• Archives of Plastic Surgery
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• v.41 no.3
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• pp.241-247
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• 2014

Background Autologous fat grafts have been widely used for cosmetic purposes and for soft tissue contour reconstruction. Because diabetes mellitus is one of the major chronic diseases in nearly every country, the requirement for fat grafts in diabetes patients is expected to increase continuously. However, the circulation complications of diabetes are serious and have been shown to involve microvascular problems, impairing ischemia-driven neovascularization in particular. After injection, revascularization is vital to the survival of the grafted fat. In this study, the authors attempted to determine whether the diabetic condition inhibits the survival of injected fat due to impaired neovascularization. Methods The rat scalp was used for testing fat graft survival. Forty-four seven-week-old male Sprague-Dawley rats were allocated to a diabetic group or a control group. 1.0 mL of processed fat was injected subcutaneously into the scalp of each rat. The effect of diabetes was evaluated by calculating the volume and the weight of the grafted fat and by histologically analyzing the fat sections. Results The surviving fat graft volume and weight were considerably smaller in the diabetic group than in the control group (P<0.05), and histological evaluations showed less vascularity, and more cysts, vacuoles, and fibrosis in the diabetic group (P<0.05). Cellular integrity and inflammation were not considerably different in the two groups. Conclusions As the final outcome, we found that the presence of diabetes might impair the survival and the quality of fat grafts, as evidenced by lower fat graft weights and volumes and poor histologic graft quality.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.133-136
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• 2017

A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency. The edema was relieved postoperatively and the graft was patent. During the second stage, which was performed 6 months later, the fistula was occluded by coil embolization. The staged procedure described herein provides an alternative for venous reconstruction when autologous vein is unavailable.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.371-374
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• 2003

Atherosclerosis has more than 60% of the causes of arterial occlusive diseases. The abdominal aorta and lower extremity arteries are the most common sites of occlusion. We have treated surgically 2 cases who had intermittent claudication and were diagnosed as simultaneous aortobifemoral and bilateral femoropopliteal obstruction by angiography, but had ineffective results from medical treatment or angioplasty. Simultaneously aortobifemoral bypass using Hemashield Y graft and bilateral femoropopliteal bypass using autologous greater saphenous vein were done. After operations, the symptom disappeared and there were no specific post-operative complications except abdominal wound dehiscence. In postoperative angiography, we had obtained good patency of bypass graft. We are following up patients through the out patient department without recurrence up to 16 months.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.185-189
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• 2021

An aneurysmal bone cyst (ABC) can occur in many parts of the human body, but a primary ABC of the talus is extremely rare. ABCs are benign, but aggressively growing tumors that usually occur in the first two decades of life. Patients mainly complain of pain, limited movement of the involved joint or a palpable mass. Pain may worsen suddenly because of pathological fractures. If not treated properly, ABC has a risk of local recurrence, followed by the destruction of the joint and a significant functional deficit. While the complete removal of the bone tumor is essential, it is also important to treat the resultant bone defect after removal. The talus has an important part to play in weight-bearing. Therefore, an appropriate bone graft is required for large bone defects that occur after an ABC removal from the talus. We report a primary ABC of the talus in a 28-year-old male that was treated by curettage and a bone pillar pattern graft of autologous tricortical iliac crest bone. The patient had an excellent functional outcome with early weight-bearing, and there was no recurrence at 16 months of follow-up.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.115-119
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• 1996

Malignant fibrous histiocytoma after radiation therapy is very rare and its prognosis is poor. A 52-year-old male patient was admitted due to painful mass at the sternal area which developed 6 months ago. The patient had a history of radiation therapy for esophageal cancer 5 years ago. The incisional biopy disclosed sternal sarcoma. In spite of 5 cycles of chemotherapy, the m ss progressively enlarged, and an operation was performed. Total sternectomy with overlying skin and postal cartilage was performed and reconstruction was carried out with autologous rib bone graft, bilateral pectoralis klajor muscle flap and skin graft. The microscopic examination was consistent with malignant fibrous histiocytoma. The postoperative course was uneventful and the patient was discharged on postoperative 36 day.

• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.193-197
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• 2020

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign, fibro-osseous variant of ossifying fibroma. It exhibits short-term rapid growth and has a high recurrence rate. Herein we describe a case of JPOF of the maxilla that was treated via complete excision utilizing an intraoral approach with immediate reconstruction using an iliac bone graft, in conjunction with a comprehensive review of the literature. A 20-year-old man presented with a mass on his right cheek that he reported had been growing over the last 10 months. In that cheek he had noticed fullness and experienced pressure, tenderness, and fluffiness, with no other ophthalmic or dental symptoms. After clinical, radiological, and histological examinations, the diagnosis was confirmed as JPOF. Surgical excision was performed, followed by immediate reconstruction with an autologous iliac cortical and cancellous bone graft harvested from the right iliac crest under general anesthesia. Good cicatrization of the intraoral surgical wounds and right iliac crest were evident. He was monitored for 6 months after the surgery and exhibited appropriate midfacial contour. There were no signs of recurrence or complications.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.51-55
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• 2014

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.219-225
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• 2003

Purpose: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. Materials and Methods: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were analysed with non-parameteric statistics method. Results: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced. In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. Conclusion: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.588-592
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• 2018

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.