• 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.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.400-408
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• 2010

Purpose: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. Methods: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. Results: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. Conclusion: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.496-500
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• 2013

Objective : To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women. Methods : From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease. Results : The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030). Conclusion : Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.533-538
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• 2005

Due to its safety and softness, autologous fat transplantation has been commonly performed for soft tissue correction. However, the injected fat is absorbed resulting in the reduction of volume of the graft by 40-60% within a few months. Thus, there was an attempt to use adipocytes differentiated from preadipocytes in vitro for transplantation. Differentiated adipocytes were biocompatible and matured with gradual volume increase at transplantation site in clinical study(unpublished data). In addition, they did not induce immune rejection in response to nonself lymphocytes in a mixed lymphocyte reaction(MLR)(unpublished data). The purpose of this study is to differentiate mouse preadipocytes following labeling into adipocytes to establish an animal model for allogenic transplantation. Preadipocytes isolated from inguinal and retroperitoneal fat pad of C57BL/6 mice were proliferated with growth medium by passage 3 and differentiated into adipocytes with different culture conditions after labeled with BrdU. At most suitable conditions, above 90% of preadipocytes were differentiated and BrdU labeling did not affect differentiation rate and function of differentiated adipocytes. These results demonstrate that BrdU-labeled adipocytes resulting from this in vitro differentiation protocol are useful for allogenic transplantation study.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.422-426
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• 2005

Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1327-1336
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• 1992

Between Jan. 1986 and Aug. 1992. 72 patients underwent Rastelli procedure. There were 43 male and 29 female, aged 46 days to 16 years [mean age, 5.2 years] with 18 patients less than 2 years of age. All patients had complex defect, 27 pulmonary atresia with ventricular septal defect, 18 corrected transposition of great arteries with pulmonary atresia or punmonary stenosis, 10 truncus arteriosus, 10 double outlet right ventricle with pulmonary atresia or stenosis, 7 complete transposition of great artersia with pulmonary atresia or pulmonary stenosis. The types of extracardiac valved conduit used were prosthetic valve[n=47, 24 car-bomedics, 19 Ionescu-Shiley, 4 Bjork-shiley] and hand-made trileaflet valve using pericardium. [n=23, 20 bovine pericardium, Z autologous pericardium, 1 equine pericardium] The mean size of valved cinduit was 5.25mm larger in diameter than the size of main pulmonary artery. [normalized to the patient`s body surface area] There were 17 hospital death[24%] and 4 late deaths[5.6%]. Postoperative complication rate was 38.9%a, none of which was conduit-related. All patients were followed pos-toperatively for 1 to 73 months. [mean 25.8 months] During follow-up period, reoperation was done in 6 patients due to stenosis of valved conduit. Mean interval between intial repair and reoperation was 20.3 months. In our experience, li recently extracardaic valved conduits between right ventricle [or pulmonary ventricle] and pulmonary artery were inserted with increasing frequency in infants less than 2 year, but hospital mortality was decreased, 2] Risk of reoperation due to conduit stenosis is low, so that the effect of graft failure on overall survival is minimized. 3] Nevertheless, because any type of extracardaic valved conduit is not ideal in children, we recommended that Lecompte should be done if cardiac anatomy is permitted.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.673-680
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• 2020

The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.89-92
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• 2009

Purpose: The clinical syndrome of unilateral finger ischemia, caused by digital artery occlusions from embolization from the palmar ulnar artery associated with repetitive striking of the palm, has been called the hypothenar hammer syndrome (HHS). We report the case of a man with this unique disease probably caused by manual work. Methods: A 52 - year - old male left - hand dominant manual worker complained of pain and coldness in the left 4,5th finger. On physical examination, there was a tip necrosis and the result of Allen's test was mildly positive(sluggish filling of hand from the ulnar artery). Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch and distal digital artery. Surgical bypass with reverse autologous vein grafting was performed between ulnar artery and superficial palmar arch, common digital artery. Results: He had an uneventful postoperative course and has remained asymptomatic for 18 months since discharge. Patency has been confirmed by color doppler with resolution of cold intolerance and successful digital preservation. Conclusion: We introduce very unique pattern of vascular ischemic disease and recommend the arterial bypass with vein interpositional grafting.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.68-71
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• 2006

We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.588-593
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• 2014

Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and postoperative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was $7.2{\pm}0.5$, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of $8.5{\pm}0.7$ and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.