• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.68-76
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• 2016

Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.217-223
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• 2023

Purpose: Defects involving the ankle and foot are often the result of road traffic accidents. Many such defects are composite and require a flap for coverage, which is a significant challenge for reconstructive surgeons. Various locoregional options, such as reverse sural artery, reverse peroneal artery, peroneus brevis muscle, perforator-based, and fasciocutaneous flaps, have been used, but each flap type has limitations. In this study, we used the distally based lateral supramalleolar flap to reconstruct distal dorsal defects of the foot. The aim of this study was to analyze the efficacy of the flap in reconstructing distal dorsal defects of the foot. The specific objectives were to study the adequacy, reach, and utility of the lateral supramalleolar flap for distal defects of the dorsum of the foot; to observe various complications encountered with the flap; and to study the functional outcomes of reconstruction. Methods: The distal dorsal foot defects of 10 patients were reconstructed with distal lateral supramalleolar flaps over a period of 6 months at a tertiary care center, and the results were analyzed. Results: We were able to effectively cover distal foot defects in all 10 cases. Flap congestion was observed in two cases, and minor graft loss was seen in two cases. Conclusions: The distally based lateral supramalleolar flap is a good pedicled locoregional flap for the coverage of distal dorsal foot and ankle defects of moderate size, with relatively few complications and little morbidity. It can be used as a lifeboat or even substitute for a free flap.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.506-511
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• 1997

To understand the clinical results of aortic root replacement with either inclusion or open technique, we analysed 53 patients who underwent replacement of the aortic root with composite graft between October,1980, and May, 1995. Annuloaortic ectasia was the most common indication for operation(29 patients), follwed by aortic dissection(22 patients). Among 53 patients, 19(35%) had Marfan syndrome. Three patients died during hospitalization (Mortality: 5.5%). The follow up was possible in 48 patients(Follow-up rate; 94%,mean duration;37 months). The actuarial survival rate at 24 months was 95% in open technique group, and 87% in inclusion technique group. Late complications developed in 10 patients. Dissecting aneurysm in the remaining aorta was noted in 3 patients with inclu ion 1,schnique, and a pseudoaneurysm from coronary artery anastomosis site developed in a patient with inclusion technique. In conclusion, there was no statistical differences in survival for 24 months between inclusion technique and open technique group. But late problems in the remaining aorta or death from unknown cause occurred with moderate frequency : careful follow-up after aortic root replacement thought to be important for long term survival.

• Composites Research
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• v.34 no.3
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• pp.186-191
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• 2021

The lumbar spinal fusion is a treatment performed to restore the stability of the degenerated lumbar. In this study, the intervertebral discs between two or more segments are removed and a bone graft is inserted to harden the segments. The pedicle screw system is inserted to vertebral bodies to fix two or more segments so that they can be firmly fused. In this study, a total of 7 patient-specific lumbar finite element models were created and pedicle screw systems were installed. The connecting rods made of titanium and CFR-PEEK was inserted to the generated models. Finite element analysis was conducted for four representative spine behaviors and statistical analysis was performed to investigate the biomechanical effects by the material properties of connecting rods. The intradiscal pressure of adjacent segments and the range of motion of the joints of each segment were investigated. In the subjects who used CFR-PEEK instead of Ti for connecting rods, the intradiscal pressure of adjacent segments tend to decrease and the range of motion of each segment tend to increase. However, no statistically significant difference in tendency was observed under all loading conditions.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.456-463
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• 2009

Background: Although the reports on re-operative coronary revascularization (redo-CABG) have increased, there are only limited reports on redo-CABG using arterial grafts. The aim of this study was to analyze the safety and feasibility of using various arterial grafts for redo-CABG. Material and Method: A consecutive series of patients who underwent 33 redo-CABGs from March 2001 to July 2008 were retrospectively reviewed. We performed conventional CABG in 17 patients, on-pump beating CABG in 7, off-pump CABG in 7 and minimally invasive direct coronary artery bypass in 2. The grafted that were used included 34 internal thoracic arteries (ITA), 14 radial arteries, 14 right gastroepiploic arteries and others. Arterial composite grafts were constructed in 26 patients. Of these, a previously patent in-situ left ITA was re-used as the in-flow of a composite graft in 10 patients. Result: No hospital deaths or major wound problems occurred. The post-operative complications included 2 myocardial infarctions (6%), 1 intra-aortic balloon pump insertion (3%), 5 cases of atrial fibrillation (15.1 %) and 3 neurologic complications (9.1%). The meanfollow-up duration was 31.1$\pm$22.7 months and the 3 year survival rate was 86.4%. There were 4 late deaths (2 cardiac deaths) and no recurrent angina during the follow-up period. Conclusion: Redo-CABG with using various arterial grafts is currently a safe, feasible procedure, but further investigation and long term follow-up are needed.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.621-636
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• 1999

When mucoperiosteal flaps are positioned and sutured to desirable position, the wound contains several interface between tissues which differ fundamentally in composition & biological reaction. Thus the C-T surface of the flap will, on one hand, oppose another vascularized surface, and on the other, the avascular dental material for example, when root resoptions, fractured root, endodontic perforation, deep root carious lesions were filled with amalgam, glass ionomer, resin etc. Recently, a number of case report described the successful treatment of a subgingival root lesion with restorative material & free gingival graft, open flap surgery, but more objective research was needed . Most of study on restorative materials were concerned for cytotoxicity not for actual healing event on that materials and its influencing factors such as biocompatibility, surface wettability, surface topography . The aim of this in vitro study was to evaluate the effect of amalgam, resin modified glass ionomer, composite resin per se, and their surface roughness on the growth of human gingival fibroblast. The cells were obtained and placed on culture flask and incubated for 3 days with the prepared test materials. Then count the attached cell number with hemocytometer,(n=12) and 2 samples were examined with SEM about attachment cell morphology . Another 4 samples were evaluated on their surface roughness with Talysurf and average surface roughness value(Ra) were obtained. Statistical difference in attached cell number, roughness value were analyzed using ANOVA. The number of attached cell was as follows, for root dentin specimen 16.7${\pm}$4.41, resin modified glass ionomer 14.0${\pm}$4.15, resin 8.13${\pm}$3.63, amalgam 0.72${\pm}$3.33(${\times}10^3$). Between root dentin and resin-modified glass ionomer, no significant difference was observed, but resin, amalgam showed a significant less cell numbers than for root dentin, resin modified glass ionomer cement. SEM examination expressed many cell surface attachment apparatus in root dentin and resin modified glass ionomer specimens. For resin specimen, cell attachment was observed but exposed less appratus. The average surface roughness value are following results. Dentin specimen 0.6972${\pm}$ 0.104, resin modified glass ionomer 0.0822${\pm}$0.009, resin 0.0875${\pm}$0.005, amalgam 4.2145${\pm}$0.985(${\mu}m$). Between root dentin, resin-modified glass ionomer, and resin, no significant difference was observed, but amalgam showed a significant more rough surface than other groups. When evlauated the interrelationship between cell attachment and surface roughness, therefore, there was weak reverse correlation.(pearson correlation : - 0.593) These results suggest that resin modified glass ionomer have the favorable healing potential when used for subgingival restoration. And for relationship between cell attachment and surface characteristics, further investigations were needed.

• Applied Chemistry for Engineering
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• v.26 no.2
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• pp.173-177
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• 2015

In this study, effects of both the grafted ABS-g-MAH and the added graphene oxide (GO) on the impact strength of polycarbonate (PC)/poly(acrylonitrile-butadiene-styrene) (ABS) blends were discussed. The PC/ABS blends and PC/ABS/GO composites were fabricated by using twin screw extruder with ABS-g-MAH as a compatibilizer. The ABS-g-MAH was prepared by melting extrusion of ABS and maleic anhydride (MAH) with DCP (dicumyl peroxide) as an initiator using twin screw extruder and the synthesis of ABS-g-MAH was confirmed by the presence of carbonyl group (C=O) peak at $1780cm^{-1}$ of FT-IR spectrum. According to the thermal, rheological, and impact properties of PC/ABS blends, 5 phr (parts per hundred resin) of compatibilizer was chosen as an optimum content for the PC/ABS/GO composites. It was observed that the thermal decomposition of ABS/PC/GO composites increased with GO contents, but there was no significant changes or a decrease in the impact strength. Also the composite fabricated by ABS/GO showed small increase in the impact strength. From the result of the dynamic rheometer to observe the processing properties, the complex viscosities of PC/ABS blend including the compatibilizer increased, but the complex viscosities of composites added GO were not changed.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.242-246
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• 1998

From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• Composites Research
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• v.32 no.6
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• pp.335-341
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• 2019

In this study, an acrylic acid (AAc) was grafted on a polypropylene (PP) nonwoven fabric using electron beam irradiation. Electron beam grafting was carried out under various conditions to produce AAc grafted PP (PP-g-AAc) nonwoven fabric having a grafting yield of about 50% at radiation dose of 100 kGy and a monomer concentration of 60%. The physical and chemical properties of PP-g-AAc nonwoven fabric were evaluated by SEM, ATR-FTIR, thermal analysis and tensile strength. The morphology of PP and PP-g-AAc nonwoven fabric confirmed by SEM showed no significant change, and it was judged that AAc was introduced into PP nonwoven fabric from ATR-FTIR. PP-g-AAc nonwoven fabric showed an increase in tensile strength and a decrease in tensile strain compared to PP nonwoven fabric. However, since change of value is not significant, it is considered that there is no significant influence on the physical characterization. Adsorption experiments of PP-g-AAc nonwoven fabric on various ions showed selective adsorption behavior for lead ion. In conclusion, the electron beam radiation-induced PP-g-AAc nonwoven fabric is expected to be applied as an effective adsorbent for the adsorption of lead ions.