• Title/Summary/Keyword: autologous

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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.

Apicoectomy of maxillary anterior teeth through a piezoelectric bony-window osteotomy: two case reports introducing a new technique to preserve cortical bone

  • Hirsch, Viola;Kohli, Meetu R.;Kim, Syngcuk
    • Restorative Dentistry and Endodontics
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    • v.41 no.4
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    • pp.310-315
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    • 2016
  • Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.

Analyses Using Micro-CT Scans and Tissue Staining on New Bone Formation and Bone Fusion According to the Timing of Cranioplasty via Frozen Autologous Bone Flaps in Rabbits : A Preliminary Report

  • Shin, Hee Sup;Lee, Deok-Won;Lee, Seung Hwan;Koh, Jun Seok
    • Journal of Korean Neurosurgical Society
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    • v.57 no.4
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    • pp.242-249
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    • 2015
  • Objective : The timing of cranioplasty and method of bone flap storage are known risk factors of non-union and resorption of bone flaps. In this animal experimental study, we evaluated the efficacy of cranioplasty using frozen autologous bone flap, and examined whether the timing of cranioplasty after craniectomy affects bone fusion and new bone formation. Methods : Total 8 rabbits (male, older than 16 weeks) were divided into two groups of early cranioplasty group (EG, 4 rabbits) and delayed cranioplasty group (DG, 4 rabbits). The rabbits of each group were performed cranioplasty via frozen autologous bone flaps 4 weeks (EG) and 8 weeks (DG) after craniectomy. In order to obtain control data, the cranioplasty immediate after craniectomy were made on the contralateral cranial bone of the rabbits (control group, CG). The bone fusion and new bone formation were evaluated by micro-CT scan and histological examination 8 weeks after cranioplasty on both groups. Results : In the micro-CT scans, the mean values of the volume and the surface of new bone were $50.13{\pm}7.18mm^3$ and $706.23{\pm}77.26mm^2$ in EG, $53.78{\pm}10.86mm^3$ and $726.60{\pm}170.99mm^2$ in DG, and $31.51{\pm}12.84mm^3$ and $436.65{\pm}132.24mm^2$ in CG. In the statistical results, significant differences were shown between EG and CG and between DG and CG (volume : p=0.028 and surface : p=0.008). The histological results confirmed new bone formation in all rabbits. Conclusion : We observed new bone formation on all the frozen autologous bone flaps that was stored within 8 weeks. The timing of cranioplasty may showed no difference of degree of new bone formation. Not only the healing period after cranioplasty but the time interval from craniectomy to cranioplasty could affect the new bone formation.

Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과: 내과 절골 도달법과 전방 관절낭 절개 도달법의 비교)

  • Lee, Yong-Sik;Ahn, Gil-Yeong;Nam, Il-Hyun;Lee, Yeong-Hyun;Lee, Tae-Hun;Kim, Dae-Geun;Lee, Dong-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.139-143
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    • 2017
  • Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

Second Look Arthroscopic Finding after Fibrin Matrix Autologous Chondrocyte Implantation for the Treatment of Articular Cartilage Defect of the Knee - Preliminary Report - (슬관절 연골 결손에 대한 fibrin matrix 자가 연골 세포 이식술 후 이차 관절경 소견 - 예비보고 -)

  • Choi, Sung-Wook;Oh, In-Suk;Kim, Ryuh-Sup;Park, Sun-Won;Lee, Jong-Min;Lee, Moon;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.1-6
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    • 2007
  • Purpose: The purpose of this preliminary report is to investigate the short term outcome of performing gel type fibrin matrix autologous chondrocyte implantation to patients who have damaged knee joint cartilage using secondary arthroscopy. Material and Methods: Six patients who have damaged knee joint cartilage were involved. The average size of defect was $5.13\;cm^2$. While performing primary arthroscopy, whole layer of cartilage bone was obtained either from the margin of damaged cartilage or the bilateral margin of a trochlea. The cartilaginous cells were obtained for culture for four to six weeks. While performing secondary minimal invasive arthrotomy, gel type fibrin matrix autologous chondrocyte was implanted on the chondral defect site. Results: 4 among 6 patients to be more than good in Modified Cincinnati Knee Scoring system. Lysholm function score was 59.5 preoperatively, and it improved to 76.25. ICRS grading by performing secondary arthroscopy revealed 4 out of 6 patients to be nearly normal. Conclusion: Gel type fibrin matrix autologous chondrocyte implantation is a treatment for cartilage defect, which takes less time to operate than the conventional implantation. In addition, this method minimizes the size of incision and allows arthroscopic surgery. However, long term follow up and more case study is thought to be necessary.

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Development of Artificial Vessels with Autologous Bone Marrow Cells and Polymers (자기 골수세포와 고분자 폴리머를 이용한 인공 혈관의 개발)

  • Choi, Jin-Wook;Lim, Sang-Hyun;Hong, You-Sun;Kim, Byung-Soo
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.160-169
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    • 2008
  • Bakcground: To treat anastomosis site stenosis and occlusion of the artificial vessels used in vascular surgery, tissue-engineered artificial vessels using autologous cells have been constructed. We developed artificial vessels using a polymer scaffold and autologous bone marrow cells and performed an in vivo evaluation. Material and Method: We manufactured a vascular scaffold using biodegradable PLCL (poly lactide-co-${\varepsilon}$-caprolactone) and PGA (poly glycolic acid) fibers. Then we seeded autologous bone marrow cells onto the scaffold. After implantation of the artificial vessel into the abdominal aorta, we performed an angiography 3 weeks after surgery. After the dogs were euthanized we retrieved the artificial vessels and performed histological analysis. Result: Among the six dogs, 2 dogs died of massive bleeding due to a crack in the vascular scaffold 10 days after the operation. The remaining four dogs lived for 3 weeks after the operation. In these dogs. the angiography revealed no stenosis or occlusion at 3 weeks after the operation. Gross examination revealed small thrombi on the inner surface of the vessels and the histological analysis showed three layers of vessel structure similar to the native vessel. Immunohistochemical analysis demonstrated regeneration of the endothelial and smooth muscle cell layers. Conclusion: A tissue engineered vascular graft was manufactured using a polymer scaffold and autologous bone marrow cells that had a structure similar to that of the native artery. Further research is needed to determine how to accommodate the aortic pressure.

Radiographic Analysis of Instrumented Posterolateral Fusion Mass Using Mixture of Local Autologous Bone and b-TCP (PolyBone$^{(R)}$) in a Lumbar Spinal Fusion Surgery

  • Park, Jin-Hoon;Choi, Chung-Gon;Jeon, Sang-Ryong;Rhim, Seung-Chul;Kim, Chang-Jin;Roh, Sung-Woo
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.267-272
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    • 2011
  • Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.