• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.114-119
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• 2000

The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.79-85
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• 2010

Purpose: Many trials for new therapeutic approaches such as stem cell-based transplantation have been conducted to improve the repair and regeneration of injured cord tissue and to restore functions following spinal cord injury (SCI) in animals and humans. Adipose tissue-derived stromal cells (ATSCs) have multi-lineage potential to differentiate into cells with neuron-like morphology. Most studies of stem cell transplantation therapy after SCI are focused on cellular regeneration and restoration of motor function, but not on unwanted effects after transplantation such as neuropathic pain. This study was focused on whether transplantation of ATSCs could facilitate or attenuate hindpaw pain responses to heat, cold and mechanical stimulation, as well as on improvement of locomotor function in a rat with SCI. Methods: A spinal cord injury rat model was produced using an NYU impactor by dropping a 10 g rod from a height of 25 mm on to the T9 segment. Human ATSCs (hATSCs; approximately $5{\times}10^5$ cells) or DMEM were injected into the perilesional area 9 days after the SCI. After transplantation, hindpaw withdrawal responses to heat, cold and mechanical allodynia were measured over 7 weeks. Motor recovery on the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and on the inclined plane test were also evaluated. Results: The present study demonstrated that increased hindpaw withdrawal responses to cold allodynia was observed in both groups after transplantation, but the development of cold-induced allodynia in the hATSC transplantation group was significantly larger than in the control group. The difference between the two groups in locomotor functional improvement after SCI was also significant. Conclusion: Careful consideration not only of optimal functional benefits but also of unintended side effects such as neuropathic pain is necessary before stem cell transplantation therapy after SCI.

• Journal of Periodontal and Implant Science
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• v.23 no.2
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• pp.261-281
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• 1993

The author transplanted periodontally-diseased teeth which had been treated with citric acid into a clinically healthy extraction sockets and periodontally-affected extraction sockets, and compared with the healing processes within these tissues. Recipient sites were prepared by surgically removing a part of alveolar bone of premolars of adults dogs, placing elastic orthodontic ligatures for 8weeks, thereby inducing periodontal disease. The diseased roots were extracted and transplanted into healthy extraction sockets, and these were designated as control group 1. Diseased roots transplanted into diseased sockets were designated as control group 2. Diseased roots which had been root planed, treated with citric acid and transplanted into healthy sockets were designated as experimental group 1, while identically treated roots which had been transplanted into diseased sockets were designated as experimental group 2. Observations were made at weeks 2, 8 and 12, with following results. 1. At week 2, experimental group 2 showed some inflammatory cell infiltration in the connective tissue above the extraction sockets, while control groups showed less inflammatory or foreign body reactions throughout the experiment. 2. In both control groups, root surface resorption was observed throughout the experiment, while experimental groups showed a little resorption. 3. Control group 1 & 2 showed ankylosis by newly-formed bone ground the resorbed root surfaces, while experimental group 1 & 2 displayed collagen fibers which are not functionally-arranged, with random, loose arrangement or parallel orientation to root surfaces, and newly-formed bone outside of them. 4. In both control groups & experimental groups which had been transplanted into a clinically healthy extraction sockets & periodontally affected extraction sockets groups, histological differences were not significant. 5. Root resorption or ankylosis in control group 1 & 2 had increased quantitatively as experiment progressed. 6. New bone formation developed from the base and lateral wall of extraction sockets. In both control groups & experimental groups, root surfaces lying next to the upper portion of extraction sockets showed little alveolar bone formation and surrounded by connective tissue fiber at weeks 2 & 8, while at weeks 12, they did show alveolar bone formation. 7. At week 12, experimental group 2 showed numerous cells which appeared to be periodontal ligament cells, with functionally arranged connective tissue fibers between the roots and alveolar bone.

• The Journal of Korean Physical Therapy
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• v.12 no.3
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• pp.319-329
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• 2000

The purpose of this study w8s to evaluate the effects of pulsed electromagnetic energy(Diapulse) and microcurrent on the wound healing in rabbits. 15 domestic rabbits were randomly assigned to the PRME(n=5). MC(n=5) and CON(n=91 group. Each rabbits were anesthetized with lidocaine HCL $2\%$. Skin wounds were created laterally on the back of IS domestic rabbits(33cm). From 24 hours after being injured, the rabbits of the PEME group were irradiated with an intensity of 3 at a 300 pulses per second, which were applied for 15 minutes every day during the 12 days. The MC group were stimulated with an intensity of $50{\mu}A$ at frequency of40 pulses per second, which were applied for 15 minutes every day during the 12 days. The CON group were not stimulated. The rabbits were sacrificed and the incised wound pans were processed appropriately for the light microscopic examination on the 3rd day, 6th day and 12th day before the beginning of wound treatment. The areas of wound were measured with metric graph paper. The results were as tallows. 1 The PRME and MC group compared with control group showed that wound closure rate increased on 6th, 12th day. 2. It was found that the CON group did not show a complete maturation and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue. these findings showed that wound healing was delayed. 3. It showed that inflammatory cells. fibroblasts and epithelial cells activity rapidly processed in the PEME group compared with the CON group. It was found that the PEMI; group showed a advanced remodeling of epithelial layer and a positive repair of connective tissue. 4. It showed that fibroblasts, epithelial cells and inflammatory cells activity rapidly processed in the MC group compared with the CON group. It was found that the MC group showed a improved remodeling of epithelial layer and a dense connective tissue.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.13-25
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• 2009

Purpose: The DNA repair protein, $O^6$-methylguanine-DNA methyltransferase (MGMT), removes alkyl adducts from the $O^6$ position of guanine. Epigenetic inactivation of MGMT has been found in human neoplasia and considered one of the implicated factors in chemoresistance. Materials and Methods: Sixty-two patiensts with soft tissue sarcomas (STS) were analyzed for the status of MGMT protein expression by immunohistochemistry and the promoter hypermethylation of the MGMT gene using methylation-specific PCR. Result: The loss of MGMT expression was found in 20 cases (32.3%) of total 62 STS. MGMT promoter hypermethylation rate was 25.0% (11/44 cases). The loss of MGMT expression showed significant association with high AJCC stage, high FNCLCC grade, and aggressive behavior. However,when the group who received chemotherapy was analyzed (n=27), loss of MGMT expression was correlated with worse survival in multivariate analysis (p=0.024). MGMT promoter hypermethylation is associated with high FNCLCC grade. MGMT promoter hypermethylation status had a strong correlation with loss of MGMT expression (p=0.000). Conclusion: Our results suggest that MGMT promoter hypermethylation and loss of MGMT expression had a tendency to be associated with poor prognosis and that loss of MGMT protein expression is frequently occurs via MGMT promoter hypermethylation.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.41 no.4
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• pp.401-411
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• 2015

This study was performed to investigate the wound healing effect of skin regeneration cosmetics utilizing low molecular weight Polydeoxynucleotide (PDRN). High purity PDRN was prepared from salmon testes poly-deoxy-ribonucleotide through protein and toxin removal process and molecular weight reduction. In order to evaluate the wound healing effect of PDRN in SD rats, 4 sites of dorsal skin of each animal were excised by using biopsy punch and $500{\mu}L$ of test solution was topically applied once daily for 4 weeks. The tissue changes were observed for every week during the application periods. After applying the PDRN to the wound, the skin was cut flower and contraction of the wounds more quickly, and the coating of PDRN in the wound area was reduced significantly as compared to the positive control group $Fucidin^{(R)}$ applied. The microscopic observation of stained tissue showed that a positive control was most rapid in re-epithelialization ability followed by the PH group, PDRN group, HA group. In addition, transforming growth factor ($TGF-{\beta}$) and vascular endothelial growth factor (VEGF), such as in the growth factor was similar to the results of staining of tissue lesions. In conclusion, it is determined that the low molecular weight PDRN has the therapeutic effect to the wound, and could be used as a functional material of cosmetics and medical industries.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.483-509
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• 1999

Biodegradable barrier membrane has been demonstrated to have guided bone regeneration capacity on the animal study. The purpose of this study is to evaluate the effects of cultured calvarial cell inoculated on the biodegradable barrier membrane for the regeneration of the artificial bone defect. In this experiment 35 Sprague-Dawley male rats(mean BW 150gm) were used. 30 rats were divided into 3 groups. In group I, defects were covered periosteum without membrane. In group II, defects were repaired using biodegradable barrier membrane. In group III, the defects were repaired using biodegradable barrier membrane seeded with cultured calvarial cell. Every surgical procedure were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). After anesthesia, 5 rats were sacrificed by decapitation to obtain the calvaria for bone cell culture. Calvarial cells were cultured with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. The number of cell inoculated on the membrane were $1{\times}10^6$ Cells/ml. The membrane were inserted on the artificial bone defect after 3 days of culture. A single 3-mm diameter full-thickness artificial calvarial defect was made in each animal by using with bone trephine drill. After the every surgical intervention of animal, all of the animals were sacrificed at 1, 2, 3 weeks after surgery by using of perfusion technique. For obtaining histological section, tissues were fixed in 2.5% Glutaraldehyde (0.1M cacodylate buffer, pH 7.2) and Karnovsky's fixative solution, and decalcified with 0.1M disodium ethylene diaminetetraacetate for 3 weeks. Tissue embeding was performed in paraffin and cut parallel to the surface of calvaria. Section in 7${\mu}m$ thickness of tissue was done and stained with Hematoxylin-Eosin. All the specimens were observed under the light microscopy. The following results were obtained. 1 . During the whole period of experiment, fibrous connective tissue was revealed at 1week after surgery which meant rapid soft tissue recovery. The healing rate of defected area into new bone formation of the test group was observed more rapid tendency than other two groups. 2 . The sequence of healing rate of bone defected area was as follows ； test group, positive control, negative control group. 3 . During the experiment, an osteoclastic cell around preexisted bone was not found. New bone formation was originated from the periphery of the remaing bone wall, and gradually extended into central portion of the bone defect. 4 . The biodegradable barrier membrane was observed favorable biocompatibility during this experimental period without any other noticeable foreign body reaction. And mineralization in the newly formed osteoid tissue revealed relatively more rapid than other group since early stage of the healing process. Conclusively, the cultured bone cell inoculated onto the biodegradable barrier membrane may have an important role of regeneration of artificial bone defects of alveolar bone. This study thus demonstrates a tissue-engineering the approach to the repair of bone defects, which may have clinical applications in clinical fields of the dentistry including periodontics.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.511-519
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• 2006

Background: Loss of cardiomyocytes in the myocardial infarction leads to regional contractile dysfunction, and necrotized cardiomyocytes in infracted ventricular tissues are progressively replaced by fibroblasts forming scar tissue. Although cardiomyoplasty, or implantation of ventricular assist device or artificial heart was tried in refractory heart failure, the cardiac transplantation was the only therapeutic modality because these other therapeutic strategies were not permanent. Cell transplantation is tried instead of cardiac transplantation, especially bone marrow is the most popular donated organ. But because bone marrow aspiration procedure is invasive and painful, and it had the fewer amounts of cellular population, the adipose tissue is recommended for harvesting of mesenchymal stem cells. Material and Method: After adipose tissues were extracted from abdominal subcutaneous adipose tissue and intra-abdominal adipose tissue individually, the cellular components were obtained by same method. These cellular components were tried to transformation with the various titers of 5-azacytidine to descript the appropriate concentration of 5-azacytidine and possibility of transformation ability of adipose tissue. Group 1 is abdominal subcutaneous adipose tissue and Group 2 is intra-abdominal adipose tissue-retroperitoneal adipose tissue and omentum. Cellular components were extracted by collagenase and $NH_4Cl$ et al, and these components were cultured by non-induction media - DMEM media containing 10% FBS and inducted by none, $3{\mu}mol/L,\;6{\mu}mol/L,\;and\;9{\mu}mol/L$ 5-azacytidine after the 1st and 2nd subculture. After 4 weeks incubation, tile cell blocks were made, immunostaining was done with the antibodies of CD34, heavy myosin chain, troponin T, and SMA. Result: Immunostaining of the transformed cells for troponin T was positive in the $6{\mu}mol/L\;&\;9{\mu}mol/L$ 5-azacytidine of Group 1 & 2, but CD34 and heavy myosin chain antibodies were negative and SMA antibody was positive in the $3{\mu}mol/L\;&\;6{\mu}mol/L$ 5-azacytidne of Group 2. Conclusion: These observations confirm that adult mesenchymal stem cells isolated from the abdominal subcutaneous adipose tissues and intra-abdominal adipose tissues can be chemically transformed into cardiomyocytes. This can potentially be a source of autologous cells for myocardial repair.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.112-118
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• 2020

This study was undertaken to examine the effects and to investigate the relevant mechanisms of overexpressing stromal cell-derived factor-1 (SDF-1) produced by engineered mesenchymal stem cells, in a neurogenic bladder (NB) rat model. Sprague-Dawley (SD) rats (N=48) were randomly divided into 4 groups comprising 12 rats each: control group, Injury group, Injury+imMSC group, and Injury+SDF-1 eMSC group. Rats in the Injury+imMSC group were treated with imMSCs, whereas the Injury+SDF-1 eMSC group were administered SDF-1 eMSCs. After 4-weeks therapy, the bladder and pelvic nerve (PN) tissues were examined by subjecting to Masson's trichrome staining and immunofluorescence. Administration of SDF-1 eMSC resulted in improved smooth muscle content in the bladder tissue, significantly increased β-III tubulin expression of the PN, and enhanced SDF-1 expression (P<0.05). The bladder wall repair can be attributed to the overexpression of SDF-1 by SDF-1 eMSCs. Significantly increased SDF-1 expression was obtained in the Injury+SDF-1 eMSC group (P<0.05). The crushed PN also showed significant recovery in the Injury+SDF-1 eMSC group (P<0.05). In conclusion, our results indicate that SDF-1 eMSCs express more SDF-1 in vivo, thereby facilitating the repair of injured nerve and recovery of NB in rats.