• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.203-216
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• 1991

Nerve allografts as a bridge of regeneration is useful in the repair of peripheral nerve defect resulting from trauma, and leprosy. But immunological rejection and complicated scar formation is an unavoidable problem in the application of allogeneic nerves. This article is intended to study of the regeneration of allogeneic nerve grafts in rats with histopathologically, scanning electron microscopically. 24 adult male Sprague-Dawley rats were used as the experimental animals. A 2cm skin incision was made on the lateral aspects of limb, parallel to femur. Segments of sciatic nerve trunk taken from rats, 10mm was resected at the middle of the thigh, nerve graft was inserted between the ends of gaps with perineural and epineural suture method with 10-0 prolene. Obsrevation was made simultaneously at 3 day, 1, 2, 3, 4, 5, 6, 8 weeks after surgery. The results were as follows. 1. In light and electronic microscopic studies, marked degenerative change of the graft nerves were observed at 2 weeks after surgery. 2. After surgery, blood clot fromation was observed at 3 day, granualtion tissue formation was observed at 2 week, and fibrous tissue proliferation was observed at 3 week. 3. In change of nerve fiber, there were Wallerian degeneration at early stage, decrease in degeneration at 4 week but degeneration of myeline was continuded at 8 week. 4. At 4 week, schwann cells proliferate at its cut ends to join with the distal and proximal stump of the damaged nerve. 5. Fibrous scar tissues are formed at 2 weeks and increased progressively in 8 weeks, which was interrupted the regeneration of grafted nerve.

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.41-47
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• 2018

Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.677-685
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• 2015

Background The survival rate of grafted fat is difficult to predict, and repeated procedures are frequently required. In this study, the effects of the freezing period of harvested adipose tissue and the addition of human adipose tissue-derived stem cells (ASCs) on the process of fat absorption were studied. Methods Adipose tissue was obtained from patients who underwent a lipoaspirated fat graft. The fat tissue was cryopreserved at $-20^{\circ}C$ in a domestic refrigerator. A total of 40 nude mice were used. The mice in the experimental group received three different subcutaneous injections in the back: an injection of fresh fat and ASCs, an injection of fat that had been frozen for one month and ASCs, and an injection of fat that had been frozen for two months and ASCs. The control mice received fat grafts without ASCs. The mice were sacrificed at four or eight weeks after the procedure, and the grafted fat tissues were harvested. The extracted fat was evaluated using photographic analysis, volume measurements, and histological examination. Results In the control group, the fat resorption rates four weeks after transplantation in the grafts of fresh fat, fat that had been frozen for one month, and fat that had been frozen for two months were 21.14%, 22.46%, and 42.56%, respectively. In the experimental group, the corresponding resorption rates were 6.68%, 13.0%, and 33.9%, respectively. Conclusions ASCs can increase the fat graft survival rate. The use of ASCs in fat grafting can reduce the need for repeated fat grafts and provide good long term results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.21.1-21.6
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• 2017

Background: The purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft. Methods: This retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using $Osstell^{TM}$ Mentor ($Osstell^{(R)}$, $G{\ddot{o}}teborg$, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05. Results: Fifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities. Conclusions: Satisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.474-480
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• 2005

We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.

• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.245-249
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• 2014

Gastrointestinal (GI) hemangiomas are relatively rare benign vascular tumors. The choice of an appropriate diagnostic method depends on patient age, anatomic location, and presenting symptoms. However, GI hemangiomas are not a common suspected cause of GI bleeding in children because of their rarity. Based on medical history, laboratory results, and imaging study findings, the patient could be treated with either medication or surgery. Herein, we report 3 cases of GI hemangioma found in the small bowel, rectum, and GI tract (multiple hemangiomas). Better knowledge and understanding of GI hemangioma could help reduce the delayed diagnosis rate and prevent inappropriate management. Although rare, GI hemangiomas should be considered in the differential diagnosis of GI bleeding.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.130-152
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• 1989

The purpose of this study was to observe the effect of intermaxillary fixation on the chondrocytes of the mandibular condyle under the light and the electron microscope. For this study, twenty rabbits were placed in maxillomandibular fixation, and two were used as a control group. The experimental group was subdivided into 3, 7, 14, 21 and 28 day group. After the experimental period of 3, 7, 14, 21 and 28 days, the animals were sacrificed with a vascular perfusion of 2.5% glutaraldehyde. The condylar processes were exenterated, and decalcified in 0.1M EDTA with 2.5% glutaraldehyde solution for two weeks. The specimens were rinsed with phosphate buffer solution and the post-fixation was carried out with 2% osmium tetroxide at $4^{\circ}C$ for two hours. Thereafter the specimens were dehydrated in alcohol series, cleared with propylene oxide and embedded in Epon 812 resin. Thin sections and ultra-thin sections were made, and the cellular structures of the condylar cartilages were observed with light and electron microscope. The results were as follows: 1. In the intermaxillary fixation group, the cartilaginous tissues of mandibular condyles showed a marked decrease in the thickness compared to the control group. 2. A remarkable change was noticed in the proliferating and the hypertrophic zone of the condylar cartilages in the experimental group. 3. An atrophic change of the condylar cartilage was appeared in the 3 day experimental group and degenerative change was observed in the 7 day experimental group, and recovery was seen in thereafter 14 day experimental group. 4. Calcification, degeneration and resorption of condylar cartilage were recognizable, and the cellular zone of the condylar cartilage was appeared indistinctly in 3 day and 7 day experimental group. The chondroblasts, however, were differentiated into chondrocytes and resumed mitosis, and then the cellular zones of the condylar cartilage were reorganized from the 14 day experimental group under the findings of light microscope. 5. Under the findings of electron microscope, atrophic changes and decrease in number of intracellular organelles, degenerative changes of cytoplasm, and pyknosis of nuclei were observed in early stage, however, a gradual regeneration and reorganization of the intracellular organelles were observed from 14 day experimental group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.313-323
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• 2010

Purpose: This study was conducted to evaluate the effect of beta-tricalcium phosphate (Cerasorb$^{(R)}$, Germany) and deproteinized bovine bone (Bio-Oss$^{(R)}$, Switzerland) grafted to the defect of rat calvaria artificially created and the effect of use of absorbable membrane (BioMesh$^{(R)}$, Korea) on new bone formation. Materials and Methods: Transosseous circular calvarial defects with diameters of 5 mm were prepared in the both parietal bone of 30 rats. In the control group I, no specific treatment was done on the defects. In the control group II, the defects were covered with absorbable membrane. In the experimental group I, deproteinized bovine bone was grafted without absorbable membrane; in the experimental group II, deproteinized bovine bone was grafted with absorbable membrane; in the experimental group III, beta-tricalcium phosphate was grafted without absorbable membrane; in the experimental group IV, beta-tricalcium phosphate was grafted with absorbable membrane. The animals were sacrificed after 3 weeks and 6 weeks respectively, and histologic and histomorphometric evaluations were performed. Results: Compare to the control groups, the experimental groups showed more newly formed bone. Between the experimental groups, beta-tricalcium phosphate showed more resorption than deproteinized bovine bone. Stabilization of grafted material and interception of the soft tissue invasion was observed in the specimen treated with membrane. There was no statistical difference between the experimental group I, III and experimental group II, IV classified by graft material, but statistically significant increase in the amount of newly formed bone was observed in the experimental group I, II and II, IV classified by the use of membrane (P<0.05). Conclusion: Both beta-tricalcium phosphate and deproteinized bovine bone showed similar osteoconductibility, but beta-tricalcium phosphate is thought to be closer to ideal synthetic graft material because it showed higher resorption rate in vivo. Increased new bone formation can be expected in bone graft with use of membrane.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.2
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• pp.37-49
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• 2014

Purpose: This study compares the bone formation ability of tricalcium phosphate (TCP) with and without recombinant human bone morphogenetic protein-2 (rhBMP-2) and assesses TCP as a carrier of rhBMP-2. Methods: Bilateral round defects (diameter: 8.0 mm) were formed in the cranium of eight New Zealand white rabbits. The defects were grafted with TCP only (control group) or with rhBMP-2-coated TCP (experimental group). The animals were sacrificed at 1st week, 2nd week, 4th week, and 8th week postoperatively; two rabbits sacrificed each time. The skulls were harvested and subjected to radiographic and histological examination. Results: Radiologic evaluation showed faster bone remodeling in the experimental group than in the control group. Histologic evaluation (H&E, Masson's trichrome stain) showed rapid bone formation, remodeling and calcification in the 1st and 2nd week in the experimental group. Immunohistochemical evaluation showed higher expression rate of osteoprotegerin, receptor activator of nuclear factor ${\kappa}B$ ligand, and receptor activator of nuclear factor ${\kappa}B$ in the experimental group at the 1st and 2nd week than in the control group. Conclusion: rhBMP-2 coated TCP resulted in rapid bone formation, remodeling, and calcification due to rhBMP-2's osteogenic effect. TCP performed properly as a carrier for rhBMP-2. Thus, the use of an rhBMP-2 coating on TCP had a synergic effect on bone healing and, especially, bone remodeling and maturation.

• The Journal of the Korea Contents Association
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• v.18 no.10
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• pp.134-144
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• 2018

The purpose of this study was to examine the effects of delirium prevention program in patients after hip joint surgey. A non equivalent control group post-test only design was utilized. Sixty four patients aged 65 and older who admitted to a surgical intensive care unit after hip joint surgery were assigned to either a experimental group (n=33) or a control group (n=31). The experimental group was provided with delirium prevention program consisting of orientation intervention, activity intervention, physiological intervention, nutritional intervention, sleep intervention, environmental intervention. Data were analyzed using ${\chi}^2-test$ and independent t-test. The experimental group showed lower incidence of delirium than the control group(${\chi}^2=7.048$, p=.008). The experimental group showed lower ICU stay and length of hospitalization than the control group although the difference was not statistically significant. Findings indicate that the dilirium prevention program is effective in reducing incidence of delirium in patients after hip joint surgery and delirium prevention program is recommended as a guide for the prevention of delirium.