• 제목/요약/키워드: Graft survival

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An Assessment of Allograft Function in Canine Single Lung Transplantation (일측 폐이식 실험견에서 이식폐의 기능 평가연구)

  • 박창권
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1096-1106
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    • 1995
  • We experienced 7 cases of left single lung transplantation in 14 mongrel dogs and analyzed graft lung function by hemodynamics, blood gas analysis, chest X-ray, biopsy and perfusion lung scan. We performed right pulmonary artery cuff[PA cuff for analysis of graft lung function in 3 cases. The donor lungs were flushed with modified Euro-Collins solution[n=3 or low potassium dextran glucose solution[n=4 and preserved for 4 to 5 hours[n=4 or 24 hours[n=3 at 10o C and implanted to the dogs with similar weight . Assessment of left graft lung was done by occluding the right pulmonary artery for 10 minutes using PA cuff. Assessment for graft lung function was done immediately after an operation and after 3 days, 7days and 3 weeks postoperatively. Four dogs survived for 3days, 7days[2 cases and 3 weeks respectively. Other three dogs expired within 3 hours of reperfusion. Immediate perfusion scans of left lung in four survived dogs after reperfusion were 42.1%, 36% , 11% and 5.9% respectively, and another dog with 4.8% perfusion to left lung was dead due to left atrial thrombi after 3 hours reperfusion. In one case among three acute rejections follow-up perfusion scan was done on 3rd and 11th postoperative day and the result decreased from 36% perfusion immediate postoperatively to 21% and 15% respectively. Three expired dogs postoperatively couldn`t tolerate occlusion of right pulmonary artery with above 40 mmHg of mean pulmonary artery pressure. On the other hand, three survival dogs postoperatively tolerated occlusion of right pulmonay artery with less than 30 mmHg of mean pulmonary artery pressure. and one dog couldn`t tolerate same procedure immediate postopertively but in 2 hours reperfusion later tolerated with 29 mmHg of mean pulmonary artery pressure.In conclusion we couldn`t compare the effect of two flushing solutions but low potassium dextran glucose solution showed relatively safe preservation effect in cases with preservation of more than 20 hours. Also canine left single lung transplantation model with PA cuff indicated useful method for the assessment of graft lung function with effect of lung preservation.

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Evapotranspiration Rate of Grafted Seedlings Affected by Relative Humidity and Photosynthetic Photon Flux under Artificial Lighting (인공광하에서 접목묘의 증발산속도에 미치는 상대습도와 광합성유효광량자속의 효과)

  • 김용현;박현수
    • Journal of Biosystems Engineering
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    • v.26 no.4
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    • pp.379-384
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    • 2001
  • To enhance the smooth graft-taking of grafted seedlings, the excessive evapotranspiration from grafted seedlings just after grafting should be avoided. A measurement system of the evapotranspiration rate of grafted seedling under artificial lighting was set up to investigate the effect of physical environment on the evapotranspiration and graft-taking characteristics of grafted seedlings quantitatively. The evapotranspiration rate of grafted seedlings affected by relative humidity and light intensity were analyzed using the measurement system. The hypocotyl of watermelons (Citrullus vulgaris cv. Sweetdew, Hungnong Seed Co.) was slantly cut and then inserted into a hole on the stem of rootstock (Lagenaria siceraria cv. FR-King, Hungnong Seed Co.). Grafted seedlings were healed and joined for 5 days under cool-white fluorescent lamps (FL20SEX-d/18, Keumho Electric Co.) with photoperiod of 12h$.$d$\^$-1/ except dark period for one day after grafting in a closed graft-taking enhancement system developed by Kim(2000). The evapotranspiration rate and graft-taking of grafted seedling at air temperature of 23$\^{C}$ and air current speed of 0.1m$.$s$\^$-1/ was highly affected by relative humidity. But light intensity showed higher effect on the stem length of scion than relative humidity. In conclusion, it was suggested that relative humidity should be controlled at higher than 90% with photosynthetic photon flux of 50$\mu$mol$.$m$^2$$.$s$\^$-1/ to increase the survival of grafted seedlings and to produce healthy seedlings.

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The factors that influence postoperative stability of the dental implants in posterior edentulous maxilla

  • Kim, Yun-Ho;Choi, Na-Rae;Kim, Yong-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.2.1-2.6
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    • 2017
  • Background: All clinicians are aware of the difficulty of installing a dental implant in posterior maxilla because of proximate position of maxillary sinus, insufficient bone width, and lower bone density. This study is to examine which factors will make the implantation in the posterior maxilla more difficult, and which factors will affect the postoperative implant stability in this region. Methods: Five hundred seventy-three fixtures on the maxilla posterior were included for this study from all the patients who underwent an installation of the dental implant fixture from January 2010 to December 2014 at the Department of Oral and Maxillofacial Surgery in Pusan National University Dental Hospital (Yangsan, Korea). The postoperative implant stability quotient (ISQ) value, fixture diameter and length, presence of either bone graft or sinus lift, and graft material were included in the reviewed factors. The width and height of the bone bed was assessed via preoperative cone beam CT image analysis. The postoperative ISQ value was taken just before loading by using the OsstellTM $mentor^{(R)}$ (Integration Diagnostics AB, Gothenburg, Sweden). The t test and ANOVA methods were used in the statistical analysis of the data. Results: Mean ISQ of all the included data was 79.22. Higher initial bone height, larger fixture diameter, and longer fixture length were factors that influence the implant stability on the posterior edentulous maxilla. On the other hand, the initial bone width, bone graft and sinus elevation procedure, graft material, and approach method for sinus elevation showed no significant impact associated with the implant stability on the posterior edentulous maxilla. Conclusions: It is recommended to install the fixtures accurately in a larger diameter and longer length by performing bone graft and sinus elevation.

Systemic-Pulmonary Shunts Using Microporous Polytetrafluoroethylene Prosthesis [Early and Late Results] (Polytetrafluoroethylene 인조혈관을 이용한 체-폐동맥 단락술의 조기성적 및 원격 성적)

  • 장병철
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.50-57
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    • 1986
  • Sixty-nine patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] prosthesis between 1979 and 1985. Their ages ranged from 2 months to 39 years [mean$\pm$SD: 5.2$\pm$7.4, median: 3.3 years]. Diagnosis included the following: Tetralogy of Fallot, 45: Double outlet right or left ventricle, 11: Single ventricle, .5: Transposition of great vessels, 4: Tricuspid atresia, 3 and Pulmonary atresia with intact ventricular septum, 1. Forty-eight patients had subclavian-pulmonary artery anastomosis, 12 patients aorta-right pulmonary artery anastomosis, 6 patients aorta-main pulmonary artery anastomosis, and 3 patients descending aorta-pulmonary artery anastomosis. The PTEE graft of 3 mm in diameter was used in 1, 4 mm in 29, 5 mm in 35 and 6 mm in 4 patients. Ten patients were died within 30 days after operation [mortality rate: 14.5%]. Among them, 6 patients were operated in urgency due to cardiac arrest or severe anoxic spell after cardiac catheterization, and so surgical mortality of elective operation is 9.5%. The 59 survivors showed improvement of the arterial oxygen saturation [65.4% - 9.8%] and hemoglobin [18.8 gm/dl - 16.0 gm/dl] values [V<0.01]. The follow up period ranged from 1 month to 67 months, [752 patient-months] and during this periods there were 4 late shunt failures after 3 months postoperatively with 4 mm graft, and 2 with 5 mm graft. The over-all patency rate of 4 mm PTFE was 85.9$\pm$9.2% [SEM] in 12 months and 40.9$\pm$22.5% in 24 months. The over-all patency rate of 5 mm PTFE was 87.5$\pm$9.6% in 12 months and 58.3$\pm$24.6% in 36 months. The lowest systolic pressure in death group was 64.9$\pm$15.0 mmHg and in survival group, 86.4$\pm$12.1 mmHg [P<0.001]. We think that the PTFE graft is useful in palliative shunt operation, but the effectiveness of the 4 mm PTFE graft may be limited. The blood pressure also may play an important role in patency of Prosthesis.

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Graft Strategy for Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction

  • Hong, Tae Hee;Ha, You Jin;Jeong, Dong Seop;Kim, Wook Sung;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.16-24
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    • 2019
  • Background: Optimal graft selection for coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) dysfunction remains debatable. We report an analysis of our experiences of isolated CABG in patients with severe LV dysfunction and the impact of graft strategy on long-term outcomes. Methods: We analyzed 209 patients with severe LV dysfunction (ejection fraction [EF] <30%) who underwent primary isolated CABG. Of these, 169 were revascularized with a bilateral internal thoracic arterial (ITA) graft (BITA group) and 40 were revascularized with a single ITA graft (SITA group). The mean follow-up duration was $22{\pm}32$ months. Results: There were 18 early deaths (8.6%). Overall survival at 5 years was 66.7%. The rate of freedom from cardiac-related death at 5 years was 74.1%, and was significantly higher in patients who underwent off-pump CABG (p=0.005) and in the BITA group (p=0.023). Multivariate analysis demonstrated that old age (hazard ratio [HR], 2.548; 95% confidence interval [CI], 1.134-5.762; p=0.024), off-pump CABG (HR, 0.245; 95% CI, 0.090-0.661; p=0.006), and BITA grafts (HR, 0.333; 95% CI, 0.146-0.757; p=0.009) were correlated with cardiac mortality. Conclusion: CABG in patients with severe LV dysfunction (EF <30%) showed reasonable long-term outcomes. The rate of freedom from cardiac-related death was significantly higher in patients who underwent off-pump CABG and in the BITA group. Off-pump BITA grafting strategies can be accepted as a viable primary option in patients with severe LV dysfunction if performed by an experienced surgeon.

CLINICAL RETROSPECTIVE STUDY OF SINUS BONE GRAFT AND IMPLANT PLACEMENT (상악동골이식과 임프란트 식립에 관한 후향적 임상 연구 : $7{\sim}41$개월간의 경과관찰)

  • Kim, Young-Kyun;Yun, Pil-Young;Im, Jae-Hyung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.249-257
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    • 2008
  • The authors performed the clinical and radiographic evaluation in the 29 patients with sinus bone graft and $Osstem^{(R)}$ implant placement between Sep 2003 and Jan 2006 and got the following results. 1. Fifteen complications developed in the 13 patients. Intraoperative sinus membrane perforation and postoperative maxillary sinusitis developed frequently. 2. The mean preoperative residual alveolar bone height was 4.5 mm, postoperative height 18.5 mm, height 1 year after operation 16.9 mm. 3. Three primary osseointegration failures(3.7%) developed in 3 patients. 4. The survival rate of prosthodontics was 100% at the final follow up. The mean marginal bone resorption around the implants was 0.69 mm 1 year after prosthodontic loading. Marginal bone resorption more than 1.5 mm developed in nine implants and the success rate was 88%.

Surgical Outcomes of Forearm Loop Arteriovenous Fistula Formation Using Tapered versus Non-Tapered Polytetrafluoroethylene Grafts

  • Han, Sun;Seo, Pil Won;Ryu, Jae-Wook
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.30-35
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    • 2017
  • Background: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4-6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. Methods: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. Results: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). Conclusion: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.

Clinical Considerations on Contamination Rates of Cryopreserved Autologous Fat (냉동보존한 자가지방의 오염률에 대한 임상적 고찰)

  • Kim, Jeong Tae;Seo, Woo Jin;Kim, Yeon Hwan
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.685-690
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    • 2009
  • Purpose: Autologous fat graft is a widely accepted technique used for soft tissue augmentation. Nonetheless, the use of fat graft is limited by unpredictable survival rates and repeated grafting. To avoid repeated grafting, cryopreserved fat graft technique has recently been widely used. On the other hand, the number of patients with chronic infection(who received cryopreserved fat injection) has currently been increasing. Therefore, this study was focused on the safety of cryopreserved fat injection from the infection. Methods: We collected 150 samples from local aesthetic clinics to examine the safety of cryopreserved autologous fat. To test for microbacterial contaminations of the cryopreserved fat specimens, microbacterial cultures & antibiotics sensitivity tests were performed. Then, we examined possible correlation between the preservation period and donor sites, focused on the results of microbacterial culture. Results: Cultures were positive for Staphylococcus epidermidis in 5 samples(methicillin - resistant Staphylococcus epidermidis in 4 samples), Micrococcus species in 3 samples. An average duration of preservation was 191 days and there was no significant correlation between the duration of preservation and microbacterial growth. Conclusion: Staphylococcus epidermidis was the leading cause of cryopreserved fat contamination, and the resistance to methicillin is common. Based on the above results, aseptic handling of fat during harvesting and preservation appeared to be most important.

Rehabilitative goals for patients undergoing lung retransplantation

  • Massimiliano Polastri;Robert M. Reed
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.134-138
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    • 2024
  • Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Studies on Juvenile Tissue Grafting of Some Special-use-Trees (II) An Experiment on Inverted Radicle Grafting of Crop-Tree-Species (특용수종의 유대접목에 관한 연구 (II) 유실수종의 임면지유근역위접목 및 유근역위아접에 관하여(예보))

  • 박규수
    • Journal of Plant Biology
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    • v.11 no.3
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    • pp.8-17
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    • 1968
  • A grafting method, cleft grafting of ordinary dormant scion into an inverted radicle of a germinated seed was tested with good success for chestnut as well as for walnut trees. It was seen that verticilate roots which were produced from the cut and of radicle after grafting made a complete union with scion and made healthy development to produce a successful graft. The radicle before secondary rootlets emerged from its rooting zone was proved to be best stock for inverted radicle grafting. The dormant but was also used for grafting scion with success in this method. Though green house grafting gives higher survival, field grafting was also feasible by this method. Those early growing geason after grafting, the later development of root system and the shoot of the graft were to be studied in the future.

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