• Journal of Chest Surgery
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• v.31 no.6
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• pp.624-628
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• 1998

Postpneumonectomy syndrome is a rare and delayed complication of left pneumonectomy in most patients with normal mediastinal vascular anatomy. This syndrome is characterized by dyspnea and recurrent pulmonary infection in the remaining right lung that typically occur within the first postoperative year. The condition is believed to be secondary to postsurgical changes that include a marked shift of the mediastinum to the left, clockwise rotation of the heart and great vessels, and herniation of the right lung into the left anterior thorax. These changes lead to compression of the trachea or right main bronchus among the thoracic spine and the right pulmonary artery. We report a case of postpneumonectomy syndrome in 15 year-old girl that followed by left pneumonectomy for bronchiectasis 6 years ago. We have inserted an expandable prosthesis in the left thoracic cavity posterior to the heart. After implantation of an expandable prosthesis, an anatomic reposition of the shifted mediastinum was achieved, which resulted in instantaneous and sustained relief. The post-operative course was uneventful and the patient was followed in OPD from after discharge to now.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.373-380
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• 1996

Prevention of thromboembolism is the most important task in the development of bioconpatible small caliber artificial vascular graft. In normal vessels, vascular endothelial cells maintain homeosatsis by secreting numerous factors. The aim of this study is to develope a method which Improves biocompatibility of small caliver polyurethane graft using endothelial cell culture technique, and ev luate the efTectiveness of extracelluar matrix for endothelization which was produced by cultured fibroblast. Methods ; Multiporous polyurethane tube of 3 mm diameter, 0.3 mm thickness was manufactured for vascular graft. Three mongrel dogs were intubated and internal jugular veins removed. Extracelluar matrix produced by cultured flbrobast which was obtained from dog's internal jugular vein were coated to the polyurethane graft. Then, endothelial cells extracted from Jugular vein were cultured and fixed on the extracelluar matrix layer of vascular graft. Endothelial cell coated vascular grafts were implanted to the carotid arteries of experimental dogs as interposed autograft. Implanted grafts were removed after 3 and 6 weeks. As a control, PTFE graft was interposed on carotid artery. These experiments demonstrated that extracelluar matrix produced by fibroblast can afford a base for endothelial cell linings of polyurethane graft. Although thrombosis were developed on autografted en othelial cell coated graft, 33% opening was noticed, and showed less adhesion to adjacent tissue layer. These findings suggest that fiboblast produced extracelluar matrix which can be used for edothelial cell lining vascular graft, and by improving the cultured endothelial cell function, there will be a new modality for reducing thrombosis on small vascular graft.

• Macromolecular Research
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• v.8 no.4
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• pp.179-185
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• 2000

Generally vascular grafts with a relatively large inner diameter (> 5 mm) have been successfully employed for replacement in the human body. However, the use of small diameter grafts is limited, because these grafts rapidly occlude due to the thrombosis. The ideal blood-contacting surface of a prosthesis would be an endothelial cell (EC) lining, because the confluent monolayer of healthy ECs that culture natural blood vessels represents the ideal nonthrombogenic surface. For vascular graft application, the stable EC adhesion on surface under How conditions is very important. In this study, the adhesive strength of ECs attached on polymer surfaces coated with collagen type IV (Col IV), fibronectin (Fn), laminin (Ln), and treated with corona was investigated onto polyurethane (PU) films. The EC-attached PU surfaces were mounted on parallel-plate flow chambers in a How system prepared for cell adhesiveness test. Three different shear stresses (100, 150, and 200 dyne/㎠) were applied to the How chambers and each shear stress was maintained for 120 min to investigate the effect of shear stress and surface treatment condition on the EC adhesion strength. It was observed that the EC adhesion strength on the surface-modified PU films was in the order of Ln≡Fn > Col IV > corona 》 control. More than 70% of the adhered cells were remained on surface-modified PU surface after applying the shear stress,200 dyne/㎠ for 2 hrs, whereas the cells were completely detached on the control PU surface within 10 min after applying the same shear stress. It seems that the type of adsorbed proteins and hydrophilicitv onto the PU surfaces play very important roles for cell adhesion strength.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.1-11
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• 1994

The functional deformity following removal of the maxilla is considerable, especially following maxilla cancer excision. Rehabilitation of oral and maxillofacial region used to be very difficult with prosthesis or traditional flaps. Temporal muscle and fascia flaps have been described for immediate reconstruction following hemi-maxillectomy, but not total maxillectomy. The muscle and superficial fascia of the temporal area differ in their physical characteristics, vascular supply and clinical applications. Both can be employed independently or simultaneously as regional flaps in the reconstruction of a variety of complex craniofacial defects. Four case is presented in which 3 case maxilla cancer, one case non-union after maxilla fracture, and all case showed successful use of this flap. Only one patient developed partial necrosis of the flap ; significant necrosis did not occur in any other patient. This present paper reviews the anatomy, surgical technique and utilisation of temporal muscle and fascia flaps.

• Journal of Biomedical Engineering Research
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• v.12 no.3
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• pp.165-170
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• 1991

Many experiments about endothelial cell seeding on artificial vessels were studied and conducted For this one or a combination of the extramatrix was used for the underlying matrix. But we used the whole ECM(extracellular matrix) that made excreated from flbroblasl. In thls study, we obtained human adult omental microvascular endothelium by collagenase digestion and used polyurthane sheets in order to make a new artificial vessel material. We cultured fibroblast on the polyurethane and gelatin - coated polyurethane. After confluent ingrowth we treated the polyure thane with triton in order to destroy the cytoskeleton and nucleus. We observed the preformed extra cellular matrix on the ployurethane and cultured the isolated microvascular endothelium. We also ok served the growth of microvascular endothelium on the polyurethane and gelatin. We conclude that the use of the whole ECM is promising fair as a new underying substrate for endothelial cell seeding on artificial vessels.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.380-384
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• 2009

Purpose: Autologous vessels remain the gold standard for vascular grafts in microanastomoses. However, they are sometimes unavailable and have a limited long - term patency. Synthetic vessels have high success rates in large - diameter reconstructions but failed when used as small - diameter grafts due to graft occlusion. It has been proved that endothelial cell seeding improves prosthesis performance and long - term patency. Among polyurethane, PET and ePTFE, polyurethane has the best affinity to endothelial cells and mechanical properties closest to human vessels. We examined the ability of endothelial cells to attach to a polyurethane graft manufactured by the electrospinning method. Methods: Endothelial cells, which were cultured from porcine internal jugular veins, were attached to polyurethane grafts with an internal diameter of 3 mm. The same cells were attached to allogeneic decellularized porcine internal carotid artery grafts as controls. Both of the 10 mm - long grafts were exposed to endothelial cells in a well for 1 hour. Each well contained $2{\times}10^5$ endothelial cells. The graft materials were rotated through 90 degrees every 15 minutes in order to minimize the effect of gravity. The extent of cell attachment was examined with the MTT assay. Results: The MTT assay showed good incorporation of endothelial cells into both grafts. For the evaluation of affinity, the number of attached cells was counted at 10 fields of microscopic examination with ${\times}40$ magnification. Endothelial cells adhered more to polyurethane grafts (mean, $127.4{\pm}6.2cells$) compared to porcine artery grafts (mean $45.8{\pm}5.1cells$)(p<0.05,Mann - Whitney test). Conclusion: In this study, we attached porcine endothelial cells to polyurethane grafts, manufactured by electrospinning. The grafts exhibited a better affinity to endothelial cells than allogeneic decellularized porcine internal carotid artery grafts. It is suggested that the time required for endothelial cells to attach to decellulized artery grafts may be longer than that which is required for attachment to polyurethane grafts.

• Journal of Korean society of Dental Hygiene
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• v.9 no.4
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• pp.824-835
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• 2009

Objectives : The purpose of this study was identified about oral health status and oral health needs of elderly. Moreover this study would be based further research of development of oral health in elderly. Methods : This study was undertaken to determine the oral health status and the need of oral management of over 65years elderly who were with dental prosthesis in elderly welfare center and Kyung Ro Dong in Kyung Bok and Kyung Nam. The results were as follows. Results : The sample was 200 participants. The demographical characteristic were that 74.0% of participant was female, 29.0% of participant was 75~79 years old, 42.5% of participant was under elementary, and 45.5% of participant was living alone. 43.7% of participant was pain from muscle-skeletal disease, 37.1% of participant was cardiac-vascular disease, and 31.1% of participant was ophthalmic disease. In oral health status, 54.5% of participant was partly artificial tooth and 45% of participant was whole artificial tooth. 78.0% of participant used under 10 years with partly artificial tooth and only 27.4% were satisfaction with artificial tooth. 83.5% of participant used under 10 years with whole artificial tooth and only 26.4% were satisfaction with artificial tooth. In the oral health status of partly artificial tooth, the average of toothbrush was 2 times, 42.2%. The majority method of toothbrush was 'their own freely' 55.0%. The time of toothbrush was 'after meal' 81.8%. The study result showed that majority participant didn't experience of tongue brush, regular examination, scaling, and oral health education. In the need of oral management with the whole artificial tooth, the participant who used longer artificial tooth was significantly higher about artificial irrigation and the method of management(p<.05). The need of participant who answered 'don't gum massage', was higher of xerostomia treatment(p<.01) and halitosis treatment(p<.05). In the need of oral management with the partly artificial tooth, the participant who used longer artificial tooth was significantly higher about regular examination(p<.01), oral cavity massage(p<.05), scaling(p<.05), dental caries treatment(p<.01). The need of participant who answered 'don't satisfaction with artificial tooth' was higher of regular examination and scaling(p<.05). Conclusions : Oral management needs of elderly who kept artificial tooth or denture required were regular dental examination, xerostomia management, management of artificial tooth and irrigation, and management of bad breath. This results meaned the oral health intervention program for elderly was developed regularly.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.100-103
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• 2010

We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

• Korean Journal of Head & Neck Oncology
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• v.7 no.2
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• pp.120-128
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• 1991

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.124-135
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• 2017

Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.