because CT showed that it was of adequate size and was not affected by atherosclerosis. The patient experienced no postoperative complications, and the flap survived with no vascular complications. The breasts were symmetrical at a 6-month follow-up. This case highlights that preoperative vascular imaging modalities may help surgeons avoid using diseased vessels as recipient vessels in free flap breast reconstructions.

USE OF PLATELET-RICH PLASMA (혈소판 풍부혈장의 임상적 응용)

  • Ha, Jeong-Wan;Kim, Su-Gwan;Cho, Se-In;Lee, Cheol-Woo;Chung, Tae-Young;Kim, Soo-Heung;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.452-457
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    • 2001
  • Platelet-rich plasma is an autologous source of platelet-derived growth factor and transforming growth factor beta that is obtained by sequestering and concentrating platelets by gradient density centrifugation. We have used platelet-rich plasma for bone graft, especially allobone graft, at implant surgery, sinus lift procedure, and cyst enucleation. This article is retrospective study from October 1999 to November 2000. All cases were good healing and clinical success.

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Orthopedic and Orthodontic Treatments of a Patient with Parry-Romberg Syndrome (Parry-Romberg Syndrome 환자에서 악정형 및 교정 치료)

  • You, Kug-Ho;Baik, Hyoung-Seon
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.1-10
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    • 2012
  • Parry-Romberg syndrome(PRS) is a degenerative disease characterized by progressive hemifacial atrophy. A 10-year-old girl who had been treated for linear scleroderma at the dermatologic department visited the orthodontic department. The frontal facial photograph showed mild facial asymmetry. On the left side, mild atrophy of soft tissue, enophthalmos, cheek depression, and dry skin with dark pigmentation were observed. The radiograph showed the hypoplasia of both the maxilla and mandible on the left side. This case report describes the treatment of a patient with PRS for 7 years. To minimize the effect of progressive atrophy on the facial growth, a hybrid appliance was used. The facial photos and radiographic records were periodically taken to analyze the progression of PRS. Although it is impossible to prevent the progression of facial asymmetry, it appears to be possible to limit the atrophic effect. After the stabilization of PRS, the orthodontic treatment by the fixed appliance was performed. Additionally, autologous fat graft was performed three times at 6 month intervals. After the treatment, the patient had a confident smile and facial asymmetry was improved.

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Magnetic Resonance Imaging (MRI) of a Hypertrophy of Cartilage and Simultaneous Regeneration of a Damaged Meniscus after Autologous Bone Marrow Aspirates Concentrate (BMAC) Transplantation: a Case Report and Literature Review

  • Bae, Sung Hwan;Kim, Hyun-joo;Oh, Eunsun;Hwang, Jiyoung;Hong, Seong Sook;Hwang, Jung Hwa
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.187-191
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    • 2017
  • Bone marrow aspirates concentrate (BMAC) transplantation is a well-known technique for cartilage regeneration with good clinical outcomes for symptoms in patients with osteoarthritis (OA). Magnetic resonance imaging (MRI) has an important role in evaluating the degree of cartilage repair in cartilage regeneration therapy instead of a second assessment via an arthroscopy. We experienced a case of hypertrophic regeneration of the cartilage and a presumed simultaneous regeneration of the posterior horn of the lateral meniscus after BMAC transplantation for a cartilage defect at the lateral tibial and femoral condyle. This report provides the details of a case of an unusual treatment response after a BMAC transplant. This report is the first of its kind to demonstrate a MR image that displays the simultaneous regeneration of the cartilage and meniscus with a differentiation ability of the mesenchymal stem cell to the desired cell lineage.

Fertility preservation for patients with hematologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Dong-Yun;Kim, Seul Ki;Kim, Miran;Hwang, Kyung Joo;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.187-192
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    • 2017
  • Although the survival rate of hematologic malignancies in young patients is very high, cytotoxic therapies such as chemotherapy and total body irradiation therapy can significantly reduce a patient's reproductive capacity and cause irreversible infertility. Early ovarian failure also commonly occurs following additional cancer treatment, bone marrow transplantation, or autologous transplantation. Because the risk of early ovarian failure depends on the patient's circumstances, patients with a hematologic malignancy must consult health professionals regarding fertility preservation before undergoing treatments that can potentially damage their ovaries. While it is widely known that early menopause commonly occurs following breast cancer treatment, there is a lack of reliable study results regarding fertility preservation during hematologic malignancy treatment. Therefore, an in-depth discussion between patients and health professionals about the pros and cons of the various options for fertility preservation is necessary. In this study, we review germ cell toxicity, which occurs during the treatment of hematologic malignancies, and propose guidelines for fertility preservation in younger patients with hematologic malignancies.

Involvement of Vascular NAD(P)H Oxidase-derived Superoxide in Cerebral Vasospasm after Subarachnoid Hemorrhage in Rats

  • Kim, Dong-Eun;Kim, Chi-Dae
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.1
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    • pp.15-19
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    • 2002
  • The role of vascular NAD(P)H oxidase in subarachnoid hemorrhage (SAH)-induced vasospasm in the basilar artery was examined in a rat model. Arterial vasospasm characterized by increased wall thickness and decreased lumen size was observed at 5 to 7 days after $2^{nd}$ injection of blood into cisterna magna, and these changes were significantly ameliorated by pretreatment of diphenyleneiodonium $(DPI,\;25\;{\mu}l\;of\;100\;{\mu}M),$ an inhibitor of NAD(P)H oxidase. To determine the time course of changes in the vascular NAD(P)H oxidase activity, cerebral vasculature was isolated at different time intervals from 12 hrs to 14 days after injection of autologous blood. At 24 hrs after the second injection of blood, the NAD(P)H oxidase activity was markedly increased with an enhanced membrane translocation of p47phox, but by 48 hours both the enzyme activity and p47phox translocation regained normal values, and were remained unchanged up to 14 days after SAH. However, no significant changes in the expression of p22phox mRNA was observed throughout the experiments. These findings suggest that the activation of NAD(P)H oxidase by which assembly of the oxidase components enhanced and subsequent production of superoxide in the early stages of SAH might contribute to the delayed cerebral vasospasm in SAH rats.

Mid-term Results of Arthroscopic Anterior Cruciate Ligament Reconstruction using Autologous Bone-Patellar tendon-Bone versus Hamstring tendon (자가 골-슬개건-골과 슬괵건을 이용한 관절경적 전방 십자 인대 재건술의 중기 추시 결과)

  • Sim, J.A.;Kwak, J.H.;Lee, B.K.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.45-49
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    • 2006
  • 목적: 자가 골-슬개건-골과 슬괵건을 이용한 전방 십자 인대 재건술의 5년 중기 추시 결과를 비교 분석하고자 한다. 대상 및 방법: 전방 십자 인대 재건술을 시행한 후 5년 이상 추시 관찰이 가능한 65예를 대상으로 하였고, 골-슬개건-골이 38예, 슬괵건이 27예였다. 술 후 평가는 Lysholm 점수, 관절 운동 범위, 대퇴부 중간 부위 둘레 길이, Lachman 검사, 축 이동 검사, KT 2000 관절 계측기를 시행하였고, 술 후 합병증을 평가하였다. 결과: Lysholm 점수는 골-슬개건-골군과 슬괵건국에서 각각 평균 91점, 94.2점으로 슬괵건군이 우수하였고, 대퇴부 중간 부위 둘레 길이는 건측에 비해 각각 평균 1.7cm, 1.3cm의 차이를 보였다. 양 군간에 관절 운동 범위, Lachman 검사, 축 이동 검사 및 KT 2000 관절 계측 결과는 통계적으로 유의한 차이가 없었으나, 술 후 합병증은 과도한 보행이나 운동 후 슬관절 동통이 골-슬개건-골군에서 7예, 슬괵건 군에서 4예 관찰되었고, 전방 슬관절 동통이 골-슬개건-골군에서 4예 관찰되어, 골-슬개건-골군에서 더 많이 발생하였다. 결론: 5년 중기 추시에서 자가 슬괵건군이 우수한 슬관절 기능, 적은 합병증 등 임상적으로 우수하였으나 장기 추시가 요할 것으로 사료된다.

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In Vitro Motion Analysis of Supplementary Valve (생체외 실험을 이용한 보조판막의 운동 연구)

  • 김상현;박영환
    • Journal of Biomedical Engineering Research
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    • v.19 no.1
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    • pp.47-52
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    • 1998
  • To develop the supplementary heart valve which could reduce the complications of prosthetic heart valve, in vitro experiments were performed to analyze the movement of the supplement valves from the view point of the flow dynamics and leaflet dynamics. The autologous pericardium was attached to deficient portion of the porcine valve which was dissected completely and partially. The pericardium was treated by buffered glutaraldehyde solution in the preshaped mould to preserve the shape of the leaflet. The function of the valves were evaluated in the mock circulatory system and three sets of experiment were performed. The instantaneous motion of the leaflet was pictured by the 35mm camera and the pressure drop through the valve and cardiac output were measured. The supplementary valve which was replaced completely performed better thatn the valve replaced partially. In vitro experiments showed that the supplementary valve which was replaced completely performed better than the valve replaced partially. In vitro experiments showed that the supplementary valve could undertake the prosthetic heart valve in clinic.

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Joint Modeling of Death Times and Counts Considering a Marginal Frailty Model (공변량을 포함한 사망시간과 치료횟수의 모형화를 위한 주변환경효과모형의 적용)

  • Park, Hee-Chang;Park, Jin-Pyo
    • Journal of the Korean Data and Information Science Society
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    • v.9 no.2
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    • pp.311-322
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    • 1998
  • In this paper the problem of modeling count data where the observation period is determined by the survival time of the individual under study is considered. We assume marginal frailty model in the counts. We assume that the death times follow a Weibull distribution with a rate that depends on some covariates. For the counts, given a frailty, a Poisson process is assumed with the intensity depending on time and the covariates. A gamma model is assumed for the frailty. Maximum likelihood estimators of the model parameters are obtained. The model is applied to data set of patients with breast cancer who received a bone marrow transplant. A model for the time to death and the number of supportive transfusions a patient received is constructed and consequences of the model are examined.

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Bilateral Breast Reconstruction with Free TRAM Flaps (횡복직근 유리피판술에 의한 양측 유방 재건)

  • Ahn, Hee Chang
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.127-133
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    • 2000
  • Free TRAM flap is now increasingly suggested to patients requiring breast reconstruction after the mastectomy. This study is to introduce the experiences of bilateral free TRAM flaps for reconstruction of bilateral breasts and to suggest the way of getting the more satisfactory results. A total of 6 breasts were reconstructed in 3 patients using bilateral free TRAM flaps immediately following the mastectomy. Average operative time for bilateral breast reconstruction was 8 hours comparing to 6.5 hours for unilateral breast reconstruction. Partial or total flap loss did not occur in 6 flaps. Abdomen was repaired directly with muscle and fascia sparing technique without necessity of mesh graft. There was no complication in donor site like abdominal hernia. Bilateral breast reconstruction can achieve exceptionally good aesthetic result with low complication if it is performed with skillful technique and experience. The reason for this is that fairly good symmetry usually is obtained in the initial surgery and in most cases only minimal additional surgery is required to achieve a satisfactory aesthetic result. The one disadvantage of bilateral reconstruction with autologous tissue is the length of the surgical procedure. Although the initial bilateral breast reconstruction can be a long, tedious procedure if free flaps are used, it must be a valuable treatment option for bilaterally mastectomized patients.

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