Hong, Jong Won;Kim, Young Seok;Yun, In Sik;Lee, Dong Won;Lee, Won Jai;Roh, Tai Suk;Lew, Dae Hyun;Kim, Yong Oock;Rah, Dong Kyun;Tark, Kwan Chul;Yun Park, Be-Young
Archives of Craniofacial Surgery
/
v.13
no.2
/
pp.85-94
/
2012
The world's first face transplantation was performed in France, in 2005. Since then, 21 cases of face transplantation have been performed. Face transplantation is one of the most prominent part of composite tissue allotransplantation (CTA) along with hand transplantation. Since these fields are not deal with life-saving organs, there are many arguments about immunosuppression therapy. Recent paradigm of face transplantation shows that surgical ranges are expanded from partial face transplantation to full face transplantation. Most immunosuppression protocols are triple therapy, which consists of tacrolimus (FK-506), mycophenolate mofetil and prednisolone. Anatomical researches, immunosuppression, and immunotolerance take great parts in the researches of CTA. The medical fields directly related to face transplantation are microsurgery, immunology, and transplantation. Nowadays, each field is performed widely. Therefore people, even medical teams think face transplantation could be easily realized, sooner or later. But there are lots of things that should be prepared for not only practice and immunosuppression therapy but also for the cooperation with relevant fields. That's the reason why only 21 cases of face transplantation have been done, while more than 70 cases of hand transplantation have been done in the past years. Especially in Korea, brain death patients are not enough even for organ transplantation and furthermore there are some troubles in taking part in the society of transplantation. Face transplantation has lots of problems concerning variable medical fields, administration, society, ethics, and laws. Therefore, for the realization of face transplantation in Korea, not only medical skills but also political powers are needed.
Hong, Jong Won;Chung, Soon Won;Ahn, Sung Jae;Lee, Won Jai;Lew, Dae Hyun;Kim, Yong Oock
Archives of Plastic Surgery
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v.46
no.5
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pp.405-413
/
2019
Background Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process. Methods A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs. Results The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (${\pm}15.3$). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (${\pm}14hours$ 50 minutes) and 22 hours 57 minutes (${\pm}16hours$ 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%). Conclusions When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.
Kwon, Seong Gyu;Kwon, Yang Woo;Lee, Tae Wook;Park, Gyu Tae;Kim, Jae Ho
Biomaterials Research
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v.22
no.4
/
pp.311-318
/
2018
Background: Tissue regeneration includes delivering specific types of cells or cell products to injured tissues or organs for restoration of tissue and organ function. Stem cell therapy has drawn considerable attention since transplantation of stem cells can overcome the limitations of autologous transplantation of patient's tissues; however, it is not perfect for treating diseases. To overcome the hurdles associated with stem cell therapy, tissue engineering techniques have been developed. Development of stem cell technology in combination with tissue engineering has opened new ways of producing engineered tissue substitutes. Several studies have shown that this combination of tissue engineering and stem cell technologies enhances cell viability, differentiation, and therapeutic efficacy of transplanted stem cells. Main body: Stem cells that can be used for tissue regeneration include mesenchymal stem cells, embryonic stem cells, and induced pluripotent stem cells. Transplantation of stem cells alone into injured tissues exhibited low therapeutic efficacy due to poor viability and diminished regenerative activity of transplanted cells. In this review, we will discuss the progress of biomedical engineering, including scaffolds, biomaterials, and tissue engineering techniques to overcome the low therapeutic efficacy of stem cells and to treat human diseases. Conclusion: The combination of stem cell and tissue engineering techniques overcomes the limitations of stem cells in therapy of human diseases, and presents a new path toward regeneration of injured tissues.
Background Brown adipose tissue (BAT) is a potential target for anti-obesity treatments. Previous studies have shown that BAT activation causes an acute metabolic boost and reduces adiposity. Furthermore, BAT and BAT-derived cell transplantation reportedly help treat obesity by regulating glucose and fatty acid metabolism. However, since BAT transplantation leads to whole-body weight loss, we speculated that earlier approaches cause a generalized and unnecessary fat tissue loss, including in breast and hip tissues. Methods We transplanted white adipose tissue-derived or BAT-derived preadipocytes prepared from C57BL/6 mice into one side of the inguinal fat pads of an obese mouse model (db/db mice) to examine whether it would cause fat loss at the peri-transplant site (n=5 each). The same volume of phosphate-buffered saline was injected as a control on the other side. Six weeks after transplantation, the inguinal fat pad was excised and weighed. We also measured the concentrations of glucose, triglycerides, fatty acids, and total cholesterol in the peripheral blood. Results BAT-derived preadipocytes showed abundant mitochondria and high levels of mitochondrial membrane uncoupling protein 1 expression, both in vivo and in vitro, with a remarkable reduction in weight of the inguinal fat pad after transplantation (0.17±0.12 g, P=0.043). Only free fatty acid levels tended to decrease in the BAT-transplanted group, but the difference was not significant (P=0.11). Conclusions Our results suggest that brown adipocytes drive fat degradation around the transplantation site. Thus, local transplantation of BAT-derived preadipocytes may be useful for treating obesity, as well as in cosmetic treatments.
The intact dental pulps which were free of their tooth bud from adult rat incisors, and oral mucosa were transplanted subcutaneously in homologous rats to study the formation of calcified tissue. The rat were sacrificed after 1,2,3 and 4 weeks following transplantation of dental pulp and oral mucosa. The samples which contained the transplanted and surrounding tissue were fixed in 10% NBF, stained with hematoxylin and eosin, alizarin red S, von Kossa, and alcian blue. Microscopic examinstins revealed as follows: 1. The transplanted oral mucosas were not calcified but tended to form the epithelial cysts. 2. At 1 week after transplantation of dental pulp the calcified structures were appeared at the periphery of the transplantation of dental pulp but weakly reacted to alizarin red S, von Kossa, and alcian blue. 3. At 2 weeks after transplantation of dental pulp the calcified structures began to expand from the periphery to the center of the transplanted dental pulp and occupied the large areas comparatively, and strongly reacted to alizarin red S, and von Kossa stains. 4. At 3 weeks after transplantation of pulp tissue the fibrous components were grown at the periphery of the transplanted pulp tissuesand at 4 weeks a large amount of fibrous tissues were observed. The transplanted pulp tissue tended to form foreign bodies gradually.
Objective: Nude mice with orthotopic transplantation of human ovarian epithelial cancer were used to investigate screening criteria for paraneoplastic normal ovarian tissue and the security of the freezing and thawing for ovarian tissue transplantation. Methods: Expression of CK-7, CA125, P53, survivin, MMP-2/TIMP-2 in paraneoplastic normal ovarian tissues were detected by RT-PCR as well as immunohistochemistry. The tissues of the groups with all negative indicators of RT-PCR, all negative indicators of immunohistochemistry, negative expression of CK-7, CA125 and survivin, positive expression of CK-7, CA125 and survivin, cancer tissues and normal ovarian tissues of nude mice were used for freezing and thawing transplantation, to analyze overt and occult carcinogenesis rates after transplantation. Results: When all indicators or the main indicators, CK-7, CA125 and survivin, were negative, tumorigenesis did not occur after transplantation. In addition the occult carcinogenesis rate was lower than in the group with positive expression of CK-7, CA125 and survivin (P<0.01). After subcutaneous and orthotopic transplantation of ovarian tissues, rates did not change (P>0.05). There was no statistical significance among rates after transplantation of ovarian tissues which were obtained under different severity conditions (P>0.05). Conclusion: Negative expression of CK-7, CA125 and survivin can be treated as screening criteria for security of ovarian tissues for transplantation. Immunohistochemical methods can be used as the primary detection approach. Both subcutaneous and orthotopic transplantation are safe. The initial severity does not affect the carcinogenesis rate after tissue transplantation. Freezing and thawing ovarian tissue transplantation in nude mice with human epithelial ovarian carcinoma is feasible and safe.
Although regional and myocutaneous flaps are still the standard in head and neck reconstruction. The capacity to transfer distant tissues by microsurgical technique expands the reconstructive surgeon's ability to restore severe deformities of the head and neck. From 1981 to 1985, thirteen patients with extensive defects of the head and neck after extirpative surgery of tumor have been reconstructed utilizing the technique of microsurgical composite tissue transplantation. In this series of patients, six presented with reconstructions in the different region of the head and neck with review of literatures. The results of case analysis are summarized as follows: 1) Transplantation was successful in twelve among thirteen patients (92%). 2) Seven patients presented with malignancy and six with benign tumor. 3) Frequent sites of reconstruction were face and mandible. 4) Fourteen free composite tissue transplantations for reconstruction of thirteen patients were obtained six different tissue compositions from eight different donor sites. 5) The recipient artery and vein was most often superficial temporal or facial vessels. 6) The average time of operation was ten hours.
International Journal of Computer Science & Network Security
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v.22
no.9
/
pp.307-315
/
2022
The review of known decision-making support systems and technologies regarding the possibility of donation and transplantation showed that currently there are no systems and technologies of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper models the decision-making support process regarding the possibility of donation and transplantation, which is a theoretical basis for the development of rules, methods and technology of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper also developed the technology of decision-making support regarding the possibility of donation and transplantation considering civil law as a component of the Unified State Information System for Organ and Tissue Transplantation, which automatically and free of charge determines the possibility/impossibility of donation and transplantation. In the case of the possibility of donation, the admissible type of donation is also determined - over-life or after-life donation - and data about potential donor is entered in the relevant Donor Register. In the case of the possibility of transplantation, if the recipient needs a transplant of one of the paired organs or a part of the organ/tissue, then data about potential recipient are entered in the Transplantation List from both over-life and after-life donor, otherwise, if the recipient needs a transplant of a non-paired organ or both paired organs, then data about potential recipient are entered only in the Transplantation List from after-life donor.
Decellularized matrix transplantation has emerged as a promising therapeutic approach for repairing tissue defects, with numerous studies assessing its safety and efficacy in both animal models and clinical settings. The host immune response elicited by decellularized matrix grafts of natural biological origin plays a crucial role in determining the success of tissue repair, influenced by matrix heterogeneity and the inflammatory microenvironment of the wound. However, the specific immunologic mechanisms underlying the interaction between decellularized matrix grafts and the host immune system remain elusive. This article reviews the sources of decellularized matrices, available decellularization techniques, and residual immunogenic components. It focuses on the host immune response following decellularized matrix transplantation, with emphasis on the key mechanisms of Toll-like receptor, T-cell receptor, and TGF-β/SMAD signaling in the stages of post-transplantation immunorecognition, immunomodulation, and tissue repair, respectively. Furthermore, it highlights the innovative roles of TLR10 and miR-29a-3p in improving transplantation outcomes. An in-depth understanding of the molecular mechanisms underlying the host immune response after decellularized matrix transplantation provides new directions for the repair of tissue defects.
Cell therapy applied to wound healing or tissue regeneration presents a revolutionary realm to which principles of gene engineering and delivery may be applied. One promising application is the transplantation of cells into the wounded tissue to help the tissue repair. However, when cells are transplanted from in vitro to in vivo, immune rejection occurs due to the immune response triggered by the activation of T-cell, and the transplanted cells are destroyed by the attack of activated T-cell and lose their function. Immune suppressant such as FK506 is commonly used to suppress immune rejection during transplantation. However, such kind of immune suppressants not only suppresses immune rejection in the periphery of transplanted cells but also suppresses whole immune response system against pathogenic infection. In order to solve this problem, we developed a method to protect the desired cells from immune rejection without impairing whole immune system during cell transplantation. Previously, we reported the success of constructing glomerular epithelial cells for removal of immune complex, in which complement receptor of type 1 (CR1) was over-expressed on the membrane of renal glomerular epithelial cells and could bind immune complex of DNA/anti-DNA-antibody to remove immune complex through phagocy-tosis [1]. Attempting to apply the CR1-expressing cells to cell therapy and evade immune rejection during cell transplantation, we constructed three plasmids containing genes encoding a soluble fusion protein of cytolytic T lymphocyte associated antigen-4 (CTLA4Ig) and an enhanced green fluorescent protein (EGFP). The plasmids were transfected to the above-mentioned glomerular epithelial cells to express both genes simultaneously. Using the clone cells for cell transplantation showed that mice with autoimmune disease prolonged their life significantly as compared with the control mice, and two injections of the cells at the beginning of two weeks resulted in remarkable survivability, whereas it requires half a year and 50 administrations of proteins purified from the same amount of cells to achieve the same effect.
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