• Title/Summary/Keyword: Autologous

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Nipple-Areola Complex Necrosis after Nipple-Sparing Mastectomy with Immediate Autologous Breast Reconstruction

  • Cho, Jin-Woo;Yoon, Eul-Sik;You, Hi-Jin;Kim, Hyon-Surk;Lee, Byung-Il;Park, Seung-Ha
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.601-607
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    • 2015
  • Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.

Autologous Cartilage Intracordal Injection in Unilateral Vocal Fold Paralysis

  • Wang, Soo-Geun;Lee, Byung-Joo;Goh, Eui-Kyung;Chon, Kyon-Myong;Roh, Hwan-Jung;Lee, Jin-Choon
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.182-182
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    • 2003
  • Objectives : The methods to treat glottic incompetence include thyroplasty type I, arytenoid abduction, and intracordal injection using various materials. The intracordal injection is easy and simple and does not require skin incision. In general, the grafted cartilage shows a high survival rate, a low absorption rate and small voluminous change. The authors performed injection of minced autologous auricular cartilage and fat using a Bruning injector in unilateral vocal cord palsy We evaluate the effect and safety of autologous auricular cartilage intracordal injection. Study Design : Retrospective study. Methods : Auricular cartilage was obtained by incising tragus vertically and it was minced with a scalpel and #15 blade. About 2g of abdominal fat was obtained by small periumbrical incision and cut into small pieces. The minced cartilage was put into a 1$m\ell$ injector and then the injector was filled with fat. The operation was conducted under laryngeal microscope. Minced cartilage was injected into the vocalis muscle at the junction of the middle and posterior third of the vocal fold. In three cases, we performed autologous cartilage intracordal injection. Results : We observed no postoperative complications, such as dyspnea, granulation, inflammation, in any of the cases. The voice was improved compared with the voice prior to operation in all cases. Conclusion : Although the cases are still limited and the observation period is short, we suggest that the autologous cartilage using the auricular cartilage is the ideal and new effective augmentative material in vocal cord palsy.

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The Availability of Gore-Tex® Tube as Nerve Conduit at the Peripheral Nerve Defect (말초신경 결손시 신경도관으로서 Gore-Tex® 도관의 유용성)

  • Lee, Ki Ho;Oh, Sang Ha;Lee, Seung Ryul;Kang, Nak Heon
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.613-618
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    • 2005
  • When a large peripheral nerve defect occurs, an autologous nerve graft is the most ideal method of recinstruction. But an autologous nerve graft has many limitations due to donor site morbidities. Many previous focused on finding the ideal nerve conduit. Among them, $Gore-Tex^{(R)}$ has several advantages over other conduits. It can be manipulated to a suitable size, does not collapse easily, and it is a semi- permeable material that contain pores. A round shaped nerve can be newly formed because of its smooth inner surface. The purpose of this study was to evaluate the availability of $Gore-Tex^{(R)}$ tube as a nerve conduit at the peripheral nerve defect in the rat sciatic nerve. The 10 mm nerve gap was made in each group. A $Gore-Tex^{(R)}$ tube filled with skeletal muscle was inserted and autologous nerve graft was harvested, respectively. In the experimental group, we placed a 0.5 mm thickness, $30{\mu}m$ pored, 1.8 mm in diameter and 14 mm length tube with skeletal muscle inserted inside. In the control group, the nerve gap was inserted with a rat sciatic nerve. We estimated the results electrophysiologically and histologically to 16 weeks postoperatively. Results in the nerve conduction velocity, total myelinated axon count, myelin sheath thickness and mean nerve fiber diameter, the experimental group was substantially lower than that of the control group, but the statistic difference was not significant (p<0.05). The morphology was very similar in both groups, microscopically. From the above results, We conclude that $Gore-Tex^{(R)}$ qualifies as an ideal nerve conduit. It is suggested that $Gore-Tex^{(R)}$ tube filled with skeletal muscle may, substitute for an autologous nerve graft.

Autogenous fat grafting for mild-to-moderate postoperative temporal hollowing after decompressive craniectomy: One-year follow-up

  • Choi, Jaemin;Choi, Hyungon;Shin, Donghyeok;Kim, Jeenam;Lee, Myungchul;Kim, Soonheum;Jo, Dongin;Kim, Cheolkeun
    • Archives of Plastic Surgery
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    • v.45 no.1
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    • pp.69-73
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    • 2018
  • Background Temporal hollowing is inevitable after decompressive craniectomy. This complication affects self-perception and quality of life, and various techniques and materials have therefore been used to restore patients' confidence. Autologous fat grafting in postoperative scar tissue has been considered challenging because of the hostile tissue environment. However, in this study, we demonstrate that autologous fat grafting can be a simple and safe treatment of choice, even for postoperative depressed temporal scar tissue. Methods Autologous fat grafting was performed in 13 patients from 2011 to 2016. Fat was harvested according to Coleman's strategy, using a tumescent technique. Patient-reported outcomes were collected preoperatively and at 1-month and 1-year follow-ups. Photographs were taken at each visit. Results The thighs were the donor site in all cases for the first procedure. The median final volume of harvested fat was 29.4 mL (interquartile range [IQR], 24.0-32.8 mL). The median final volume of fat transferred into the temporal area was 4.9 mL on the right side (IQR, 2.5-7.1 mL) and 4.6 mL on the left side (IQR, 3.7-5.9 mL). There were no major complications. The patient-reported outcomes showed significantly improved self-perceptions at 1 month and at 1 year. Conclusions Despite concerns about the survival of grafted fat in scar tissue, we advise autologous fat grafting for patients with temporal hollowing resulting from a previous craniectomy.

Osteochondral Lesions of the Talus: Autologous Osteochondral Transplantation (거골의 골연골병변: 자가 골연골 이식술)

  • Bae, Su-Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.55-60
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    • 2020
  • Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.

Surgical Repair of Aortic Incompetence using Autologous Pericardium - A Case Report - (자가 심낭편을 이용한 대동맥판 폐쇄 부전의 수술적 교정;1례 보고)

  • 우석정
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1157-1160
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    • 1992
  • Aortic valve repair with the use of tailored autologous pericardial extension to the native cusp was performed in one patient with rheumatic aortic valve incompetence. The patient was a 10-year-old girl with Grade II aortic regurgitation and tiny postoperative recannalization of the patent ductus arteriosus. The left aortic coronary cusp appeared to be a little thickened and a cicatrical shortening of the distance between the free edge of the cusp and its annular attachment. A semilunar shaped patch of autologous pericardium, treated with glutaraldehyde solution[6 minutes in 0.6% solution] was sutured along the free edge of the left coronry cusp. Postoperative recovery was uneventful. Echocardiography 8 months later showed Grade I aortic regurgitation. She is now conducting as usual life.

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Reconstruction of Aorto-mitral Fibrous Skeleton in Complicated Native Valve Endocarditis -A Case Report- (심내막염 환자에서의 Aorto-mitral fibrous skeleton의 재건술 -치험 1례-)

  • Min, Gyeong-Seok;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.183-187
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    • 1995
  • This is a report of successful management of a patient with complicated native valvular endocarditis. Initially stable patient showed sudden collapse at the end of 4th week of antibiotics coverage. Echocardiography revealed that previous vegetation at the Aorto-mitral Fibrous Skeleton[AMFS developed into a false aneurysm, perforated to left atrium and caused fistulous communication between left ventricle and left atrium. Extensive debridement was performed including part of the ascending aorta, aortic cusps, the AMFS, anterior mitral cusp and roof of the left atrium. Reconstruction of the AMFS with tailored single piece of autologous pericardium enabled the implantation of mechanical valves at the aortic and the mitral position. Ascending aorta and roof of the left atrium were repaired with autologous pulmonary artery patch graft and another autologous pericardial patch. The patient was discharged on postoperative 16th day and followed - up till now without any residuae or sequelae.

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TECHNETIUM-99m BONE SCAN FOR EVALUATING AUTOLOGOUS ILIAC BONE GRAFT AND FREEZE-DRIED BONE ALLOGRAFT IN DOG'S MANDIBLE (Technetium-99m 골주사를 이용한 하악골의 자가골 및 동종골 이식의 평가에 대한 실험적 연구)

  • Jin, Sung-Bark;Kim, Soo-Kyung
    • The Journal of the Korean dental association
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    • v.22 no.1 s.176
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    • pp.37-48
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    • 1984
  • Clinical assessment of bone-graft healing in the maxillofacial region is generally limited to clinical evaluation, radiographs, and biopsy. Sequential interpretation of osseous repair, more sensitive than with conventional radiography is possible with a non-invasive, non-destructive radionuclide method. Technetium-99m radionuclide bone scan was used in the evaluation of the progress of osteogenic activity in autologous iliac bone graft and freeze-dried bone allograft of dog's mandible. Bone scan was performed at 1wk, 2wk, 4wk, 6wk, and 8wk after grafting. In autologous graft the activity ratio for the graft bone remained greater than that of the host since 2자 after grafting; however, in lyophilized allograft the activity ratio for graft bone was greater than that of the host at 6자 after grafting.

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Bronchoplasty using Autologous Pericardium and Costal Cartilage -2 cases report- (자가 늑연골과 심낭막을 이용한 기관 및 기관지성형술 -2례 보고-)

  • 권종범;나석주
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.231-234
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    • 1996
  • In the bronchial stenosis due to benign causes, bronchoplastic procedure has been considered as one of the best surgical treatment, because of preserving normal lung tissue below the affected bronchi. We have treated 2 patients (tracheal leiomyoma, bronchial stenosis due to chronic inflammatory cicatrization) that suffered from benign tracheal and bronchial stenosis by bronchoplastic procedure using autologous costal cartilage covered with pericardium. Patients showed good patency of bronchoplastic bronchi in bronchoscopic examination that was performed at 6 months afte the operation.

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Anterior Tracheoplasty Using Glutaraldehyde-Soaked Autologous Pericardium -One Case Report- (글루타르알데하이드에 담근 자가심막을 이용한 전방기관성형술 -1례 보고-)

  • 이석열;송철민;장원호;박형주;이철세;이길노
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.487-490
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    • 2002
  • A 60-year-old female was admitted to our hospital complaining of dyspnea. In the past history, she had received tracheal diversion due to recurrent aspiration after brain surgery and tracheostomy. Emergency three dimensional spiral tracheal computed tomograhpy revealed distal tracheal stenosis. The operation was performed by anterior tracheoplasty using glutaraldehyde-soaked autologous pericardium through median sternotomy. Herein we report a case of anterior tracheoplasty using glutaraldehyde-soaked autologous pericardium.