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Biomedical subjects

Y Vajaradul

Publications and source records attributed to Y Vajaradul.

9 recordsLinked to original sources
PubMed2001

Amniotic membrane transplantation for ocular surface reconstruction.

OBJECTIVE: To study the efficacy of amniotic membrane transplantation in various indications for ocular surface reconstruction. METHOD: Amniotic membrane transplantations were performed in 140 eyes (130 patients) for ocular surface reconstruction. The indications for the corneal group were limbal stem cell deficiency, bullous keratopathy, persistent epithelial defect, band keratopathy, prosthesis, corneal ulcer and acute chemical burn. The indications for the conjunctival group were grafts for pterygium, conjunctival tumors, symblepharon, and covering the scleral graft. RESULTS: Success was noted in 75.7 per cent (106/140) eyes, partial success in 17.9 per cent (25/140) eyes, and failure in 6.4 per cent (9/140) eyes for a mean follow-up of 6.6 months (1-19 months). The success and partial success rate were 80.6 per cent (54/67), 14.9 per cent (10/67) in the corneal group and 71.2 per cent (52/73), 20.6 per cent (15/73) in the conjunctival group. CONCLUSION: Amniotic membrane transplantation can solve some difficult ocular surface problems, and can be used to promote epithelial healing, reduce inflammation and scarring.

Adolescent↗
PubMed2000

Cryopreserved, irradiated tracheal homograft transplantation for laryngotracheal reconstruction in human beings.

Subglottic tracheal stenosis is a common clinical entity. Management in severe cases is often problematic. Various techniques for tracheal replacement have been used with varying degrees of success. In this study we used cryopreserved, irradiated tracheal homografts, the use of which in human beings has not been reported previously. In a sterile setup, the tracheas were harvested from donor cadavers within 24 hours of death. The grafts were initially kept at 57 degrees C for 20 minutes; they were then placed in a -70 degrees C chamber for another 2 to 3 days or more and were irradiated to 25 kGy (2.5 million rad). Finally, the grafts were stored at -70 degrees C until usage. Seven patients underwent the surgery, but only 4 are presented here. In the remaining 3 patients, the follow-up time was too short to be evaluated. Four patients, 2 male and 2 female (aged 2-40 years, mean 16 years), with severe subglottic tracheal stenosis underwent segmental tracheal graft reconstruction. Immunosuppressant medications were not given to any patient. Follow-up ranged from 18 to 20 months. Three patients successfully underwent decannulation, and 1 patient had local infection and dislodgment of the intraluminal stent with subsequent restenosis. The postoperative tracheal lumen appeared to be near normal, with histologic evidence of normal respiratory epithelium at the grafted site. In conclusion, cryopreserved, irradiated tracheal homograft transplantation is a valuable alternative for subglottic tracheal reconstruction.

Adolescent↗
PubMed2000

Bangkok biomaterial center: 15 years experience in tissue banking.

Tissue banking is started in Thailand in 1979 at the Department of Orthopaedic Surgery, Siriraj Hospital, Bangkok. At that time tissues produced were freeze-dried bone allografts which were sterilized by ethylene oxide. In 1984, the freeze-dried tissue allograft project received an award from the National Research Council of Thailand. The Bangkok Biomaterial Center was officially inaugurated on December 6, 1984 under the Royal Patronage of H.R.H. Princess Galyanivadhana and is located inside the Siriraj Hospital. The Center is involved in the procurement, processing, storage and development of bone and tissue allografts. A variety of allografts including bone, cartilage, fascia lata, dura mater, cornea and also cardiovascular tissues have been procured and processed. Preservation and long-term storage are accomplished by freeze drying and deep freezing. Grafts prepared by the Center are supplied free of charge at the request of surgeons in hospitals throughout Thailand and in neighboring countries. The Center acts as the National Tissue and Allograft Bank of Thailand. From December 1984 to February 2000, the Center has processed a total of 20 524 allografts: 16 981 freeze-dried bones, 705 deep-frozen bones, 1838 freeze-dried amnion, 559 freeze-dried dura mater, 342 freeze-dried fascia lata, 46 costal cartilage, 18 corneas, 2 skin, 5 trachea, 22 fresh tendon and 6 bone substitutes. The allografts processed were used in 2049 patients by 223 surgeons in 53 hospitals in Thailand and 4 cases in neighboring countries. There have been 413 cadaveric donors, 619 living donors, 16 brain dead donors and 270 graveyard donors. There have been complications in 126 patients (6.14%) due to various clinical conditions. There have been production and application of 4 hydroxyapatite occular implant by the Center. The Center is in the process of establishing a full-fledged Research, Clinical and Cell Culture Laboratory.

Journal Article↗
PubMed1996

Bone banking in Thailand. A 10-year experience (1984-1994).

The tissue bank of the Bangkok Biomaterial Center was initiated in Thailand in 1984, and the first 10 years of progress are summarized. Three hundred ninety-seven cadavers and sixteen living donors provided a total of 13,676 bone and soft tissue allografts. They were used by 134 surgeons in 44 hospitals. A total of 1178 patients were surgically treated (581 males and 486 females). There were 240 cases of deep-frozen bone allografts, 600 cases of freeze-dried bone allografts, and 338 cases of soft tissue allografts. The results for 1035 cases (95.3%) were normal, whereas the results for 51 cases (4.33%) showed complications.

Bone Banks↗
PubMed1994

Massive allograft implantation for limb salvage: a clinical study of 20 cases.

From January 1986 to October 1991, the resection of tumorous bone conditions and large allograft implantations were performed in 20 patients at the Department of Orthopaedics and Rehabilitation Medicine, Ramathibodi Hospital, Bangkok, Thailand. The allografts were provided by Bangkok Biomaterial Center at Siriraj Hospital. There were 3 basic groups of grafts: osteoarticular 14, intercalary 3, and allograft-prosthetic composite 3. The diagnosis included 11 osteosarcomas, 1 secondary chondrosarcoma, 1 primary lymphoma, 5 giant cell tumors and 2 metastatic tumors. The average age of the patients was 23.5 years. The average length of the grafts was 14.9 cms. The average follow-up period was 36 months. At the time of evaluation, 70 per cent of the patients had excellent or good results. The complication rate was about 35 per cent but only 15 per cent needed amputation. Rejection of the graft was detected in only 1 patient. The use of large fresh frozen allografts is still necessary in this country because it provides a simple, inexpensive and effective technique of limb salvage in Thailand.

Adolescent↗
PubMed1990

Application of freeze-dried amniotic membrane: a control trial at the donor site of split-thickness skin grafting.

Sixty five patients (51 males and 14 females) underwent a control trial of freeze-dried amniotic membrane applied in the form of split-thickness skin grafts over an area from which skin had been surgically removed. The average size of the grafts was 15 x 20 cm. The patients were randomly divided into two groups. In the first group (36 patients), the membrane was applied at the upper half of the wound; in the second group (29 patients), the membrane was applied at the lower half of the wound. The remaining areas of the wounds were covered by antibiotic-impregnated fine-mesh greased gauze. Pain, infection, and the progress of healing were monitored. Covering the wound with the amniotic membrane had good results in terms of pain reduction, but the promotion of healing and the prevention of infection were not demonstrated. Hyperemia and hypertrophic scar responses to the membrane in some cases were considered as disadvantages.

Adolescent↗
PubMed1990

Dura arthroplasty of the hip: a case report.

The authors describe the use of a freeze-dried human dura allograft in a 9-year-old child with a dislocated hip of many years duration. The membrane was placed over the deformed femoral head prior to open reduction and a Chiari medial displacement osteotomy to prevent damage to the articular cartilage.

Arthroplasty↗
PubMed1981

Double-blind clinical evaluation of intra-articular glucosamine in outpatients with gonarthrosis.

Fifty-four outpatients with gonarthrosis participated in a double-blind clinical test with the aim of evaluating the efficacy and tolerance of intra-articular glucosamine in comparison with a 0.9% NaCl placebo. Each patient had one intra-articular injection per week for five consecutive weeks. Pain, active and passive mobility of the joint, swelling, and generalized and local intolerance symptoms were recorded before beginning the treatment, and four weeks after the last injection. glucosamine reduced pain to a significantly greater extent than did placebo, and resulted in significantly more pain-free patients. The angle of joint flexion substantially increased after glucosamine treatment. Active mobility increased with both treatments, with a more favorable trend after glucosamine administration. Knee swelling did not decrease significantly after glucosamine, whereas it worsened (although no significantly) after placebo. There were no local or general intolerance symptoms during and after treatment. Glucosamine administration was able to accelerate the recovery of arthrosic patients, with no resulting side effects, and to partially restore articular function. In addition, the clinical recovery did not fade after treatment ended, but lasted for the following month, at least. These features are a definite improvement over antirheumatic drugs, the major drawbacks of which are action of short duration and side effects. Glucosamine therapy therefore deserves a selected place in the management of osteoarthrosis.

Adult↗