• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.437-447
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• 2013

The fibula is one of the most useful sources for harvest of a vascularized bone graft. The fibula is a straight, long, tubed bone, much stronger than any other available bone that can currently be used for a vascularized graft. It has a reliable peroneal vascular pedicle with a large diameter and moderate length. There is a definite nutrient artery that enters the medullary cavity, as well as multiple arcade vessels, which add to the supply of the bone through periosteal circulation. The vascularized fibula graft is used mainly for long segment defects of the long tubed bone of the upper and lower extremities. It can provide a long, straight length up to 25 cm in an adult. The fibula can be easily osteotomized and can be used in reconstruction of the curved mandible. Since the first description as a vascularized free fibula bone graft by Taylor in 1975 and as a mandibular reconstruction by Hidalgo in 1989, the fibula has continued to replace the bone and soft tissue reconstruction options in the field of maxillofacial reconstruction. For the better understanding of a fibular free flap, the constant anatomical findings must be learned and memorized by young doctors during the specialized training course for the Korean National Board of Oral and Maxillofacial Surgery. This article reviews the anatomical basis of a fibular free flap with Korean language.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.488-496
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• 1988

Thirty-seven patients of aortic aneurysm underwent operations during January 1984 December 1987 at our hospital. Twenty-six patients had aneurysms involving ascending aorta, three patients had aneurysms involving both ascending aorta and abdominal aorta. and eleven patients had aneurysms involving descending thoracic or abdominal aorta. Among the patients who had aneurysms involving ascending aorta, annuloaortic ectasia with aortic regurgitation were thirteen and all of these underwent ascending aorta graft replacement + AVR with composite graft. The patients who had aortic regurgitation due to ascending aortic dissection were three and all of these underwent intraluminal ringed graft insertion at ascending aorta + aortic valve resuspension. Intraluminal ringed graft insertion was safe, simple, and fast method in the operation for aortic aneurysm. Eleven patients were underwent this operation and the results were good. Major causes of death of the patients who underwent aortic aneurysm operation are underlying cardiovascular diseases or delayed rupture of the aneurysm or complications related newly appeared aneurysm. Among our patients, dissection progressions were appeared in two but neither severe nor complicated. And no patient died from delayed rupture of aneurysm or complications related newly appeared aneurysm. All patients were followed up via OPD and were controlled hypertension or heart failure if present. Operative mortality is 18.9\ulcornera in all, 23% in patients who had aneurysms involving ascending aorta and 7.6` who had aneurysms involving descending thoracic or abdominal aorta. Comparing with other reports, our operative mortality is still high but improved steadily. So we recommend aggressive surgical management of the aortic aneurysm.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.35-42
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• 2004

Background: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were peformed. This study was performed to investigate whether V-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. Material and Method: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. Result: left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizations by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal blanches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. Conclusion: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.474-481
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• 2004

Background: Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and other oncologic conditions but bears. many critical problems compared to other organ transplantations. The purpose of this study was to develop intestine-cartilage composite grafts for potential application in tracheal reconstruction by free intestinal graft. Material and Method: Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chondrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3 kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Result: We identified implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory. Microscopic examinations included special stain s howed absorption of scaffold and cartilage formation even though it was not fully matured. Conclusion: Intestine-cartilage composite graft could be applicable in the future as tracheal substitute and should be further investigated.

• Composites Research
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• v.35 no.6
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• pp.419-424
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• 2022

Using non-biodegradable polymers is a severe environmental problem as they are not recyclable and generate a large amount of waste. Biopolymers, such as starch-based composites, have been considered one of the most promising replacement materials. These eco-friendly materials have the advantage of being low-cost, biodegradable, and obtained from renewable sources. However, as starch tends to be brittle and hydrophilic, it can make these materials unusable when exposed to water and limit its processability for further applications. In this work, a biobased modified starch was grafted using two bioderived materials, lauryl methacrylate (LMA) and tetrahydrofurfuryl methacrylate (THFMA), by radical polymerization. A polylactic acid (PLA) composite based on the modified starch (m-St) was fabricated to enhance its toughness. These samples were characterized by Fourier transform infrared, ¹H NMR and ¹³C NMR analysis, optical and scanning electron microscopy. The starch was successfully grafted, thus improving the compatibility with the PLA matrix. The mechanical properties of these films were also studied. Results from mechanical tests showed a slight enhancement of the mechanical performance of these composites when m-St was added to the PLA matrix. Such behavior is related to the improved dispersion of m-St 1:2 on PLA, confirmed by SEM images showing enhanced compatibility between modified starch and PLA matrix. This indicated excellent properties of the produced composite film for further eco-friendly applications.

• Membrane Journal
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• v.25 no.6
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• pp.496-502
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• 2015

Facilitated transport is one of the possible solutions to simultaneously improve permeability and selectivity, which is challenging in conventional polymer-based membranes. Olefin/paraffin separation using facilitated transport membrane has received much attention as an alternative solution to the conventional distillation process. Herein, we report olefin separation composite membranes based on the polymer blends containing $AgBF_4/Al(NO_3)_3$ mixed salts. Free radical polymerization process was used to synthesize an amphiphilic graft copolymer of poly(dimethyl siloxane)-graft- poly(ethylene glycol) methyl ether methacrylate (PDMS-g-POEM). In addition, poly(ethylene oxide) (PEO) was introduced to the PDMS-g-POEM graft copolymer to form polymer blends with various ratios. The propylene/propane mixed-gas selectivity and permeance reached up to 5.6 and 10.05 GPU, respectively, when the PEO loading was 70 wt% in polymer blend. The improvement of olefin separation performance was attributed to the olefin facilitating silver ions as well as the highly permeable blend matrix. The stabilization of silver ions in the composite membrane was achieved through the introduction of $Al(NO_3)_3$ which suppressed the reduction of silver ions to silver particles.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.659-665
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• 2003

The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6％ (272/276) for ITAs and 97.0％ (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9％ (234/244) for ITAs and 88.6％ (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0％) immediate postoperatively and 7 of the 88 patients (8.0％) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.114-120
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• 1990

This is a case report of correction of posttraumatic diplopia and enophthalmos using autogenous composite conchal cartilage and temporal fascia. The results are as follows. 1. Diplopia and enophthalmos may be persistent complications in zygomatic complex fracture. 2. The concha is a reservior of autogenous cartilage which leaves no cosmetic and functional deformity in reconstruction of orbital floor. 3. Warpping the cartilage in temporal fascia may serve to increase implant stability and get graft with smooth edge. 4. Donor incision lines are well hidden within the scalp and in auriculocephalic fold.

• Polymer(Korea)
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• v.31 no.4
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• pp.308-314
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• 2007

A composite film of polyurethane(PU)-graft-poly(acrylic acid) (PAAc)/polyaniline (PU-g-AAc/PANI) was successfully fabricated for the purpose of adding conductivity on the surface of a general purpose polymer and improving adhesive property between the general purpose polymer and conducting polymer layer. The results from ATR-FTIR and XPS analyses also supported the successful synthesis of the composite film by showing characteristic peaks for every step. A low surface resistivity of $2{\times}10^3\;ohm/sq$ proved the surface conductivity of synthesized PU-g-AAc/PANI film and the surface resistance decreased with increasing the amount of grafted AAc, which acted as a dopant for PANI film.

• Polymer(Korea)
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• v.37 no.5
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• pp.649-655
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• 2013

In order to use as supporters for the reinforced composite fuel cell membrane, poly(acrylic acid)-grafted porous polytetrafluoroethylenes (PTFEs) were prepared via introduction of poly(acrylic acid) graft chains by a radiation grafting method. FTIR was utilized to confirm the successful introduction of poly(acrylic acid) graft polymer chains into the porous PTFEs. Contact angles were examined to observe the hydrophilicity of the surface of the prepared substrates. The result indicates that the hyrophilicity of the surface in the prepared substrates increases with an increase in the number of hydrophilic polymer chains. FE-SEM, gurley number, and tensile strength were also utilized to characterize the prepared substrates.