• Journal of Korean Dental Science
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• 제7권1호
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• pp.38-42
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• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.448-454
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• 2007

Purpose: The objective of this study was to evaluate the outcomes of using the free flap in the reconstruction of maxillary defects. Methods: 27 consecutive cases of maxillary reconstruction with free flap were reviewed. All clinical data were analyzed, including ideal selection of flap, time of reconstruction, recurrence of cancer, postoperative complications, flap design, and follow-up results. The main operative functional items, including speech, oral diet, mastication, eye globe position and function, respiration, and aesthetic results were evaluated. Results: Among the 24 patients who underwent maxillary reconstruction with the free flap, 14 patients underwent immediate reconstruction after maxillary cancer ablation, and 10 patients underwent delayed reconstruction. There occurred 1 flap loss. Recurrences of the cancer after the reconstruction happened in 2 cases. Postoperative complications were 3 cases of gravitational ptosis of the flap, 2 cases of the nasal obstruction, and 1 case of fistula formation. Out of 27 free flaps, there were 15 latissimus dorsi myocutaneous flaps, 5 radial forearm, 4 rectus abdominis myocutaneous flaps, 1 scapular flap, 2 fibula osteocutaneous flap, respectively. Flaps were designed such as 1 lobe in 9 cases, 2 lobes in 9 cases, and 3 lobes in 5 cases. Among the 14 patients who had intraoral defect or who had palatal resection surgery, 2 patients complained the inaccuracy of the pronunciation due to the ptosis of the flap. It was corrected by the reconstruction of the maxillary buttress and hung the sling to the upper direction. All of the 14 patients were able to take unrestricted diets. In 6 patients who had reconstruction of inferior orbital wall with rib bone graft, they preserved normal vision. Aesthetically, most of the patients were satisfied with the result. Conclusion: LD free flap is suggested in uni-maxilla defect as the 1st choice, and fibular osteocutaneous flap and calvarial bone graft to cover the larger defect in bi-maxilla defect.

• 화훼연구
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• 제16권4호
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• pp.321-324
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• 2008

노란색 접목선인장 '황성'은 G. mihanovichii와 G. marsoneri 간의 종간교잡종으로 농촌진흥청 국립원예 특작과학원에서 육성되었다. 1998년 IG-124(G. mihanovichii) ${\times}$ IG-223(G. marsoneri) 교배조합에서 2001년 2계통을 선발하였다. 2001년 선발된 두 계통 중 '9834024'를 모본으로 '9834036'을 부본으로 교배하여 후대를 양성하고 3차의 특성검정 후 황색의 '원교G1-169'을 육성하였다. '원교G1-169'은 2005년 농촌진흥청 직무육성 신품종 선정위원회에서 '황성'으로 명명되었다. '황성'의 특성은 다음과 같다. 구색은 모구와 자구가 황색이다. 구의 모양은 편원형으로 7~9개의 깊은 결각을 형성한다. 가시는 갈색으로 길이가 길고 반 직립한다. 생육은 정식 10개월 후에 직경이 49.5 mm로 빠르다. 자구수는 7.2개로 증식력이 우수하다. '황성'은 미국과 유럽지역의 수출용으로 적합하며 품종의 특성은 영양번식에 의하여 유지된다.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.465-478
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• 2007

Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.

• Journal of Chest Surgery
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• 제32권6호
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• pp.532-535
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• 1999

배경: 하행 흉부 대동맥류에 대한 외과적 치료에 대하여 수술 방법과 술 후 합병증 등에 대하여 알아보고자 하였다. 대상 및 방법: 인제대학교 의과대학 서울백병원 흉부외과학 교실에서는 1987 년 3 월부터 1997년 8월까지 하행 흉부 대동맥류로 수술을 시행한 22예를 대상으로 후향적 조사를 하였다. 결과: 환자는 남자가 18예 여자 4예로 남자가 많았으며 연령은 33세에서 82 세 이었고 평균은 49 세였다. 대동맥류의 원인은 대동맥 박리증 13, 죽상경화증 3, 진균성 3, 외상성 2, 원인불명 1예였다. 수술은 절제 및 이식편 치환술 16, 액와동맥-양측 대퇴동맥 우회로 이식술 2, 대퇴동맥-대퇴정맥 우회로 이식술 1, 동맥류 공치술(exclusion) 1, 동맥류 봉합술 1, 경대퇴동맥 스텐트 삽입술 1예였다. 수술 시 대동맥을 차단하고 수술한 예는 16예였고, 이 중 14예는 대퇴동맥-대퇴정맥 바이패스를 실시하였고, 2예는 우회로 이식술을 먼저 하였다. 평균 대동맥 차단시간은 91분이었고 체외순환 시간은 116 분이었다. 사망 예는 1예로 공치술 한 환자가 술 후 52일에 갑작스런 출혈로 사망하였고, 대마비 1, 급성 신부전증 2, 급성 호흡부전증 1예가 발생하였다. 결론: 하행 흉부 대동맥류 수술은 많은 술 후 합병증이 예상되나 적절한 환자의 선택과 섬세하고 다양한 수술 기법을 사용하면 비교적 적은 합병율로 수술할 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.265-273
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• 2000

Purpose : The aim of this study was to evaluate the bone mineral density of iliac and tibial bone which are frequently selected as autogenic bone graft donor sites, and to evaluate the efficiency of this method as a guideline for the selection of bone graft donor site. Materials and Methods : In this study 61 male and 70 female volunteers at Chungbuk National University Hospital were involved between Jan. 1998 to Sept. 1999. We measured bone mineral density of the iliac and the tibial bone using dual energy X-ray absorptiometry. We evaluated the data using the SAS system for Windows and bone mineral density of the lumbar was used for control. Results : Age showed the highest correlation in correlation matrix between physical and bone variables. Height and weight showed lower correlation of linear increment. In man, the change of bone density according to age demonstrated linear decrease irrespective of the lumbar, ilium, and tibia. In woman, the change of bone density according to age showed cubic form, which increased in the third and forth decade. So it had a peak bone mass on about 35 year-old, thereafter, the change of bone density slowly decreased until 50 year-old, but it rapidly decreased after 50 year-old and it slowly decreased again after 65 year-old. Both in all subjects and subject with osteoporosis, the change of bone mineral density according to age showed statistically significant decrease in lumbar and tibia, but ilium was irrespective. Conclusion : In patients of aged or with osteoporosis, ilium demonstrated less tendency of decrease in bone mineral density than tibia. So this preliminary study suggested that ilium seemed better donor site for autogenic bone graft than tibia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.405-418
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• 2007

Mesenchymal stem cells(MSCs) have been though to be multipotent cells that can replicate that have the potential to differentiate into lineages of mesenchymal tissue including the bone, cartilage, fat, tendon, muscle, and marrow stroma. Especially, scaffolds to support cell-based tissue engineering are critical determinants of clinical efforts to regenerate and repair the body. Selection of a matrix carrier imvolves consideration of the matrix's role as a scaffold for physical support and host tissue integration as well as its ability to support of synergize the osteoinductive program of the implanted mesenchymal stem cell. The aim of this study is to evaluate the effect of autobone and Bio-$Oss^{(R)}$ to adherent mesenchymal stem cells as scaffolds on sinus augmentation with fibrin glue mixture in a rabbit model. 16 New Zealand White rabbits were divided randomly into 4 groups based on their time of sacrifice(1, 2, 4 and 8 weeks). First, mesenchymal stem cells were isolated from iliac crest marrow of rabbits and expanded in vitro. Cell culture was performed in accordance with the technique described by Tsutsumi et al. In the present study, the animals were sacrificed at 1, 2, 4 and 8 weeks after transplantation, and the bone formation ability of each sides was evaluated clinically, radiologically, histologically and histomorphologically. According to the histological observations, autobone scaffolds group showed integrated graft bone with host bone from sinus wall. At 2 and 4 weeks, it showed active newly formed bone and neovascularization. At 8 weeks, lamellae bone was observed in sinus graft material area. Radiologically, autobone with stem cell showed more radiopaque than Bio-$Oss^{(R)}$ scaffolds group. there were significant differences in bone volume between 4 and 8 weeks(p<0.05).

• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• Journal of Chest Surgery
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• 제57권1호
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• pp.62-69
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• 2024

Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1055-1062
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• 2000

Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.