• Journal of the Korean Orthopaedic Association
• /
• v.54 no.6
• /
• pp.475-477
• /
• 2019

Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and the relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. On the other hand, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system, few reliable clinical studies have been published. Stem cell therapy can be applied locally for bone, cartilage, and tendon regeneration. The candidate disease modalities in bone regeneration include large bone defects, nonunion of fractures, and osteonecrosis. Focal osteochondral defect and osteoarthritis are the current targets for cartilage regeneration. For tendon regeneration, bone-tendon junction problems, such as rotator cuff tears are hot topics in clinical research. To date, the literature supporting stem cell-based therapies comprises mostly case reports or case series.

• Journal of Chest Surgery
• /
• v.31 no.12
• /
• pp.1127-1133
• /
• 1998

Background: There are no ideal substitutes for tracheal replacement. Therefore we investigated the possibility of clinical use of cryopreserved tracheal homograft with special interest in the viability and rejection of the epithelial cell and cartilage. Material and Method: Rabbit's trachea was sected and stored in liquid nitrogen tank for 1 month. Tracheal replacement was done in 45 rabbits with autograft(n=15, Group 1), fresh allograft(n=15, Group 2) and cryopreserved homograft(n=15, Group 3). After 7, 14, and 30 days, 5 rabbits in each group were sacrificed and the regeneration of epithelium and cartilage and the degree of rejection were assessed by counting the monocellular infiltration. Result: Investigation at day 7, showed no difference in epithelial regeneration, however, at days 14 and 30, Group 1 showed better regeneration of epithelium than groups 2 and 3. There was no difference of epithelial regeneration between group 2 and 3. There was little rejection at day 7, but at days 14 and 30, there was significant rejection in group 2 and group 3.(P<0.05). Group 3 showed lesser rejection than group 2 at days 14 and 30, but it was not statistically significant. Cartilage showed no rejection and maintained its viability in groups 2 and 3. Conclusion: Cryopreserved tracheal homograft can maintain its viability, therefore it may represent a possibility of clinical application for tracheal replacement. However, cryopreservation can not eliminate the antigenicity of the trachea completely. Furthere studies for lowering the antigenicity and rejection should be performed for an ideal substitute for tracheal replacement.

• 건강소식
• /
• v.32 no.4 s.353
• /
• pp.18-19
• /
• 2008

포근한 날씨가 이어지면서 몸과 마음을 펼치고자 주말 등산에 오르는 사람들이 많다. 초보자들은 무리한 산행을 하지 않도록 한다. 평소 지속적으로 운동을 즐겨하던 사람들도 갑작스런 근육 사용의 증가로 쉽게 지칠 수 있다. 초보자들은 다리가 후들거리는 상태가 되면 가급적 쉬었다 이동하거나 더 이상 을 타지 않고 내려오는 것이 좋다. 근력이 떨어졌을 때 무릎이나 발목이 다치기 쉽기 때문이다. 특히 릎 연골이나 골판은 한 번 손상을 받으면 재생이 되지 않는다. 그러므로 다치지 않는 것이 최상이다. 등산 시 꼭 숙지해야 할 안전사고에 대처하는 요령과 응급처치에 대해 알아본다.

• Journal of the Korean Arthroscopy Society
• /
• v.17 no.1
• /
• pp.6-10
• /
• 2013

Purpose: This study intends to verify the usefulness of magnetic resonance imaging (MRI) for estimate recovery after arthroscopic pull-out repair at root tears of medial meniscus. Materials and Methods: We performed 17 patients who examined MRI and arthroscopy among patients who had received repair of medial meniscus from November, 2007 to June, 2011. To determine restoration meniscus, we performed arthroscopy and MRI. Results: Lysholm knee scores before and after operation were average 56.4 and 79.0 and visual analogue scale (VAS) score was improved from 8 points to 3 points. From secondary look arthroscopy performed after operation, 17 cases showed stabilization after regeneration. However, In MRI, cleft sign implying root tears of medial meniscus was observed in all cases before and after operation, ghost sign was observed in 10 cases and 9 cases respectively, radial linear defect was showed 17 cases and 15 cases respectively. Conclusion: It was not useful that MRI after medial meniscus repair in non-anatomical site, to consider restoration of medial meniscus. To evaluate for recovery medial meniscus after repair more exactly, secondary arthroscopy would be required.

• Polymer(Korea)
• /
• v.35 no.6
• /
• pp.499-504
• /
• 2011

Articular cartilage has an intrinsic difficulty in recovering damages, which requires its tissue engineering treatment. Demineralized bone particle (DBP) contains various bioactive molecules. It is widely used biomaterials in the field of tissue engineering. We developed the synthetic/natural hybrid scaffolds with poly(lactide-co-glycolide) (PLGA) and solution of DBP. The chondrocytes were seeded on the PLGA-DBP scaffolds and MTT assay, morphological observation, biological assay for collagen, sGAG, and RT-PCR were performed to analyze the effect of the DBP on cell viability and extracellular matrix secretion. In SEM observation, we observed that PLGA-DBP scaffolds had uniform porosity. As MTT assay showed scaffolds containing DB solution had higher cell viability then only PLGA scaffolds. The PLGA-DBP scaffolds had better ECM production than PLGA scaffold. It was proven by the higher specific mRNA expression in the PLGA-DBP scaffold than that in PLGA scaffold. These results indicated that PLGA-DBP scaffolds might serve as potential cell delivery vehicles and structural bases for in vitro tissue engineered articular cartilage.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.2
• /
• pp.83-91
• /
• 2011

Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

• Proceedings of the KSME Conference
• /
• 2007.05a
• /
• pp.1265-1270
• /
• 2007

Conventional methods for fabricating three-dimensional (3-D) scaffolds have substantial limitations. In this paper, we present 3-D scaffolds that can be made repeatedly with the same dimensions using a microstereolithography system. This system allows the fabrication of a pre-designed internal structure, such as pore size and porosity, by stacking photopolymerized materials. The scaffolds must be manufactured in a material that is biocompatible and biodegradable. In this regard, we synthesized liquid photocurable biodegradable TMC/TMP, followed by acrylation at terminal ends. And also, solidification properties of TMC/TMP polymer are to be obtained through experiments. Cell adhesion to scaffolds significantly affects tissue regeneration. As a typical example, we seeded chondrocytes on two types of 3-D scaffold and compared the adhesion results. Based on these results, the scaffold geometry is one of the most important factors in chondrocyte adhesion. These 3-D scaffolds could be key factors for studying cell behavior in complex environments and eventually lead to the optimum design of scaffolds for the regeneration of various tissues, such as cartilage and bone.

• Archives of Plastic Surgery
• /
• v.32 no.1
• /
• pp.1-4
• /
• 2005

Previous sucessful results of neocartilage formation using tissue engineering technique in immunocompromised nude mouse xenograft model were reported. For clinical application, autogenous cell is preferrable to allogenic or xenogenic cell for circumvention of immune rejection. This study evaluates the feasibility of producing a engineered cartilage using autogenous chondrocytes. Chondrocytes were isolated from the auricular catilage of New Zealand White rabbit and seeded onto PGA polymer coated with polylactic acid in round pattern(diameter 0.7 cm, thickness 0.1 cm) at a concentration $7{\times}10^7$ chondrocytes per $cm^3$. Each Autogenous Cell-polymer constructs were implanted subcutaneously into the left side of dorsum of twelve Rabbits. Polymer templates not containg cells were implanted into the right side as a control. Fifteen rabbits were sacrificed at the following intervals: 5 rabbits at nine weeks, 7 rabbits at twelve weeksNew autogenous cartilage formation which retained the approximate dimensions of origianl round polymer template in 11 of 12 cell seeded implants. Histological examination using hematoxyline and eosin stain revealed vast majority of implants developed into mature cartilage. This study opens up the possibility of autologus cell transplant to construct autogenous cartilge.

• Archives of Plastic Surgery
• /
• v.34 no.4
• /
• pp.413-419
• /
• 2007

Purpose: In this study, porous type I collagen scaffolds were cross-linked using dehydrothermal(DHT) treatment and/or 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide(EDC), in the presence and absence of chondroitin-6-sulfate(CS) and cultured autologous chondrocytes(Chondro) for cartilage regeneration. Methods: Cartilage defects were created in the proximal part of the ear of New Zealand rabbits. Four prepared types of scaffolds(n=4) were inserted. The groups included Chondro-Collagen-DHT(Group 1), Chondro- Collagen-DHT-EDC(Group 2), Chondro-CS-Collagen- DHT(Group 3), and Chondro-CS-Collagen-DHT-EDC (Group 4). Histomorphometric analysis and cartilage-specific gene expression of the reconstructed tissues were evaluated 4, 8, and 12 weeks after implantation. Results: EDC cross-linked groups 2 and 4 regenerated more cartilage than other groups. However, calcification was observed in the 4th week after implantation. CS did not increase chondrogenesis in all groups. Cartilage-specific type II collagen mRNA expression increased in the course of time in all groups.Conclusion: EDC cross-linking methods maintain the scaffold and promote extracellular matrix production of chondrocytes.

• Archives of Plastic Surgery
• /
• v.32 no.4
• /
• pp.521-528
• /
• 2005

The purpose of this research is to find out the degree of cartilage regeneration by inserting the atelo-collagen scaffold obtained from dermis of a calf on cartilage defect site. Dissection underneath the perichondrium by the periosteal elevator on both side of ears of six New Zealand white rabbits were made to expose the cartilage, leaving pairs of circular holes 3, 6, 9 mm width with punches. One hole was left for a control, and on the other hole atelo-collagen scaffold of the same size was transplanted. In postoperative 1, 2, 4 weeks, the tissues were dyed. The length of long axis of neocartilage was measured through an optical microscope with a 0.1 mm graduation at original magnification, ${\times}40$. In the first and second week, both group showed no sign of cartilage regeneration. In the fourth week, regeneration on marginal portions was observed on all groups and the average values of length of long axis of neocartilage according to defect size were as follows: In the cases with 3mm defect, it was $0.85{\pm}0.30mm$ in the control group, and $1.85{\pm}0.38mm$ in the graft group; in the cases with 6 mm defect, $1.33{\pm}0.58mm$ in the control group, and $2.25{\pm}0.46mm$ in the graft group; and in the cases with 9 mm defect, $2.33{\pm}0.77mm$ in the control group, and $4.47{\pm}1.39mm$ in the graft group. This means that the collagen scaffold has an influence on the regeneration of neocartilage. But the relative ratio of the length of neocartilage to cartilage defect size was not significant in the statistics.