• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.104-109
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• 1991

외상이나 감염 또는 종양의 적출에 의해 발생한 하악골 결손부는 심미적, 기능적으로 많은 문제를 야기한다. Sykoff가 1900년에 자가골 이식으로 하악골 결손부를 수복한 이후 현재까지 많은 이식물과 이식 방법이 이용되어져 왔으며 특히 늑연골은 1920년에 Gillies에 의해서 TMJ 수복에 처음 사용된 이후 성장기 아동의 과두결손부 수복에 많이 이용되고 있다. 또한 자가장골은 안면부의 수복에 보편적으로 이용되고 있는 공급부위이며 특히 많은 양의 망상골이 필요한 경우에는 후방 접근법을 이용함으로서 충분한 양의 골을 얻을 수 있다. 수복의 시기는 환자마다 차이가 있어서 나이, 과거력, 초기질별의 상태, 성장발육정도 및 심미적, 정신적인 면을 고려하여야 하며 악성종양의 제거시에는 재발여부와 방사선 치료 등을 고려하여 적절한 시기를 선택하여야 하나, 일반적으로 술후 약 1-2년 후에 시행할 수 있다. 본원에서는 하악골 골육종으로 진단된 15세 남자 환자에서 과두를 포함하는 좌측 하악골 절단술후 임시로 레진수복물을 장착한뒤 약 20개월간의 주기적인 검진결과 재발의 기미가 없어 늑연골과 장골의 복합이식을 통하여 심미적, 기능적으로 양호한 결과를 얻었기에 그 증례를 보고하는 바이다.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.571-577
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• 2009

Purpose: The Provision of thin and pliable tissue and the adequate coverage of tendon - gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report will discuss our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand. Methods: Between February 2004 and August 2008, seven patients with full - thickness soft tissue defects of the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma (n=5), scar contracture (n=1) and necrosis due to ischemia (n=1). Flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split - thickness skin graft was performed. Result: All flaps survived completely. The size of the transferred flap ranged from $2{\times}4cm$ to $5{\times}8cm$. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed. Conclusion: The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon - gliding mechanism, minimal bulk, minimal donor site morbidity. The disadvantages of this technique were the need for a skin graft and the muscle herniation of donor site.

• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.254-259
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• 2018

Background: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences. Methods: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications. Results: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft. Conclusion: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.

• Journal of Periodontal and Implant Science
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• 제26권3호
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• pp.605-624
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• 1996

Various bonegraft materials and the technique of guided tissue regeneration have been used to regenerate lost periodontal tissue. Calcium sulfate has been known as a bone graft material because of good biocompatibility, rapid resorption and effective osteoinduction. It has been known that calcium sulfate works as a binder to stabilize the defect when it is used with synthetic graft materials. The effects on the regeneration of pericxiontal tissue were studied in dogs after grafting 3-wall intrabony defects with calcium carbonate and calcium sulfate and covering with calcium sulfate barrier. The 3-wall intrabony defectstdmm width, 4mm depth, 4mm length) were created in anterior area and treated with flap operation alone(contol group), with porous resorbable calcium carbonate graft alonetexperirnental group 1), with calcium sulfate graft alonetexperimental group 2) and with composite graft of 80% calcium carbonate and 20% calcium sulfate with calcium sulfate barriertexperimental group 3). Healing responses were histologically observed after 8 weeks and the results were as follows: 1. The alveolar bone formation was $0.59{\pm}0.19mm$ in the control group, $1.80{\pm}0.25mm$ in experimental group 1, $1.61{\pm}0.21mm$ in experimental group 2 and $1.94{\pm}0.11mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(P<0.05). There were statistically significant differences between experimental group 1 and group 2 (P<0.05). 2. The new cementum formation was $0.48{\pm}0.19mm$ in the control group. $1.72{\pm}0.26mm$ in experimental group 1, $1.43{\pm}0.17mm$ in experimental group 2, $1.89{\pm}0.15mm$ in experimental group 3 with statiscally significant differences between control group and all experimental groups (p<0.05). There were statistically significant differences between experimental group 1 and group 2, and between experimental group 2 and group 3(P<0.05). 3. The length of junctional epithelium was $1.61{\pm}0.20mm$ in the contol group, $0.95{\pm}0.06mm$ in experimental group 1, $1.34{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.11mm$ in experimental group 3 with statiscally significant differences between control group and experimental group 1. and btween control group and experimental group 3(p<0.05). There were statistically significant differences between experimental group 1 ,and group 2, and between experimental group 2 and group 3(P<0.05). 4. The connective tissue adhesion was $1.67{\pm}O.20mm$ in the control group, $1.33{\pm}0.24mm$ in experimental group 1. $1.23{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.14mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(p<0.05). There were nostatistically significant differences between all experimental groups. As a result, epithelial migration was not prevented when calcium sulfate was used alone, but new bone and cementum formation were enhanced. Epithelial migration was prevented and new bone and cementum formation were also enhanced when calcium carbonate was used alone and when both calcium carbonate and calcium sulfate were used.

• 한국해양바이오학회지
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• 제7권2호
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• pp.58-70
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• 2015

Injectable RGD-bioconjugated Mussel Adhesive Proteins (RGD-MAPs) composite hydroxypropyl methylcellulose (HPMC) hydrogels provide local periodontal tissue for bone filling in periodontal surgery. Previously we developed a novel type of injectable self-supported hydrogel (2 mg/ml of RGD-MAPs/HPMC) based porcine nano hydroxyapatite (MPH) for dental graft, which could good handling property, biodegradation or biocompatibility with the hydrogel disassembly and provided efficient cell adhesion activity and no inflammatory responses. Herein, the aim of this work was to evaluate bone formation following implantation of MPH and collagen membrane in rabbit calvarial defects. Eight male New Zealand rabbits were used and four circular calvarial defects were created on each animal. Defects were filled with different graft materials: 1) collagen membrane, 2) collagen membrane with MPH, 3) collagen membrane with bovine bone hydroxyapatite (BBH), and 4) control. The animals were sacrificed after 2 and 8 weeks of healing periods for histologic analysis. Both sites receiving MPH and BBH showed statistically increased augmented volume and new bone formation (p < 0.05). However, there was no statistical difference in new bone formation between the MPH, BBH and collagen membrane group at all healing periods. Within the limits of this study, collagen membrane with MPH was an effective material for bone formation and space maintaining in rabbit calvarial defects.

• 멤브레인
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• 제31권3호
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• pp.212-218
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• 2021

화석 연료를 사용할 때, 불완전 연소는 필연적으로 발생하는 문제이다. 이러한 관점에서 연소 후 기체 분리는 불완전 연소 기체의 재활용 가능성을 시사한다. 이와 관련하여 본 연구에서는 일산화탄소 기체 분리용 촉진수송 고분자 분리막을 제조하였다. 이를 위해 poly(vinyl alcohol) (PVA) 주사슬 기반으로 acrylic acid (AA) 단량체를 자유 라디칼 중합법으로 PVA-g-PAA 공중합체를 제조하였다. 본 공중합체를 일산화탄소 활용에 적용하는 사례는 처음이며, 제조한 공중합체는 AgBF₄ 염과 HBF₄를 혼합하여 기체 분리막에 적용하였다. 공중합체 합성 결과는 FT-IR을 통해 분석하였으며, 공중합체와 AgBF₄, HBF₄의 상호작용은 TEM를 통해 분석하였다. 염의 첨가를 통해 일산화탄소 기체의 촉진수송 채널을 형성하였으며 이를 통해 일산화탄소 분리막 분야에 촉진수송 및 그래프팅 방법이라는 새로운 접근법을 제시하였다.

• Composites Research
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• 제28권3호
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• pp.89-93
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• 2015

본 연구는 무릎 인공관절의 이식 조직으로서 사용되는 이식 부품을 분석한다. 저탄성 티타늄 합금은 응력 차폐 현상을 해소하기 위해 적용되어진다. 이식 부품들의 응력 분포를 연구하기 위하여 시뮬레이션 해석이 수행되어진다. 저탄성 티타늄 합금의 탄성계수에 따른 등가응력 분포를 통하여 골격과의 상관 관계가 도출되고 연구된다. 이식 부품의 응력은 탄성계수가 감소함에 따라 처음에는 감소하다가 약 46 GPa 부근에서 가장 크게 감소하고 다시 증가한다. 이식 부품에 걸리는 응력의 감소는 골격에 더 큰 응력이 가해지게 되므로 응력차폐현상으로 볼 수 있다. 본 연구 결과는 무릎 인공관절의 이식 부품과 같은 복합 재료의 안전한 설계를 개발하는데 필요한 자료로 사료된다.

• 대한치과의사협회지
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• 제55권10호
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• pp.676-687
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• 2017

Objectives : The aim of this study was to evaluate the effects of a composite of bone substitute and collagen barrier membrane (bone patch) for local ridge augmentation at peri-implant dehiscence defects on the clinical efficacy and positional stability in dogs. Materials and methods : Implant placement and ridge augmentation procedure were performed at surgically created peri-implant dehiscence defects in canine mandible (n=6). Four treatment modalities were randomly applied: i) bone patch group, ii) Guided bone regeneration (GBR) without pin fixation group (bone graft and collagen membrane), iii) GBR with pin fixation group, and iv) negative control group. After 12 weeks, clinical, micro-CT and histological analyses were performed. Results : Histologic analysis showed that bone patch group had similar results to GBR group and GBR with fixation group in terms of new bone formation. Micro-CT analysis revealed similar results to histologic analysis in terms of total volume maintenance. Operating time was shorter in bone patch group compared to GBR group and GBR with fixation groups. Conclusions : GBR using bone patch could simplify the ridge augmentation procedure with reduced operating time and equivalent biological performance compared to the conventional procedure.

• Archives of Plastic Surgery
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• 제50권4호
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• pp.415-421
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• 2023

The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.237-240
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• 1998

Aneurysmal bone cyst is a benign lesion of bone consisting of a septated, cystic cavity filled with non-endothelium-lined, blood-filled spaces. As it grows, expanding and destroying the affected part of the bone by direct compression, the lesion characteristically produces a prominent bulging of the affected bone, which eventually erodes the overlying cortex. Patients rarely complain of pain unless the cyst affects adjacent nerves or its expasion is great enough to impinge on the surrounding joints and soft tissue. Teeth adjacent to the cyst may be displaced, but usually remain vital. Development of the lesion in the craniofacial region is rare, and the mandible is more often affected than the maxilla. Complete surgical excision is used to treat aneurysmal bone cyst, with either curettage or composite resection. This is a case report of 49 years old female with aneurysmal bone cyst treated with surgical excision & DFDB graft.