• Title/Summary/Keyword: Bone Transplantation

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Attenuation of Hepatic Graft-versus-host Disease in Allogeneic Recipients of MyD88-deficient Donor Bone Marrow

  • Lim, Ji-Young;Lee, Young-Kwan;Lee, Sung-Eun;Ju, Ji-Min;Park, Gyeongsin;Choi, Eun Young;Min, Chang-Ki
    • IMMUNE NETWORK
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    • v.15 no.3
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    • pp.125-134
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    • 2015
  • Acute graft-versus-host-disease (GVHD) is characterized by selective damage to the liver, the skin, and the gastrointestinal tract. Following allogeneic hematopoietic stem cell transplantation, donor bone marrow (BM) cells repopulate the immune system of the recipient. We previously demonstrated that the acute intestinal GVHD (iGVHD) mortality rate was higher in MyD88-deficient BM recipients than that in the control BM recipients. In the present study, the role of MyD88 (expressed by donor BM) in the pathophysiology of hepatic GVHD (hGVHD) was examined. Unlike iGVHD, transplantation with MyD88-deficient T-cell depleted (TCD) BM attenuated hGVHD severity and was associated with low infiltration of T cells into the liver of the recipients. Moreover, GVHD hosts, transplanted with MyD88-deficient TCD BM, exhibited markedly reduced expansion of $CD11b^+Gr-1^+$ myeloidderived suppressor cells (MDSC) in the liver. Adoptive injection of the MDSC from wild type mice, but not MyD88-deficient mice, enhanced hepatic T cell infiltration in the MyD88-deficient TCD BM recipients. Pre-treatment of BM donors with LPS increased MDSC levels in the liver of allogeneic wild type BM recipients. In conclusion, hGVHD and iGVHD may occur through various mechanisms based on the presence of MyD88 in the non-T cell compartment of the allograft.

Treatment of Fibrous Dysplasia of the Fronto-Orbital Area with Radical Resection and Autogenous Reconstruction Using Split Calvarial Bone Graft: A Case Report (전두-안와 구역에 발생한 섬유성 이형성증의 근치적 절제술 및 자가두개골 이식을 이용한 재건을 통한 치료: 증례보고)

  • Choi, Ji-An;Kwak, Jung-Ha;Yoon, Chung-Min
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.57-61
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    • 2021
  • Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

Predictors of Avascular Necrosis after Kidney Transplantation

  • Ko, Young Min;Kwon, Hyunwook;Chun, Sung Jin;Kim, Young Hoon;Choi, Ji Yoon;Shin, Sung;Jung, Joo Hee;Park, Su-Kil;Han, Duck Jong
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.200-206
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    • 2017
  • Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P<0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.

Cone-beam computed tomographic comparison of chin symphysis bone particles and allograft versus iliac crest bone graft alone for reconstruction of alveolar bone defects in cleft patients

  • Attar, Bijan Movahedian;Soltani, Parisa;Davari, Davood;Mehdizadeh, Mojdeh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.85-93
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    • 2022
  • Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

Performance Status and Quality Life of Patients with Hematopoietic Stem Cell Transplantation According to Period of Survival (조혈모세포이식 후 생존기간에 따른 수행능력과 삶의 질)

  • Woo, Hyae-Deok;Park, Jeong-Sook
    • Asian Oncology Nursing
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    • v.12 no.2
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    • pp.132-138
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    • 2012
  • Purpose: The purpose of this study was to identify the performance status and quality of life (QOL) of patients after hematopoietic stem cell transplantation (HSCT) according to period of survival. Methods: Participants consists of 83 HSCT patients who were being treated regularly at out-patient clinic in two general hospitals in D city. Data were collected using questionnaires that were modified by Functional Assessment of Cancer Therapy-Bone Marrow Transplabtation (FACT-BMT) scale and Eastern Cooperative Oncology Group (ECOG). Results: The unrelated HSCT group's survival period was significantly worse than related HSCT group and autologous HSCT group. Performance status of the group with more than 3 years survival was significantly higher than that of the group with less than a year survival. The mean score of total QOL of HSCT patients was 2.69 out of 4. Total QOL was not significantly different among period of survival less than 1 year, 1-3 years, and more than 3 years. But BMT QOL was shown that the group with more than 3 years survival was higher than the groups with less than a year survival. Conclusion: Performance status and BMT QOL of the group with less than 1 year survival was significantly lowered than the groups with more than 3 years survival.

A Clinical Study of Free Vascularized Osteocutaneous Fibular Transplantation in Infected Nonunion of Tibia (감염성 경골 불유합에 시행한 혈관 부착 유리 피부편 및 생비골 이식 수술의 임상적 고찰)

  • Song, Joon-Min;Kim, Jin-Ill;Kwon, Hee;Yoo, Jae-Eung;Park, Jong-Suk;Rah, Soo-Kyoon;Choi, Chang-Uk
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.27-36
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    • 2000
  • February 1995 to September 1999, authors have experienced seven cases of infected nonunion of tibial fractures with associated soft tissue injury and skin defect, and have accomplished union in all cases by free vascularized fibular graft. All grafts healed with no radiographic evidence of bone necrosis or resorption and have been able to treat large bony defect and skin defect simultaneously. In this study, five cases of vascularized free fibular osteocutaneous flap transfer and two cases of free fibular graft are reported. All of seven cases were infected nonunion of tibia. The results were obtained as follows 1) The mean duration of the radiologic bone union was average 5.3months. 2) Grafted fibular has been hypertrophied, average 10.6 months. 3) In five cases of preservation of posterior cortex of tibia, bony union and hypertrophy of grafted bone were earlier than that two cases of complete segmental resection of tibia. 4) In two cases which only free vascularized fibular graft were performed because achievement of cutaneous flap was failed, authors found that soft tissue defect was filled with granulation tissue and split-thickness skin graft was possible over the granulation tissue after 3 weeks postoperatively.

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Muscle Free Flap Transplantation in Chronic Osteomyelitis of the Lower Extremities (하지의 만성 골수염에 시행된 근 유리 판 이식술)

  • Lee, Jun-Mo;Song, Kwang-Hun;Park, Jong-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.49-54
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    • 2009
  • Purpose: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. Materials and Methods: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. Results: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. Conclusion: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

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Effects and Mechanisms of Bone Marrow Mesenchymal Stem Cell Transplantation for Treatment of Ischemic Stroke in Hypertensive Rats

  • Yulin Liu;Ying Zhao;Yu Min;Kaifeng Guo;Yuling Chen;Zhen Huang;Cheng Long
    • International Journal of Stem Cells
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    • v.15 no.2
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    • pp.217-226
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    • 2022
  • Background and Objectives: Stroke is the most common cause of human death and functional disability, resulting in more than 5 million deaths worldwide each year. Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cell that are able to self-renew and differentiate into many types of tissues. Therefore, BMSCs have the potential to replace damaged neurons and promote the reconstruction of nerve conduction pathways and connective tissue. However, it remains unknown whether transplanted BMSCs promote angiogenesis or improve the tissue microenvironment directly or indirectly through paracrine interactions. This study aimed to determine the therapeutic effect of BMSCs on ischemic stroke with hypertension in a rodent model and to explore the possible mechanisms underlying any benefits. Methods and Results: Middle cerebral artery occlusion was used to establish the experimental stroke model. The area of cerebral infarction, expression of vascular endothelial growth factor (VEGF) and glial cell line-derived neurotrophic factor (GDNF), and increment of astrocyte were measured by TTC staining, western blot, real-time quantitative polymerase chain reaction (RT-qPCR) and immunocytochemistry. The results showed a smaller area of cerebral infarction and improved neurological function scores in animals treated with BMSCs compared to controls. The results of RT-qPCR and western blot assays showed higher expression of VEGF and GDNF in BMSC-treated animals compared with controls. Our study also showed that one round of BMSCs transplantation significantly promoted the proliferation of subventricular zone and cortical cells, especially astrocytes, on the ischemic side following cerebral ischemia. Conclusions: Above findings support that BMSCs have therapeutic effects for ischemic stroke complicated with hypertension, which may occur via up-regulated expression of VEGF and GDNF and reduction of neuronal apoptosis, thereby promoting the recovery of nerve function.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

GUIDED BONE REGENERATION USING $REGENAFORM^{(R)}\;AND\;OSSIX^{(R)}$ MEMBRANE: THREE CASE REPORTS ($Regenaform^{(R)}$$Ossix^{(R)}$ 차단막을 이용한 골유도재생술: 증례보고)

  • Kim, Young-Kyun;Yun, Pil-Young;Lim, Sung-Chul;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.648-653
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    • 2007
  • This case study investigated the clinical effect of guided bone regeneration(GBR) using $Regenaform^{(R)}\;and\;Ossix^{(R)}$ membrane and the histology of the new bone that formed just under the membranes. $Regenaform^{(R)}$ transplantation and covering with $Ossix^{(R)}$ membrane were performed to repair bone defects around implants after implantation in three patients. After $3{\sim}4$ months, the membranes were removed in a second operation, and a biopsy was taken under the membrane. The biopsies showed a bone density of $23{\sim}42%$, and subsequent prosthetic treatments were successful in all cases.