• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권4호
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• pp.303-316
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• 1993

The auricular cartilage grafts have been widely used in replacement of the temporomandibular joint disk. Cartilage grafts itself have a low metabolism and high survival rate after grafting. In processing the grafting materials, it was important to preserve the properties of chondrocyte proper. We used 15% glycerol and 10% DMSO (Dimethyl Sulfoxide) solutions for cartilage fixation before deep freezing. We have performed the allogenic auricular cartilage graft in the temporomandibular joint of 20 rabbits which 10 specimen was treated with 15% glycerol and the other 10 specimen was treated with 10% DMSO respectively and examined in 1, 2, 4, 6 and 8 weeks after operation histopathologically. The result were : 1. Inflammatory cell infiltration around the grafted material appeared more glycerol groups than DMSO groups at 1 week, but each group has no differences after 2 weeks. 2. Degenerative changes of grafted auricular chondrocytes were more deveolped in glycerol group than DMSO groups till 4 weeks, but there were no differences between two groups after 6 weeks. 3. Fibrous union between grafted fragment and mandibular condyle was prominent in DMSO group. 4. Vascular proliferation of the grafted auricualr cartilage was more developed in DMSO groups than glycerol group in early stage. 5. Amount of the additional growth of grafted auricular cartilage was more existed in DMSO groups than glycerol group. 6. General survival rate after grafting was more prominent in DMSO group. In summary, allogenic auricular cartilage grafts treated with 15% glycerol and 10% DMSO solution have supported to survivalbility as a cryopreservative agents, especially DMSO groups have little inflammatory cell infiltration in early stages and degenerative changes and additional growth are more prominent than glycerol groups.

• 대한족부족관절학회지
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• 제1권1호
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• pp.15-22
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• 1997

A variety of surgical approach for ankle and tibiotalocalcaneal arthrodesis has been described. We used a transfibular approach between the sural nerve and lateral branch of the superficial peroneal nerve. This permits excellent visualization of the ankle and subtalar joint so that the fusion can readily be achieved under the direct visualization. Eight ankle fusions and four tibiotalocalcaneal fusions were carried out through a transfibular approach and reviewed. The resected fibula was utilized for bone graft. The follow up period was from 12 to 22 months. Ages of the patients ranged from 27 to 58 years. The postoperative regimen was six weeks nonweight bearing in a short leg cast, followed by weight bearing in a short leg cast until union occurred. All cases were fused except one who had preoperative pyogenic arthritis of the ankle and hindfoot. The results were as follows; 1. The chance of incisional neuroma is lessened through incision between the sural nerve and superficial peroneal nerve. 2. The possibility of a skin slough is reduced by using full thickness skin flaps. 3. Excellent visualization of the ankle and subtalar joint is easily achieved. So, we believed that the transfibular approach for ankle and tibiotalocalcaneal arthrodesis is the excellent surgical approach.

• 한국임상수의학회지
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• 제32권5호
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• pp.417-421
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• 2015

골대체재는 지연유합이나 유합부전 그리고 골절술과 관절고정술 시 골편의 연속성 확립이 필요한 경우 골절의 주요 결손부위를 채우는데 주로 활용되고 있다. 자가골을 대체할 수 있는 천연 골이식재의 대표적인 것이 calcium carbonate (CC)이며, 갑오징어의 오적골(Cuttlebone, CB) 또한 천연 CC로 이루어져 있다. 본 연구에서는 오적골의 다양한 전처리 후 직경 5 mm 두께 2 mm의 형태로 가공하여 생체적합성을 평가하고자 하였다. 조직검사에서 결합조직 두께는 2, 4주차 모두 CBHA군에서 가장 유의성 있게 얇았다 (p < 0.05). 이상의 결과들은 CBHA가 생체 내에 적용하는 골대체재로서 생체적합성이 매우 높은 것으로 나타났다. 따라서 CBHA는 편평골에 있어 생체적합성이 뛰어난 골대체재로 그 가치가 있는 것으로 생각되며, 수의 임상에 있어서 활용성이 매우 높을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1469-1475
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• 2000

Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.637-642
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• 2006

Purpose: Incidence of chronic osteomyelitis in femur is lower than that of tibia due to abundantsurrounding soft tissue like muscles and subcutaneous fat. However, if the femur is infected, surgical approach would be very difficult because of surrounding soft tissue and bony defects would be getting larger due to the late detection. Chronic osteomyelitis of femur is an intractable disease with frequent recurrence and remained bone instability in spite of multiple classical operations. Methods: From August 1998 to October 2005, we had 7 cases of fibular osteocutaneous free flap to reconstruct the femur. Those were followed-up for 23 months. All 7 cases were male. 4 cases were in midshaft and the others are distal part of femur. Results: The 7 cases that had not been healed in spite of average 9.1 times previous operations were reconstructed successfully without the recurrence of chronic osteomyelitis. Continuous rehabilitation therapy and brace were very helpful for the ambulation. It took 5.6 months for complete union of bone, and 9.8 months for the ambulation. Conclusion: After wide resection, reconstruction of the femur using fibular osteocutaneous free flap guaranteed bone stability and prevented recurrence of osteomyelitis through rich blood supplying fibula and muscle. Double barrel graft of fibula would be needed in case of the sufficient strength and thickness of femur. We report the successful results of reconstruction of femur with fibular osteocutaneous free flap for chronic osteomyelitis of femur.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.5-10
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• 2008

Objective : To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis with patients who had failed medical management. Methods : A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. Results : There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from $3.78{\pm}0.78$ preoperatively to $4.78{\pm}0.35$ at final follow up and mean VAS score was improved from $7.43{\pm}0.54$ to $2.07{\pm}1.12$. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. Conclusion : According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.37-41
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• 2005

Purpose: The purpose of this study was to evaluate the effectiveness of internal transport using Ilizarov apparatus with free flap surgery for infected tibial nonunion. Materials and Methods: We reviewed 8 patients of infected tibial nonunion treated with internal transport using Ilizarov apparatus and free flap surgery. Seven of eight patients were available for at least 1 year follow-up. All patients were male. The mean age at the time of the surgery was All fractures were Gustilo's type III B open fracture. The mean length of the bone defect was 8.5 cm. All used flaps for covering the soft tissue defect were free rectus abdominis muscle flap. We evaluated bone and functional results with use of the Paley and Catagni's classification. And we classified the complication with use of the Paley's classification. Results: Acceptable length and solid union of bone was achieved in all cases. The mean size of the bone length was 7.2 cm. The mean healing index was 69.5 days/cm. All but one case needed bone graft at docking site. All flaps were survived. There was no recurrence of infection. According to Paley and Catagni's classification, all cases showed excellent or good results. Complications were pin tract infection in 3 cases, persistent pain in 2 cases and limitation of joint motion in 2 cases. Conclusion: Simultaneous free-tissue transfer and Ilizarov distraction osteogenesis was thought to be an attractive treatment modality for infected nonunion of the tibia.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.27-36
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• 2003

Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

• 복식
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• 제66권7호
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• pp.124-138
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• 2016

The present study observes collaboration methods in which 3D printing was a part of the fashion manufacturing process, expression methods of such cases, and their ripple effects. As a result, the three types of collaborations between fashion designers and other industry fields, fashion brands and 3D printing companies, and fashion designers and artists. Case analysis results and ripple effects found according to each collaboration method were as follows. First, in collaborations found were between fashion designers and other industry fields, 3D printed fashion works with futuristic images were seen through the fusion of future industries, which claim to support cutting edge digital technology, and creative fashion design. As they were mainly collaborations between automobile industries with cutting edge images or digital related industries and fashion designers, they were expressed as a new form of experimental clothing, and were used as strategies to improve future corporate images of the high tech industry. Second, in collaborations between fashion brands and 3D printing technology businesses, the sporting good brands and the shoe industry attempted to let their products be known through the promotion of functional material or ergonomic technology. While they emphasize practicality by mainly using flexible material, they were mainly proposed as functional sporting goods for famous players or as shoe accessories, so methods are still used for public distribution as brand promoting marketing strategies. Third, with collaborations between fashion designers and artists, creative pieces were shown through the grafting of 3D printing technology, the artistry of artists, and the experimentation of fashion designers. In particular, the innovative value of fashion as art was created through the union of the artistic 3D modeling technology support of artists and the creativity of designers. Like this, 3D printing fashion can graft the cutting edge nature of fashion to other industry fields through collaborations, enhancing pacesetting images, and in the fashion field, it can improve possibilities for innovations in the fashion industry through the support of 3D printing technology businesses and artists, raising expectations towards future human living.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.68-74
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• 2008

Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.