• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.3
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• pp.146-152
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• 2009

Traditional surgical method or injection using filler is performed for soft tissue augmentation. Surgical methods have disadvantage of surgical morbidity. Commercially available injectable materials have the disadvantages such as resorption, short-term effect. repeated application and hypersensitivity. Significant shortcoming of cell therapy using autologous fibroblasts is delay of treatment effect. Chitosan/${\beta}$-glycerol phosphate (GP) solution has thermosensitive property and allows sol-gel transition at physiologic pH and temperature. These properties may resolve the delay of treatment effect. The purposes of this study are to evaluate the viscosity and pH changes of chitosan/${\beta}$-GP solutions and to evaluate the effect of chitosan/${\beta}$-GP solution on fibroblast proliferation and production of collagen. We measured the viscosity and pH as function of temperature, of the solution containing 1:0.7, 1:0.75, 1:0.8 chitosan (1, 10, 100, 700 kDa) /${\beta}$-GP. Fibroblasts from ears of 5 rats were cultured in chitosan/${\beta}$-GP solutions for 3 weeks. Cell proliferation and collagen contents were measured every week with WST (water-soluble tetrazolium salt) assay and Collagen assay respectively. The Results are 1) Chitosan(100 kDa<)/${\beta}$-GP solution (1:0.75) showed sol-gel transition at physiologic pH and body temperature and injectable properties. It will enable to resolve the delay in treatment effect 2) Cell proliferation and total collagen contents of the control group were increased with time. However, these decreased after the 1st week in experimental group 3) Collagen contents in the experimental group are higher than that of control group. Chitosan/${\beta}$-GP solution may provide favorable conditions for cell function

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.1-38
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• 1997

This study was performed to investigate the effects of Kamigyemyoungsan and each compositive herbs on the intravascular coagulation and subcutaneous hematoma. The intravascular coagulation was induced by the injection of endotoxin into the caudal vein of the rats. These rats were treated with endotoxin after administering orally extracts of Kamigyemyoungsan and each compositive herbs. Then the number of platelet, prothrombin time, the concentration of fibrinogen and FDP(fibrinogen degration product), hematocrit and RBC and WBC were measured. The subcutaneous hematoma was induced by the subcutaneous injection of the autologous whole blood to produce clotting in situ in rats. Then the extracts of Kamigyemyoungsan and each compositive herbs were administered orally. The lesions were then dissected and observed. The results were obtained as follows ; 1. The number of platelets of the trial groups was increased as compared with the control group, and revealed significance in sample Ⅰ. 2. The concentration of fibrinogen of the trial groups was increased as compared with the control group, and revealed significance in sample Ⅰ, sampleⅡ and sample Ⅴ. 3. The prothrombin time was shortened significantly in the trial groups, except sampleⅡ and sampleⅣ as compared with the control group. 4. The concentration of FDP decreased in the trial groups, and revealed significance in sample Ⅰ and sample Ⅵ as compared with the control group. 5. The hematocrit significantly increased in sample Ⅰ, sampleⅢ and sample Ⅵ as compared with the control group. 6. The number of RBC significantly increased in sample Ⅵ only as compared with the control group. 7. The number of WBC significantly increased in the trial groups, except sampleⅣ and sample Ⅵ as compared with the control group. 8. Histologically, the lesions in the trial groups showed significantly thinner fibroblastic neomembrane than the control group, except sampleⅢ. According to the above results, it is considered that Kamigyemyoungsan and each compositive herbs have inhibitive effects on the thrombosis and the fibroblastic neomembrane development. Therefore, it seems to be applicable to the diseases related to thrombosis and hematoma.

• Clinical and Experimental Pediatrics
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• v.62 no.11
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• pp.422-427
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• 2019

Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results: The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion: BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

• The Korean Journal of Physiology
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• v.11 no.1
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• pp.21-26
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• 1977

Many cases have been reported that a post spinal headache can be relieved immediately by an epidural injection of saline; and autologous blood also has recently been used successfully instead of saline. The changes of the cerebrospinal fluid pressure in 40 cases were observed in the present study in support of the concept; that a continuous leakage in association with hypovolemia and hypotension of the cerebrospinal fluid is the primary cause of a post spinal headache. Subarachnoid pressure increased immediately with saline injection into the lumber epidural space. A spinal needle was inserted into the subarachnoid space at the level of $L2{\sim}3$ and opening pressure of the cerebrospinal fluid was read. An epidural Tuohy needle was insertad at the$L3{\sim}4$ and 25m1 of saline was injected into the epidural space and the cerebrospinal fluid pressure was read in the sitting position. $\underline{Sitting\;Position:}$ Mean pressure after injection $555{\pm}(110.9)mm\;H_2O$, Pressure rise rise (%) 51.3%, Mean opening pressure $366{\pm}(52.2)mm\;H_{2}O$, $\underline{Lateral\;position:}$ Mean pressure after injection $308{\pm}(70.8)mm\;H_{2}O$, Pressure(%) 86.7%, Mean opening pressure $165{\pm}(42.6)mm\;H_{2}O$. These pressure changes responded almost simultaneously as saline was injected. This pressure rise of 51.3% in the sitting position and 86.7% in the lateral position are clinically very significant. Therefore, it is most possible that the immediate relieve of post, spinal headache by injection of fluid into the epidural space is simultaneous with the increase of the cerebrospinal fluid pressure.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.14-21
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• 2014

Background: There are several options for replacement of the dermal layer in fullthickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools. Methods: We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements. Results: The average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group. Conclusion: The new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.327-333
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• 2006

Future cell-based therapies such as tissue engineering will benefit from a source of autogenous pluripotent stem cells. There are embryonic stem cells (ESC) and autologous adult stem cells, two general types of stem cells potentilally useful for these applications. But practical use of ESC is limited due to potential problems of cell regulation and ethical considerations. To get bone marrow stem cells is relatively burden to patients because of pain, anesthesia requirement. The ideal stem cells are required of such as the following advantages: easy to obtain, minimal patient discomfort and a capability of yielding enough cell numbers. Adipose autologus tissue taken from intraoral fatty pad or abdomen may represent such a source. Our study designed to demonstrate the ability of human adipose tissue-derived stromal cells (hATSC) from human abdominal adipose tissue diffentiating into osteocyte and adipocyte under culture in vitro conditions. As a result of experiment, we identified stromal cell derived adipose tissue has the multilineage potentiality under appropriate culture conditions. And the adipose stromal cells expressed several mesenchymal stem cell related antigen (CD29, CD44) reactions. Secondary, we compared the culture results of a group of hATSC stimulated with TGF-${\beta}$1, bFGF with a hATSC group without growth factors to confirm whether cytokines have a important role of the proliferation in osteogenic differentiation. The role of cytokines such as TGF-${\beta}$1, bFGF increased hATSC's osteogenic differentiation especially when TGF-${\beta}$1 and bFGF were used together. These results suggest that adipose stromal cells with growth factors could be efficiently available for cell-based bone regeneration.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.229-236
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• 2007

Purpose: Breast reconstruction with deep inferior epigastric perforator(DIEP) free flap is known to be the most advanced method of utilizing autologous tissue. The DIEP free flap method saves most of the rectus abdominis muscle as well as anterior rectus sheath. Therefore, the morbidity of the donor site is minimized and the risk of hernia is markedly decreased. Methods: We chose the internal mammary artery and its venae comitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels. The number and location of the perforators derived from medial or lateral branch of deep inferior epigastric artery(DIEA) in 23 DIEP flaps were identified. Ten patients underwent evaluation of their abdominal wall function preoperatively and 6 months postoperatively by using Lacote's muscle grading system. Results: Of the 23 patients, a patient with one perforator from lateral branch of DIEA experienced partial necrosis of flap. Total flap loss occurred in one patient. Mild abdominal bulging was reported in one patient 4 months postoperatively probably because of early vigorous rehabilitational therapy for her frozen shoulder. Postoperative abdominal wall function tests in 10 patients showed almost complete recovery of muscle function upto their preoperative level of upper and lower rectus abdominis and external oblique muscle function at 6 months postoperatively. All patients have been able to resume their daily activities. Conclusion: The breast reconstruction with DIEP free flap is reliable and valuable method which provide ample soft tissue from abdomen without compromising the integrity of abdominal wall. Selection of reliable perforators is important and including more than two perforators may decrease fat necrosis and partial necrosis of flap.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.726-731
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• 2010

Purpose: Autologous fat grafting is a popular procedure for the correction of the soft tissue depression and deformity. But there are several issues required to be carefully considered in relation to this procedure, mainly about the unpredictability and the low survival rate of the grafted fat due to absorption and partial necrosis. Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator that has been proposed to promote angiogenesis and to regulate the differentiation of adipose derived stromal cells (ASCs). In this study, we analyzed the viability of the grafted fat tissue mixed with S1P into each 12 nude mice (cann.cg-fox1nu/crlori) compared to the group of mice grafted fat tissue only. Methods: Human aspirated fat was grafted subcutaneously into the backs of 8-week-old nude mice with or without S1P. Eight weeks later, the grafted fat was harvested and the weight and volume were checked. The fat was stained with hematoxylin-eosin and 4',6-diamidino-2-phenylindole. Results: S1P group weighed significantly more than the control group (p=0.009), and the volume from the S1P group was considerably larger than that of the control group (p=0.004) either. In histological features, the surviving layer of the S1P group was thicker than the control group and microvasculature appeared to be prominent in the S1P group, especially in the outer layers. Conclusion: These findings suggest that S1P plays a vital role in the soft tissue augmentation, potentially providing a novel point of the control in adipose tissue for microfat graft.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.678-683
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• 1995

Arterial bypass for the chronic ischemia of the lower extremities underlying atherosclerotic obliterans has been performed with a number of alternative conduits from 1941 by Kunlin. It is indicated for the limb salvage of patients with threatened limb loss despite of several controversies in surgical treatment of atherosclerotic obliterans. From March 1991 to January 1995, 26 arterial bypasses were performed in 23 patients with the chronic ischemia of the lower extremities in our hospital. Their mean follow up period is 18.9 months ranging from 4 months to 44 months. Mean age is 60.9 years ranging 47 years to 76 years and the most prevalent incidence is the 6th decade. 21 patients are male and 2 patients are female. 19 of 23 patients are smokers. Clinical classifications by Fontaine are class II[21.7% , class III[34.8% and class IV[43.5% .Diabetes mellitus[47.8% , hypertension[43.5% , hyperlipid-emia[26% , tuberculosis[21.7% , cerebrovascular accident[13.0% and cardiac diseases[8.7% are associated. Aorto-single femoral bypass in 4 cases, aorto-bifemoral bypass in 5 cases, aortofemoral & femoropopliteal bypass in 2 cases, femoropopliteal bypass in 10 cases, popliteotibial bypass in 3 cases, femoropedal bypass[composite graft bypass in 2 cases were surgically approached. There are complicated early thrombosis in 4 cases those are required immediately reoperation, wound infection in 3 cases, hematoma in 3 cases, and so on. Postoperative complication rate is 53.8%.Postoperative patency rates are 84.6% at 6 months, 75.0% at 1 year, 70.0% at 2 years and 66.7% at 3 years. We usually used 6 mm & 8 mm graft for bypass, and the rate of thrombosis formation is 28.6%[2/7 in 6 mm graft and 12.5%[2/16 in 8 mm separately. In according to the graft materials, the rate of thrombosis formation is higher in the group using artificial graft than in that using autologous saphenous vein[16.6% vs 12.5% . Limb salvage rate is 76.9%. Postoperative mortality rate is zero %.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.948-953
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• 2000

일반적으로 개심술에는 많은 양의 실현이 따르게 마련이고 그 결과로 많은 수혈을 하게 되는데, 응혈 이상증, 과민반응, 급성호흡곤란증 등의 수혈부작용과 간염 및 후천성면역결핍증 등의 질병 감염의 위험성, 그리고 종교적인 이유 등으로 최근들어 동종수혈을 줄이고자 하는 노력이 계속되고 있다. 개심술시 동종수혈에 따른 부작용을 피하기 위해, 동종수혈 없이 자가수혈만으로도 성인개심술이 가능한지 연구하였다. 서울대학교 의과대학 흉부외과학 교실에서는 1996년 1월부터 12월까지 1년 간 자가수혈만으로 개심술을 시행한 실험군 126명과 동종수혈을 시행한 대조군 45명을 대상으로 양군을 비교하였다. 양군 간에 환자의 성별, 대동맥 질환을 제외한 기타 질환, 대동맥수술과정을 제외한 단순 및 복잡수술과정, 평균 대동맥 겸자시간, 수술전 및 수술후 1일째와 7일째 혈색소수치 및 적혈구용적, 수술 전후의 protein 수치와 수술후 albumin 수치, 자가수혈량과 혈장증량제 사용량 등에서는 유의한 차이가 없었으나, 연령, 대동맥질환 및 대동맥수술과정, 평균체외순환시간, 수술 후 회수된 피의 양, 수술직후의 혈색소수치와 적혈구용적, 수술 전 albumin 수치, 그리고 3일간 흉관으로 배액된 양에 있어 차이가 있었다. 본 연구를 통해 동종수혈 없이 자가수혈만으로도 큰 차이없이 여러 종류의 성인 개심술을 성공적으로 할 수 있음을 보고한다.