• Title/Summary/Keyword: Grafts

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Clinical evaluation of autologous fat graft for facial deformity: a case series study

  • Khorasani, Mansour;Janbaz, Pejman
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.286-290
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    • 2021
  • Objectives: The use of fat grafts in maxillofacial sculpturing is currently a common technique. Unlike fillers, autologous fats unite with facial tissues, but long-term results may still be unsatisfactory. Sharing long-term follow-ups can be helpful in making outcomes more predictable. Materials and Methods: The data from patients who were admitted from 2014 to 2016 for fat augmentation were collected. In all cases, fat grafts were injected by blunt cannula using a tunneling technique in different planes. A fan shape order for the malar, periorbital, nasolabial fold, mandibular angle and body, and perioral area was established. Results: Autologous fat was used for different sites of the maxillofacial regions. Of 15 patients, two patients were not satisfied due to fat graft resorption. For this, further injections were performed six months after the first injection using preserved fat grafts. One patient continued to be dissatisfied. There were no other complications related to fat transplants. Conclusion: Fat transplantation is a safe, reliable, and non-invasive method for facial contour and facial soft tissue defect restoration. Additional methods such as mesenchymal stem cells along with fat injection increase the survival rate of transferred fat.

Vascularized bone grafts for post-traumatic defects in the upper extremity

  • Petrella, Giovanna;Tosi, Daniele;Pantaleoni, Filippo;Adani, Roberto
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.84-90
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    • 2021
  • Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

Clinical Outcomes of Diverse Patch Grafts (광범위 회전근개 파열의 봉합술에서 Patch Graft 종류별 임상적 결과)

  • Lho, Taewoo;Chung, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.472-483
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    • 2021
  • With increased development of patch graft, the number of repair using patch graft in massive rotator cuff tear has increased. Understanding characteristics of various patch graft might be helpful for selection of type of patch, and to improve the outcomes for the treatment of massive rotator cuff tears using patch grafts. Therefore, this paper reviews various studies dealing with clinical outcomes of rotator cuff repair using diverse patch grafts in massive rotator cuff tears.

Tuberculous Aneurysm of the Abdominal Aorta: Endovascular Repair Using Stent Grafts in Two Cases

  • Wei Chiang Liu;Byung Kook Kwak;Kyo Nam Kim;Soon Yong Kim;Joung Joo Woo;Dong Jin Chung;Ju Hee Hong;Ho Sung Kim;Chang Jun Lee;Hyung Jin Shim
    • Korean Journal of Radiology
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    • v.1 no.4
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    • pp.215-218
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    • 2000
  • Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess.

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Studies on the Propagation of the Genus Osmanthus (목서류(木犀類)의 증식(增殖)에 관(關)한 연구(研究))

  • Youn, Ki Sik;Goo, Gwan Hyo;Jo, Chung Suk
    • Journal of Korean Society of Forest Science
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    • v.75 no.1
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    • pp.19-24
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    • 1986
  • Present studies were carried out to understand the way of propagation of Osmanthus which has much value as ornamental trees in southern parts of Korea. The results of these experiments were summarized as follows: 1. In order to increase the survival of Osmanthus, scions of Osmanthus was grafted on the stocks of Ligustrum obtusifolium S. et Z. The survival of the grafts were 63% for Osmanthus fragrans var. aurantiacus Makino and 60% for Osmanthus asiaticus Nakai. 2. The growth of the grafts was initiated from 28th day after the grafting and the height growth resumed three times, and the growth percentage was 63% for Osmanthus fragrans var. aurantiacus and 59% for Osmanthus asiaticus. 3. Cutting medium mixed with perlite and vermiculite (1:1) gave better results than either use of them separately, and the rooting percentage was 93% for Osmanthus fragrans var. aurantiacus and 90% for Osmanthus asiaticus. 4. Rooting percentage of cuttings was lower in hard-wood cutting than that of in green-wood cutting. 5. Grafts showed fairly good height growth in July and September, and ceased growth in October. 6. Correlation between height growth and diameter of root collar of grafts in case of Osmanthus fiagrans var. aurantiacus was highly significant and showed linear correlation ($r=0.70^{**}$)

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Clinical Outcomes of Surgical Repair with a Composite Graft for Abdominal Aortic Aneurysm Accompanied by Iliac Artery Aneurysm

  • Sohn, Bongyeon;Kim, Hak Ju;Chang, Hyoung Woo;Lee, Jae Hang;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay Hyun
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.339-345
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    • 2020
  • Background: Iliac artery aneurysm is frequently found in patients undergoing surgical repair of an abdominal aortic aneurysm. The use of commercial bifurcated grafts is insufficient for aorto-biiliac replacement with complete iliac artery aneurysm resection. We evaluated the effectiveness of handmade composite grafts for this purpose. Methods: A total of 233 patients underwent open surgery for abdominal aortic aneurysm between 2003 and 2019, including 155 patients (67%) treated with commercial grafts and 78 patients (33%) treated with handmade composite grafts. Their operative characteristics, postoperative outcomes, and late outcomes were retrospectively reviewed. Results: The early mortality rate did not differ significantly between the groups. On average, the handmade composite graft technique took approximately 15 minutes longer than the commercial graft technique (p=0.037). Among patients who underwent elective surgery, no significant differences between the conventional and composite groups were observed in the major outcomes, including red blood cell transfusion volume (2.8±4.7 units vs. 3.1±4.7 units, respectively; p=0.680), reoperation for bleeding (2.7% vs. 3.1%, respectively; p>0.999), bowel ischemia (0% vs. 1.6%, respectively; p=0.364), and intensive care unit stay duration (1.9±6.6 days vs. 1.6±2.4 days, respectively; p=0.680). The incidence of target vessel occlusion also did not differ significantly between groups. Conclusion: The increased technical demand involved with handmade composite grafting did not negatively impact the outcomes. This technique may be a viable option because it overcomes problems associated with commercial grafts.

Guided Tissue Regeneration Using Barrier Membrane and Osseous Grafts in Surgically Created Furcation Defects in Dogs (성견의 외과적 치근이개부 골결손에 차폐막과 골이식재를 이용한 조직유도재생술시 치유양상)

  • Chung, Eun-Hee;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.26 no.4
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    • pp.967-987
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    • 1996
  • The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

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Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion : A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

  • Kim, Bum-Joon;Kim, Se-Hoon;Lee, Haebin;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.225-231
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    • 2017
  • Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

The Effect of Platelet-Rich Plasma(PRP) on the Survival of the Autologous Fat Graft (혈소판 농축액이 이식된 지방의 생존에 미치는 영향)

  • Kim, Seung Jun;Choi, Won Il;Lee, Byung Il;Park, Seung Ha;Park, Chul;Koo, Sang Hwan
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.291-297
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    • 2007
  • Purpose: Platelet-rich plasma(PRP) contains protein growth factors, which are actively secreted by platelets to promote wound healing. However, it is not clear whether the injection of PRP into the autologous fat grafts increases the survival rate and the degree of angiogenesis. Methods: New Zealand White rabbit ears were injected fat with PRP, saline, insulin or isoproterenol (n=8/each group) for observation of the survival and degree of angiogenesis of the injected fat. The volume of the harvested fat and the degree of angiogenesis from dorsum of rabbit ears were evaluated 4, 8, and 12 weeks after the autologous fat graft. The degree of angiogenesis was measured with microvascular density (MVD) counts. Results: The volume of harvested fat decreased in a time-dependent manner after autologous fat grafts, but the decrease rate in volume of harvested fat was slower in PRP-injected group compared to that of other control groups. The difference in the volume of the harvested fat between PRP-injected group and other control groups became significant from 4 weeks after the autologous fat graft, and was maintained up to 12 weeks. However, there was no significant difference between PRP-injected group and insulin-injected group 8 and 12 weeks after the autologous fat graft. On the contrary, MVD counts increased in a time-dependent manner after autologous fat grafts. The MVD counts were significantly higher in PRP-and insulin-injected groups than in other control groups from 4 weeks after the autologous fat graft, and these differences were maintained up to 12 weeks. There was no correlation between mean platelet numbers and the volume of harvested fat. Conclusion: The present study demonstrates that PRP-injection into autologous fat grafts increases the survival rate and the degree of angiogenesis. Thus, PRP injection with autologous fat grafts would be a promising tool for maintaining the volume of the grafted fat.

Studies on the Juvenile Grafts with Plastic Tubes for Forcing Stock Growth in Juglans sinensis (호도나무 대목촉성재(臺木促成材) Plastic원통(圓筒)을 이용(利用)한 유경녹기(幼莖綠技) 접목(接木)에 관(關)한 연구(硏究))

  • Youn, Ki Sik;Goo, Gwan Hyo;Jo, Chung Suk
    • Journal of Korean Society of Forest Science
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    • v.78 no.2
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    • pp.189-197
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    • 1989
  • This study was carried out to produce the grafts of Juglans sinensis by juvenile grafting method which epicotyl of newly germinated seeds were used as stocks and juvenile fresh shoots were used as scion. The results obtained were as follows ; 1. When plastic tube installed covering up seed with soil up to 6cm height for diameter increment of epicotyl, the epicotyl can be grown up to thickness of 10mm. 2. When the soft fruit branches and the soft water sprout with the terminal bud 8cm to 12cm long were used as scions, the survival rates showed 90 Percent. 3. The optimum date for making juvenile grafts was around the 20th of May, and the survival rates of grafted seedlings showed 86 percent in average. 4. The grafted seedlings showed first sprouting the 15th of June, that is 25 days after making graft, and the sprouting rate was 72 percent. 5. The height-growth of grafted seedlings finished at the end of July, and diameter growth lasted into the end of October. 6. There was positive correlation between the height of grafted seedlings and the diameter at root collar. 7. In general, it takes two years to make plantable graft seedlings from hardwood scion and stock, but the juvenile graft seedlings can be easily obtained in a year and so it seems to be economic.

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