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1.
Soft Matter ; 17(39): 8769-8785, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34604877

RESUMO

Three-dimensional (3D) bioprinting has rapidly developed in the last decade, playing an increasingly important role in applications including pharmacokinetics research, tissue engineering, and organ regeneration. As a cutting-edge technology in 3D printing, gel bath-supported 3D bioprinting enables the freeform construction of complex structures with soft and water-containing materials, facilitating the in vitro fabrication of live tissue or organ models. To realize in vivo-like organs or tissues in terms of biological functions and complex structures by 3D printing, high resolution and fidelity are prerequisites. Although a wide range of gel matrices have recently been developed as supporting materials, the effect of bath properties and printing parameters on the print resolution is still not clearly understood. This review systematically introduces the decisive factors for resolution in both bulk gel bath systems and granular microgel bath systems, providing guidelines for high-resolution 3D bioprinting based on bath properties and printing parameters.

2.
Biosensors (Basel) ; 11(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34436072

RESUMO

Fluorescence-linked immunosorbent assay (FLISA) is a commonly used, quantitative technique for detecting biochemical changes based on antigen-antibody binding reactions using a well-plate platform. As the manufacturing technology of microfluidic system evolves, FLISA can be implemented onto microfluidic disk platforms which allows the detection of trace biochemical reactions with high resolutions. Herein, we propose a novel microfluidic system comprising a disk with a three-dimensional incubation chamber, which can reduce the amount of the reagents to 1/10 and the required time for the entire process to less than an hour. The incubation process achieves an antigen-antibody binding reaction as well as the binding of fluorogenic substrates to target proteins. The FLISA protocol in the 3D incubation chamber necessitates performing the antibody-conjugated microbeads' movement during each step in order to ensure sufficient binding reactions. Vascular endothelial growth factor as concentration with ng mL-1 is detected sequentially using a benchtop process employing this 3D microfluidic disk. The 3D microfluidic disk works without requiring manual intervention or additional procedures for liquid control. During the incubation process, microbead movement is controlled by centrifugal force from the rotating disk and the sedimentation by gravitational force at the tilted floor of the chamber.

3.
Nat Commun ; 12(1): 5059, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429413

RESUMO

With the current interest in cultured meat, mammalian cell-based meat has mostly been unstructured. There is thus still a high demand for artificial steak-like meat. We demonstrate in vitro construction of engineered steak-like tissue assembled of three types of bovine cell fibers (muscle, fat, and vessel). Because actual meat is an aligned assembly of the fibers connected to the tendon for the actions of contraction and relaxation, tendon-gel integrated bioprinting was developed to construct tendon-like gels. In this study, a total of 72 fibers comprising 42 muscles, 28 adipose tissues, and 2 blood capillaries were constructed by tendon-gel integrated bioprinting and manually assembled to fabricate steak-like meat with a diameter of 5 mm and a length of 10 mm inspired by a meat cut. The developed tendon-gel integrated bioprinting here could be a promising technology for the fabrication of the desired types of steak-like cultured meats.


Assuntos
Bioimpressão/métodos , Géis , Carne , Tendões , Animais , Bovinos , Técnicas de Cultura de Células , Colágeno , Células Endoteliais , Músculos/citologia , Músculos/fisiologia , Impressão Tridimensional , Células-Tronco , Tendões/citologia , Engenharia Tecidual
4.
ACS Appl Mater Interfaces ; 12(47): 53184-53192, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33191748

RESUMO

Thermoacoustic (TA) loudspeakers have garnered significant attention in recent times as a novel film speaker that utilizes temperature oscillation to vibrate the surrounding air. Conventional film-type TA loudspeakers are known to experience problems when external environments damage their conductive networks, causing them to malfunction. Therefore, introducing self-healing polymers in TA loudspeakers could be an effective way to restore the surface damage of conductive networks. In this study, we present transparent, flexible, and self-healable TA loudspeakers based on silver nanowire (AgNW)-poly(urethane-hindered urea) (PUHU) conductive electrodes. Our self-healable AgNW/PUHU electrodes exhibit significant self-healing for repairing the surface damages that are caused due to the dynamic reconstruction of reversible bulky urea bonds in PUHU. The fabricated self-healable TA loudspeakers generate a sound pressure level of 61 dB at 10 kHz frequency (alternating current (AC) 7 V/direct current (DC) 1 V). In particular, the TA speakers are able to recover the original sound after healing the surface damages of electrodes at 95 °C and 80% relative humidity within 5 min. We believe that the technique proposed in this study provides a robust and powerful platform for the fabrication of transparent and flexible TA loudspeakers with excellent self-healing, which can be applied in flexible and wearable acoustic electronics.

5.
J Cell Mol Med ; 24(20): 12211-12218, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32931139

RESUMO

Although diesel airborne particulate matter (PM2.5) has been known to play a role in many human diseases, there is no direct evidence that therapeutic drugs or proteins can diminish PM2.5-induced diseases. Nevertheless, studies examining the negative control mechanisms of PM2.5-induced diseases are critical to develop novel therapeutic medications. In this study, the consensus PDZ peptide of ZO-1 inhibited PM2.5-induced inflammatory cell infiltration, pro-inflammatory cytokine gene expression, and TEER in bronchoalveolar lavage (BAL) fluid and AM cells. Our data indicated that the PDZ domain in ZO-1 is critical for regulation of the PM2.5-induced inflammatory microenvironment. Therefore, the PDZ peptide may be a potential therapeutic candidate during PM-induced respiratory diseases.


Assuntos
Regulação para Baixo , Gasolina/efeitos adversos , Material Particulado/efeitos adversos , Peptídeos/farmacologia , Pneumonia/induzido quimicamente , Pneumonia/patologia , Proteína da Zônula de Oclusão-1/química , Motivos de Aminoácidos , Linhagem Celular , Regulação para Baixo/efeitos dos fármacos , Humanos , Domínios PDZ , Tamanho da Partícula
6.
Lab Chip ; 20(23): 4433-4441, 2020 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-32832953

RESUMO

A microfluidic circuit on a disk platform, also known as lab-on-a-disk, is an integrated system for automated high-throughput screening for biochemical analysis. The microfluidic circuit on a disk performs biochemical analysis through sequential processes such as filtration, separation, detection, and synthesis of reagents. Sequential processes in microfluidic circuits operate through the systematically linked components, which include channels, valves, and chambers. The microchannels should have micrometer-scale for precise micro-volume liquid control in the microfluidic circuit on a disk. However, it is difficult to also consider productivity in the traditional technology. In addition, as the channel length increases, much effort is required to construct the components of the microfluidic circuit in the limited space of the disk. 3D printing is drawing attention as a microfluidic channel fabrication technique in order to overcome the physical limitations of the traditional methods. A new concept of a 3D slope valve has been developed, which performs precise and sequential micro-volume liquid control through centrifugal and gravitational forces. Micro-volumes of liquids in a slope valve-equipped circuit are controlled over a wide range of angular velocities through the control of the valve geometry, types of liquid and volume. For sequential micro-volume of liquid control, three lines of assembled modules are connected to a microfluidic circuit. In the microfluidic circuit with slope valves, the detection of fluorescent dye tagged-VEGF is possible through sequential mixing and reaction processes. As a result, micro-volume liquid is successfully controlled with high accuracy using the 3D microfluidic circuit with a slope valve.

7.
Arch Craniofac Surg ; 21(3): 156-160, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32630986

RESUMO

BACKGROUND: We have reported orbital wall restoration surgery with primary orbital wall fragment in pure blowout fractures using a combination of transorbital and transnasal approach in pure blow out fractures. However, this method was thought to be difficult to use for complex orbital wall fractures, since the sharp screw tip that fixate the maxillary wall increases the risk of balloon ruptures. In this study, we reviewed 23 cases of complex orbital fractures that underwent orbital wall restoration surgery with primary orbital wall fragment and evaluated the result. METHODS: A retrospective review was conducted of 23 patients with complex orbital fracture who underwent orbital restoration surgery with primary orbital wall fragments between 2012 and 2019. The patients underwent orbital wall restoration surgery with primary orbital wall fragment with temporary balloon support. The surgical results were evaluated by the Naugle scale and a comparison of preoperative and postoperative orbital volume ratio. Complex fracture type, type of screw used for fixation and complications such as balloon rupture were also investigated. RESULTS: There were 23 patients with complex orbital fracture that used transnasal balloon technique for restoration. 17 cases had a successful outcome with no complications, three patients had postoperative balloon rupture, two patients had soft-tissue infection, and one patient had balloon malposition. CONCLUSION: The orbital wall restoration technique with temporary balloon support can produce favorable results when done correctly even in complex orbital wall fracture. Seventeen cases had favorable results, six cases had postoperative complications thus additional procedure seems necessary to complement this method.

8.
Arch Plast Surg ; 47(3): 223-227, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32453930

RESUMO

BACKGROUND: After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. METHODS: From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). RESULTS: The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. CONCLUSIONS: Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

9.
Arch Craniofac Surg ; 20(5): 324-328, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31658798

RESUMO

Intraorbital infection shows a low incidence, but it might cause blindness or even death. This case is unusual in that its origin from a craniofacial bone fracture prior to infection of the maxillary sinus. A 33-year-old female patient was referred for right cheek swelling. When she visited the emergency room, we removed right cheek hematoma and bacterial examination was done. In the past, she had craniofacial bone surgical history due to a traffic accident 6 years ago. Next day, the swelling had remained with proptosis and pus was recognized in the conjunctiva. We planned an emergency operation and removed the pus which was already spread inside the orbit. And the evaluation for sinusitis was consulted to the otorhinolaryngology department simultaneously. There were Prevotella oralis and methicillin-resistant Staphylococcus epidermidis bacterial infection in the intraorbital and sinus respectively. Afterwards, the vigorous dressing was done for over a month with intravenous antibiotics. Though the intraorbital infection was resolved, blindness and extraocular movement limitation were inevitable. In conclusion, close follow up of the maxillary sinus in facial bone fracture patients is important and aggressive treatment is needed when an infection is diagnosed.

10.
Ann Pediatr Endocrinol Metab ; 24(2): 116-123, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261476

RESUMO

PURPOSE: This study aimed to investigate the outcomes of gonadotropin-releasing hormone agonist (GnRHa) therapy with or without growth hormone (GH) therapy for girls with idiopathic central precocious puberty (CPP). METHODS: The medical records of 166 girls diagnosed with CPP from 2002 to 2017 were retrospectively reviewed. All included patients were treated with GnRHa for ≥36 months. Changes in height standard deviation score (SDS) for bone age, chronological age (CA), and predicted adult height (PAH) were assessed for the first three years of treatment. The final height gain SDS was calculated as the difference between the initial PAH SDS and adult height (AH) SDS; these were then compared between the GnRHa group (group A, n=135) and the combined GnRHa/GH group (group B, n=31). RESULTS: The initial mean CA was 7.89 years. The mean menarcheal age was 13.12 years (group A, 13.1±0.99; group B, 13.18±0.58 years; P=0.755). PAH SDS at the start of GnRHa treatment and AH SDS were significantly lower in group B than in group A (PAH SDS: -2.20±0.83 vs. -3.19±0.84, P<0.001; AH SDS: 0.18±084 vs. -0.30±0.66, P=0.021). The increase in PAH SDS was higher in group B than in group A for the first three years of GnRHa treatment (1.66±0.66 vs. 2.35±0.93, P<0.001). The height gain SDS was significantly higher in group B than in group A (2.5±0.75 vs. 2.93±1.02, P=0.048). Younger age, higher PAH at the start of treatment, and a greater increase in PAH SDS during the first year of GnRHa treatment positively affected AH. CONCLUSION: The combined GH group had more additional height gain than the GnRHa-alone group.

11.
Korean J Neurotrauma ; 15(1): 11-18, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31098344

RESUMO

Objective: Forehead deformities are often caused by lack of treatment or incorrect restoration of the frontal buttress, so the underlying frontal buttress should be restored to its previous position to ensure that the previous forehead contour is restored in cases of complex depressed skull fractures. However, since brain injuries from skull fractures could have fatal consequences, the clinical concern in primary surgery has been to save the patient's life, and cosmetic concerns have always been secondary. We retrospectively reviewed fronto-orbital fracture patients who underwent primary restoration with primary bone fragments or an alloplastic implant and compared the surgical outcomes of autologous bone (group 1) and artificial materials (group 2). Methods: A retrospective review was conducted of 47 patients with fronto-orbital fractures between March 2012 and January 2018. The patients underwent primary reconstruction with primary bone fragments or an alloplastic implant. The surgical results were evaluated by the incidence of infection and cosmetic satisfaction of patients. Results: Infections occurred in one patient (5%) in group 1 and in two patients (15.3%) in group 2, which was not a statistically significant difference. In contrast, at 6 months after surgery, patient satisfaction showed a statistically significant between-group difference (group 1: 4.32 points, group 2: 3.54 points, p=0.001). Conclusion: Primary reconstruction using fractured bone fragments is an effective and preferable method that could result in better surgical outcomes than restoration using an alloplastic implant.

12.
Nanotechnology ; 30(36): 365303, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31100752

RESUMO

Zinc oxide(ZnO) is a versatile semiconductor material and its use is expanding into photoelectric applications. Anisotropic growth characteristics of ZnO are advantageous for growing a nanowire structure. ZnO nanowire based sensors exhibit enhanced performance in terms of photodetection due to their large specific surface area. ZnO nanowires on a highly aligned electrospun poly(vinylidene fluoride-co-trifluoroethylene) (PVDF-TrFE) nanofiber-based film are fabricated high performance ultraviolet (UV) detector. The movement of photo-induced electrons from ZnO nanowires is more effective in aligned electrospun film substrate (Rsq,off/Rsq,on = 551.0) than random electrospun film substrate (Rsq,off/Rsq,on = 47.8) under continuous UV irradiation. The current difference is 3.98 times higher on ZnO nanowires on aligned electrospun film than it is on random electrospun film in UV light on-off cycles. As a result, we improve the performance of photo sensitivity of electrospun nanofiber-based ZnO nanowires through controlling the directionality and fabrication time of the electrospun film without additional processes.

13.
J Craniofac Surg ; 30(6): 1894-1897, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31022132

RESUMO

PURPOSE: Anatomical variation in supraorbital transcranial exits, which can be divided into the lateral supraorbital exit and the medial frontal exit, has been investigated in several studies during the past few decades. However, in previous studies, inconsistent criteria were used for classifying those exits. The authors analyzed variations in supraorbital transcranial exits using 3 dimensional multidetector computed tomography (3D MDCT), and present a consistent classification of the types of those exits with precise location measurements. METHODS: In 1181 patients (2362 orbits) who underwent facial 3D MDCT, the authors measured a set of qualitative and quantitative parameters. The qualitative parameters included an assessment of the location and type of the exit, and the number of accessory foramina. The quantitative parameters included various distance measurements. RESULTS: A frontal exit was present in 2071 orbits and a supraorbital exit in 953. Neither a frontal exit nor a supraorbital exit was found in 11 orbits. The most common type of frontal exit was the notch type, followed by the foramen type and none. The mean distance from the nasion to the frontal exit was 24.70 ± 3.50 mm on the right side and 23.69 ± 3.42 mm on the left side. CONCLUSION: In conclusion, various types of supraorbital transcranial exits were observed, of which the frontal notch was the most common. This is the first study to conduct a consistent analysis of a large sample of skulls to characterize the distribution of supraorbital transcranial exit types using a comprehensive and clear set of criteria.


Assuntos
Tomografia Computadorizada Multidetectores , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Variação Anatômica , Coleta de Dados , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Órbita/diagnóstico por imagem , Crânio/diagnóstico por imagem , Dente/diagnóstico por imagem , Adulto Jovem
14.
J Craniofac Surg ; 30(3): e263-e265, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30817540

RESUMO

PURPOSE: The global trend of resident work-hour restrictions requires a more time efficient way of resident training. Among many training programs for learning the facial anatomy, the cadaver is the most similar to live patients. A cadaver should be used as efficiently as possible due to human dignity as well as the consideration of cost. The authors designed an effective cadaver dissection method in learning facial anatomy using the plastic surgery approach. METHOD: A 51-year-old male cadaver was used for dissection. The program was proceeded 6 times over 6 weeks, and 4 to 8 hours each day. We used standard surgical instruments with magnifying loupes. The results were analyzed through a numerical scale survey. RESULT: We planned to dissect the face from medial to lateral, cephalic to caudal, and superficial to deep portion. The overall knowledge and confidence level of the face were increased in all 7 participants. The mean knowledge level before and after the seminar was 3.00 and 4.03, respectively. Confidence level also increased through the seminar from 1.86 to 2.86. CONCLUSION: The authors believe this cadaver dissection program could optimize learning anatomical knowledge and improve resident's surgical confidence through a wide range of procedures.


Assuntos
Dissecação/educação , Face/anatomia & histologia , Face/cirurgia , Internato e Residência/métodos , Cirurgia Plástica/educação , Cadáver , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos/educação
15.
Arch Craniofac Surg ; 20(6): 347-353, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31914488

RESUMO

Most orbital surgeons believe that it's difficult to restore the primary orbital wall to its previous position and that the orbital wall is so thin that cannot be firmly its primary position. Therefore, orbital wall fractures generally have been reconstructed by replacing the bony defect with a synthetic implant. Although synthetic implants have sufficient strength to maintain their shape and position in the orbital cavity, replacement surgery has some drawbacks due to the residual permanent implants. In previous studies, the author has reported an orbital wall restoring technique in which the primary orbital wall fragment was restored to its prior position through a combination of the transorbital and transantral approaches. Simple straight and curved elevators were introduced transnasally to restore the orbital wall and to maintain temporary extraorbital support in the maxillary and ethmoid sinus. A transconjunctival approach provided sufficient space for implant insertion, while the transnasal approach enabled restoration of the herniated soft tissue back into the orbit. Fracture defect was reduced by restoring the primary orbital wall fragment to its primary position, making it possible to use relatively small size implant, furthermore, extraorbital support from both sinuses decreased the incidence of implant displacement. The author could recreate a natural shape of the orbit with the patient's own orbital bone fragments with this dual approach and effectively restored the orbital volume and shape. This procedure has the advantages for retrieving the orbital contents and restoring the primary orbital wall to its prior position.

16.
Arch Craniofac Surg ; 19(4): 264-269, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30332891

RESUMO

BACKGROUND: Orbital resorbable mesh plates are adequate to use for isolated floor and medial wall fractures with an intact bony buttress, but are not recommended to use for large orbital wall fractures that need load bearing support. The author previously reported an orbital wall restoring surgery that restored the orbital floor to its prior position through the transnasal approach and maintained temporary extraorbital support with a balloon in the maxillary sinus. Extraorbital support could reduce the load applied on the orbital implants in orbital wall restoring surgery and the use of resorbable implants was considered appropriate for the author's orbital wall restoring technique. METHODS: A retrospective review was conducted of 31 patients with pure unilateral orbital floor fractures between May 2014 and May 2018. The patients underwent transnasal restoration of the orbital floor through insertion of a resorbable mesh plate and maintenance of temporary balloon support. The surgical results were evaluated by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. RESULTS: The OVR decreased significantly, by an average of 6.01% (p< 0.05) and the preoperative and postoperative Hertel scale measurements decreased by an average of 0.34 mm with statistical significance (p< 0.05). No complications such as buckling or sagging of the implant occurred among the 31 patients. CONCLUSION: The use of resorbable mesh plate in orbital floor restoration surgery is an effective and safe technique that can reduce implant deformation or complications deriving from the residual permanent implant.

17.
Int J Syst Evol Microbiol ; 68(6): 2048-2053, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29701577

RESUMO

A Gram-reaction-negative, S-shaped, motile, poly-ß-hydroxybutyrate-accumulating, facultatively anaerobic, beige-pigmented bacterium, designated strain KMU-80T, was isolated from seawater collected from the Republic of Korea. Phylogenetic analysis based on the 16S rRNA gene sequence revealed that the novel isolate was affiliated with the family Methylocystaceae, of the class Alphaproteobacteria, and that it possessed the greatest sequence similarity (96.7 %) to Terasakiella pusilla NBRC 13613T. The DNA G+C content of KMU-80T was 48.3 mol%, and ubiquinone 10 was the sole respiratory quinone. The predominant cellular fatty acids consisted of C18 : 1ω7c (60.2 %), C16 : 0 (13.4 %) and C16 : 1ω7c and/or C16 : 1ω6c (11.1 %). Strain KMU-80T had phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, an unidentified aminolipid, an unidentified phospholipid and four unidentified lipids as polar lipids. Based on its distinct phylogenetic position and the combination of genotypic and phenotypic characteristics, this strain is considered to represent a novel species of the genus Terasakiella, for which the name Terasakiella salincola sp. nov. is proposed. The type strain of T. salincola sp. nov. is KMU-80T (= KCCM 90274T = NBRC 112846T). An amended description of the genus Terasakiella is also provided.


Assuntos
Methylocystaceae/classificação , Filogenia , Água do Mar/microbiologia , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Hidroxibutiratos , Methylocystaceae/genética , Methylocystaceae/isolamento & purificação , Fosfolipídeos/química , Poliésteres , RNA Ribossômico 16S/genética , República da Coreia , Análise de Sequência de DNA , Ubiquinona/química
18.
Arch Plast Surg ; 45(1): 23-28, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29076315

RESUMO

BACKGROUND: Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process. METHODS: Nine patients with medially dislocated condylar process fractures underwent surgical correction from January 2012 to December 2016. In 6 of them, it was possible to realign the fractures with a conventional retromandibular approach, but for 3 cases of severe dislocation to the middle cranial fossa, a supplementary transoral procedure was carried out. The angle difference between the ramus and condyle, ramus height, and maximal mouth opening (MMO) were evaluated. RESULTS: All 9 cases were restored to the proper anatomical alignment without any major complications, and postoperative images revealed successful union. The angle difference was 8.94°±4.11° preoperatively, and 0.99±0.49° at the 6-month follow-up. The pretreatment ramus height difference was 6.12±6.09 mm, and the postoperative difference was 0.18±0.10 mm. These changes after surgery were statistically significant. The MMO before surgery was 11.44±3.0 mm, and the postoperative MMO was 37.2±2.9 mm, reflecting a significant increase after reduction. CONCLUSIONS: Retromandibular reduction is a useful method in medially dislocated condylar process fractures, and additional transoral assistance should be considered to realign condylar processes that severely dislocate to the middle cranial fossa.

19.
Arch Craniofac Surg ; 18(3): 186-190, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29090200

RESUMO

We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.

20.
Korean J Pain ; 30(3): 214-219, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28757922

RESUMO

BACKGROUND: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. METHODS: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. RESULTS: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were 64.3 ± 10.6 and 66.9 ± 10.7 years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were 8.5 ± 6.3 and 15.3 ± 10.7 months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. CONCLUSIONS: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result.

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