• The Journal of the Korean dental association
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• v.50 no.8
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• pp.474-481
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• 2012

The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.

• Proceedings of the KSAR Conference
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• 2003.06a
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• pp.77-77
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• 2003

Chimeric animals are referred to as an organism composed of tissues derived from more than one species. In order to examine if a pluripotency of embryonic stem cells can cross the limitation of a species, we tried to establish human-mouse chimeric animals. Human embryonic stem cells were genetically modified to express eGFP using eukaryonic expression vector pcDNA 3.1 (In Vitrogene) for an easy identification. After selection with neomycin, approximately 15 cells were implanted into mouse blastocoele cavity. Ten chimeric blastocysts were transferred to one of the uterine horn of 2.5 days pesudopregnent ICR female. Out of 272 blastocysts transferred to pseudopregnant recipients 20 live newborn were obtained after 20 days. When newborn were obtained, pups were quickly removed immersed into 4% PFA. By histological examination using fluorescent microscope, green fluorescence was observed from the liver, heart, and spleen in newborn mice. Three weeks after born, presence of eGFP sequence within mouse genome (tail and kidney) was reconfirmed by PCR. eGFP sequence was amplified from the progenies of the animal suggesting a genetic transmission of the transgene. These chimeric mice having human cells at the beginning of development, are expected to recognize human cells as “self”, therefore, human cells or tissues will be able to escape the immunological surveillance of the host if grafted into the animal. These animals will serve as a good model system for studying the graft rejection in tissue transplantation and the potential of the cells to work well in many human disease.

• Journal of Embryo Transfer
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• v.28 no.3
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• pp.289-295
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• 2013

Xenotransplantation of pig organs into primates results in fatal damage, referred as hyperacute rejection (HAR), and acute humoral xenograft rejection (AHXR), to the organ graft mediated by antibodies pre-existing and newly-producing in primates against their cognate pig antigens. Functional ablation of ${\alpha}1$,3-galactosyltransferase (Gal-T KO) of pig which is an enzyme involved in synthesis of Gala1-3Galb1-4GlcNAc-R antigen is essentially required to prevent HAR. Moreover, additional genetic modification under Gal-T KO background for enforced expression of human complement regulatory proteins which can inhibits complement activation is known to effectively imped HAR and AHXR. In this study, we constructed a membrane cofactor protein (MCP) expression cassette under control of human $EF1{\alpha}$ promoter. This cassette was inserted between homologous recombination regions corresponding to Gal-T locus. Subsequently this vector was introduced into ear skin fibroblasts of female pig by nucleofection. We were able to obtained 40 clones by neomycin selection and 4 clones among them were identified as clones targeted into Gal-T locus of MCP expression cassette by long-range PCR. Real time RT-PCR was shown to down-regulation of Gal-T expression. From these results, we demonstrated human $EF1{\alpha}$ promoter could induce efficient expression of MCP on cell surface of fibroblasts of female pig.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.53-58
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• 2017

Background Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. Methods A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015. Exclusion criteria included amputations of the distal phalanx, comminuted fractures, and intra-articular fractures. Patients were classified according to 5 categories of fixation methods: single K-wire, double longitudinal K-wires, cross K-wires, wire with, and wire without K-wire support. Bone union was evaluated by 5-month postoperative X-ray and fixation outcomes were compared across the 5 groups. Results The exclusion criteria were applied, and 88 patients with 103 replanted digits remained for analysis. Single K-wire fixation was used in 40 digits, double longitudinal K-wires in 30, and cross fixation in 14. Wire with and without K-wire support was required in 15 and 4 digits. Nonunion was observed in 32 digits (31.1%), of which 13 required additional operations such as bone graft or corrective osteotomy. The highest percent of nonunion was observed after cross fixation (35.7%) and the lowest after wire alone (25.0%). Conclusions In this study, contrary to general knowledge, we found that single K-wire fixation was not associated with poorer outcomes. Successful bone union outcomes may be achieved by careful selection of bone fixation methods. This study provides useful information for planning bone fixation in digital replantation.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.575-583
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• 2013

Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. Conclusions The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.184-191
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• 2014

In the mandibular posterior molar area, ridge deficiency is an unfortunate obstacle in the field of implant dentistry. Many techniques are available to rebuild the deficient ridge. Selection and necessity of these techniques are associated with significant morbidity and often require a second surgical site. With the advent of guided bone regeneration (GBR), one may now graft the deficient ridge with decreased morbidity and without a second surgical site. In this case, guided bone regeneration procedures were performed with a combination of allograft, xenograft, and alloplast, excepting autogerous bone at severe defected mandibular alveolar ridge and then placed to the implant successfully. We report that implant placement were good in two cases.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.83-92
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• 2020

In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.128-135
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• 2008

Purpose: As the care of surgical patients becomes increasingly complex and catheter-based techniques are more frequently applied, the pattern of iatrogenic vascular injuries may be increasing. Major vascular injuries can jeopardize a patient's life or limb survival. The purpose of this study was to examine the current etiology and prognosis for iatrogenic vascular injuries. Methods: We reviewed medical records of 29 cases of iatrogenic vascular injury that were treated Seoul National University Bundang Hospital between October 2003 and October 2008. We studied clinical variables including demographics, cause of injury, clinical presentations, management and prognosis. Results: The mean age was 60.8 years (range: 25-86), and the male to female ratio was 1.9 : 1. The causes of injuries were operation related complication in 18 cases (62.1%), endovascular intervention and diagnostic angiography in 11 cases (37.9%). The types of vascular injury were partial severance in 14 cases, pseudoaneurysm in 8, arteriovenous fistula (AVF) in 3, thrombosis in 2, complete severance in 2. Especially, device related complication including percutaneous closing device were occurred in 9 and the others came from inadvertent physician's procedure. Primary repair were done in 12 cases, end-to-end anastomosis in 5, interposition graft in 4, ligation in 2, patch angioplasty in 1, peudoaneurysm excision and arteriorrhaphy in 1, hematoma evacuation in 1, and endovascular repair in 3. There were 2 cases of mortality, one of them due to hemorrhagic shock and the other due to septic shock. Conclusion: Proper selection of treatment modalities should be important to have better outcome according to the type of injury as well as anatomical location. Each physician should be familiar to new device as well as patient's topographical feature. Immediate referral to vascular specialist is also essential to reduce morbidity.

• Horticultural Science & Technology
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• v.19 no.1
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• pp.43-47
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• 2001

This study was conducted to investigate the integrated control strategy against pear black leaf spot disease. Using indicator plant PS-95 we selected six virus-free trees (cv. Niitaka) from commercial orchards in the major pear production area. Disease symptom by pear black leaf spot in the shoot of pear (Niitaka) has been successfully inhibited by heat treatments for 3 weeks at temperature of $40^{\circ}C$ (day) and $32^{\circ}C$ (night) or 4 weeks at $37^{\circ}C$ and $30^{\circ}C$, respectively. However, survival rate of the shoot tips on stocks was low. Seven cultivars Niitaka, Imamura- aki, Waseaka, Nijisseiki, Wasenijisseiki, Shinsetsu and Whangkeumbae produced visible symptoms in the first year after inoculation with the virus. Other 11 selections remained symptomless. Two resistant cultivars Suwhangbae and Gamcheonbae were selected, which showed high fruit quality. It is recommended that these cultivars could be top-grafted onto the infected Niitaka trees to overcome the damage caused by the disease in the orchard.