• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.299-304
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• 2017

Objectives: To test the feasibility of submandibular salivary gland (SMG) replantation techniques and the survival of the replanted glands. Such a study can provide a rationale for later allotransplantation procedures, along with implementation of conventional and advanced immunosuppression therapy. Materials and Methods: Six SMG replantations were performed in New Zealand white rabbits. One week postoperatively, $^{99m}Tc$ scintigraphy was performed and the uptake ratio and salivary excretion fraction were calculated. Two to four weeks later, submandibular glands were excised, fixed, and stained with H&E for histomorphometric evaluation. Results: Intraoperatively, all glands showed patent blood perfusion except gland 5. Positive tracer uptake and saliva excretion were documented by scintigraphy. On excision, all of the glands except glands 4 and 5 looked viable, with a red color and patent pedicles. Gland 4 was infected and filled with creamy pus, while gland 5 looked pale and necrotic. Histologically, glands 1, 2, 3, and 6 had preserved normal glandular tissue with slight variations from the contralateral normal glands, as their parenchyma was composed of mildly atrophic acini. Conclusion: Four out of six replanted SMGs successfully survived. The glands maintained good viability and function. Such success depends on safe harvesting, short anastomosis time, and strict control of infection.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.306-310
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• 2009

Purpose: Owing to improvement of microscope, microsurgery implements, and microsuture, finger replantation has shown much development. With high success rate of microsurgery in children, positive results have been reported ever from distal amputation. Here, we report the patients demographics, methods, and results of the microsurgery performed in children in our hospital for the last 8 years. Methods: From the medical records of 21 patients who had given the treatment in our hospital from January 2000 to December 2007, we analyzed patients' sex, age, operative method, and complication retrospectively. Results: The number of male patients was twice as many as female, where most patients belong to the ages of five to ten years. Operative methods performed in this study included end - to - end anastomosis of artery and vein, vein graft, and epineurial suture. As a result, 19 out of 21 cases were successfully accomplished, and four of them went through the debridement of necrotic tissue due to the partial necrosis of the lesion. A one - year follow - up observation was done after surgery and most of them were almost fully recovered like in their previous state. Conclusion: The success rate of finger replantaion in children is continuously improving despite the difficulty of vessel anastomotic procedure, rehabilitation treatment and management after surgery. We report the satisfactory results of pediatric finger replantation technically and aesthetically.

• Archives of Reconstructive Microsurgery
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• 제15권1호
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• pp.10-16
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• 2006

We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

• 대한소아치과학회지
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• 제27권2호
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• pp.256-261
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• 2000

파절의 종류는 치관파절 치근파절, 동시에 나타난 치관-치근파절이 있고 치수노출에 따라 단순파절과 복잡파절로 나뉜다. 치아파절이 치은 연하로 침범하여 치아장축을 따라 나타난 경우나 치근의 1/3 이상을 넘어선 경우 발치가 원칙이다. 그러나 치근쪽 파절편을 교정적으로 정출시켜서 수복시켜 주는 방법과 인위적으로 발치하여 적절하게 수복 가능한 위치로 재식 시켜주는 방법을 선택적으로 이용할 수 있다. 본 증례에선 치아외상으로 상악 중절치가 치관-치근 파절된 혼합치열기의 환아에서 의도적 재식술을 이용하여 발치 후 즉일 근관치료와 역충전 후 레진수복을 시행하여 치료하였기에 보고하는 바이다.

• 한국환경복원기술학회지
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• 제6권5호
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• pp.48-58
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• 2003

This study was carried out to select proper species for early stage replantation in granite forest road cut-slope. From one to thirteen year elapsed forest roads in five regional areas of Chungcheong-do and Kyungsangbuk-do, sample plots were selected, and their vegetations and environmental factors were investigated. Soil organic matter, total nitrogen, soil moisture content, and bulk density in the granite weathering soils were below 0.5%, 0.02%, 10%, and above 1.2g/$cm^3$, respectively. The environmental factors affecting distribution of species in the granite forest road were the elapsed year, elevation, cut-slope aspect, and cut-slope. Sowing plants of Dactylis glomerata, Lolium perenne, and Eragrostis curvula were found in the early stage of forest road-cut. Annual herbs of Youngia denticulata, Erigeron annuus, etc. were found in the 2-3 years elasped forest road-cut. Perennial herbs of Artemisia princeps var. orientalis, Miscanthus sinensis, etc., parachute woody plants of Weigela subsessilis, Pinus densiflora, etc., and gravitative trees of Prunus sargentii, Lindera obtusiloba, Quercus sp., etc. were found in the forest road cut-slope after 3 years of road-cut. Leguma of Lespedeza cureata, Amorpha fruticosa, Lespedeza bicolor, Pueraria thunbergiana, Albizzia julibrissin, etc., herbs of Artemisia keiskeana, Artemisia princeps var. orientalis, Miscanthus sinensis, etc., and woody plants of Rubus crataegifolius, Weigela subsessilis, Zanthoxylum schinifolium, Pinus densiflora, etc. were considered as proper species for replantation in granite forest road cut-slope.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.79-83
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• 2009

Purpose: Avulsion injuries of digits have been presented for a long time as complex management problems. Despite of microsurgical advances, it is difficult to achieve good functional results and their management remains somewhat controversial. However, in a finger there are three transverse digital palmar arches. The middle and distal transverse digital palmar arches are consistently large(almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. 39-year-old man presented with avulsion amputation of the ulnar three digits, was operated using only arterial anastomosis with rerouting the transverse digital palmar arches. Methods: Replantation was performed using the artery-only technique. Because the digital arteries had been damaged, we did that the transverse digital palmar arches were transposed in an inverted Y to I configuration and were lengthened with rerouting them for the purpose of direct anastomosis of the digital artery. Venous drainage was provided by an external bleeding method with partial nail excision and external heparin irrigation. Results: The authors conclude that complete avulsion amputations with only soft tissue at the distal to insertion of the flexor digitorum superficialis tendon were salvageable with acceptable functional results. All three fingers survived. Conclusion: With technical advancements, the transverse digital palmar arches play an important role for finger amputation. Three digital palmar arches give us additional treatment option for the finger amputation. In this case, replantation with only-arterial anastomosis was successful and we obtained good aesthetic and functional outcome.

• Restorative Dentistry and Endodontics
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• 제26권2호
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• pp.111-120
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• 2001

Calcium hydroxide pastes is widely used in conventional endodontics. Along with the expanded clinical use of calcium hydroxide, literatures suggest mixing calcium hydroxide with other substance. Among added substances the vehicle plays the most importance role in the overall process because it is directly related with the velocity of ionic dissociation of $Ca^{2+}$ and OH ion. In this study, we evalutated and compared periapical tissue response and root resorption after canal was filled with mixture of saline and calcium hydroxide(Junsei Chemical Co.. Japan) as a aqueous vehicle, Metapaste(Meta Co., Korea) as a viscous vehicle paste, Vitapex(Neo Dental, Japan) as a oily vehicle paste and IRM(Caulk Dentsply, USA) in replantation of rat molar. A total of 31 maxillary first molars of Sprague-Dawley female rats, 30 days old were used. The upper 1st molar was extracted and the mesiobuccal canal was filled with mixture of saline and calcium hydroxide, Metapaste, Vitapex. IRM and then replanted. Rats were sacrificed 3 weeks after replantation. the maxillae were removed. section of 4 micron were cut and stained with hematoxylin-eosin, Apical tissue response were observed under light microscope. The results were as follows: 1. Saline mixing group and Metapaste group were significant different in fibrous capsule width compared to Vitapex group and IRM group(P<0.05). 2. Saline mixing group. Metapaste group. Vitapex group and IRM group did not prevent root resorption and there were no statistical difference. 3. In saline mixing group and Metapaste group. loss of pastes were observed in all samples. From the results of our study. we observed loss of pastes in saline mixing group and Metapaste group because of water soluble property and assumed it was related to inflammation in apical area and sealing ability of material. So, we should study and develop calcium hydroxide vehicle which is easily removed and more stable and because of only 3 weeks observation we need more evaluation in long period.

• 대한소아치과학회지
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• 제24권2호
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• pp.361-382
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• 1997

The effect of fluoride pretreatment upon root resorption after delayed replantation was studied in beagle dogs. Upper and lower incisors were extracted and bench dried for 45 minutes. 1% Stannous fluoride solution, 2% neutral sodium fluoride gel and 1.23% acidulated phosphate fluoride gel were used for the pre-treatment of replanted root surface in the experimental groups. Replantation was done with no treatment in control group. After of an experimental periods 3 weeks, animals were sacrificed by perfusion followed by sample preparation. A histomorphometric method was applied for evaluation of tissue reactions observed in each group under light microscope. Scanning electron microscopic observation was done to find out any different surface topography between groups. The results were as follows: 1. Fluoride-treated groups showed in general the better healing patterns than untreated control group. 2. Comparisons between three experimental groups revealed the general superiority of APF-treated group over the other groups in terms of tissue healing reaction by showing the highest frequency in uncomplicated healing pattern and surface resorption and the lowest in inflammatory resorption, but with no statistical significance(p>.05). 3. Scanning elecron micrographs showed the irregular distribution of resorption cavities and the attached bone of variable size and shape in all groups. 4. It can be concluded that the types of fluoride did not have significant impact on the early tissue reactions after delayed replantation under the condition of the present experiment.

• 대한소아치과학회지
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• 제31권4호
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• pp.729-733
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• 2004

완전 탈구된 치아의 치료 목적은 치주인대 세포의 손상과 치수 조직의 감염에 의한 염증 반응을 예방하거나 최소화하는 것이다. 치주인대 세포의 생활력은 완전 탈구된 치아의 예후에 있어 중요한 요소인데 치주인대 세포가 생활력을 유지하는 경우 재식시 재부착을 하게 되어 최소한의 염증반응 후 신생 백악질로 회복되지만, 생활력을 상실하게 되면 심한 염증반응을 야기하게 되어 광범위한 치근 흡수와 유착이 나타나게 된다. 치근이 유착되면 특히 성장하는 어린이일 경우 치조돌기의 성장을 방해하여 저위교합을 유발하게 된다. 또한 광범위한 치근 흡수나 유착으로 인한 치아의 조기 상실은 치조골의 흡수와 인접치의 지속적인 이동을 야기하여 기능적, 심미적인 문제를 발생케 한다. 본 증례는 상악 우측 중절치의 완전 탈구 후 재식한 후 항생제 투여 및 장기간의 수산화 칼슘 적용을 통해 9년에 걸쳐 기능적, 심미적으로 양호한 결과를 얻었기에 이에 보고하는 바이다.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.