• 제목/요약/키워드: Ligament

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남아 있는 인대를 보존하고 신선 동결 동종 아킬레스건을 이용한 후방십자인대 재건술 (Posterior cruciate ligament reconstruction using fresh-frozen Achilles tendon allograft with preservation of ligament remnant)

  • 김영진;채수욱;김종윤;김병수
    • 대한정형외과스포츠의학회지
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    • 제10권2호
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    • pp.54-60
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    • 2011
  • 목적: 슬관절의 후방십자인대 파열시 잔존하는 절단단 또는 이완된 인대를 유지하면서 신선 동결 동종 아킬레스건을 이용하여 재건술을 시행한 결과를 후향적으로 분석해 보고자 하였다. 대상 및 방법: 2004년 10월부터 2010년 3월까지 후방십자인대 완전 파열로 진단되어서 동종 아킬레스건을 이용한 재건술을 시행한 환자 중에서 최소 1년 이상 추시가 가능하였던 22례를 대상으로 하였다. 평균 추시는 3년 7개월(1년~6년 4개월)이었다. 수술시 연령은 평균 31.5세 이었으며, 성별은 남자가 14례, 여자가 8례였다. 운동 가능 범위, 후방 전위 검사, Telos stress 방사선 검사, Lysholm knee score, Tegner activity score, International Knee Documentation Commiittee (IKDC)의 판정 기준을 이용하여서 술 후 기능 평가, 2차적 관절경 검사 등을 시행하여 주관적 및 객관적 지표로 삼았다. 결과: 슬관절 안정성에 대한 이학적 검사인 후방 전위 검사, 최종 추시 시에 후방 스트레스 방사선 사진, Lysholm knee score, Tegner activity score, IKDC score 등은 통계학적 의의가 있는 좋은 결과를 보였다. 결론: 후방십자인대 파열시 잔존하는 인대의 절단단 또는 이완된 인대를 유지하면서 신선 동결 동종 아킬레스건을 이용한 재건술은 양호한 슬관절의 안정성과 기능 회복을 얻을수 있는 좋은 수술 방법으로 사료된다.

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백서 치아 발거후 잔존 치주인대가 발치와의 치조골 재건에 미치는 영향 (THE EFFECT OF RESIDUAL PERIODONTAL LIGAMENT ON ALVEOLAR BONE REMODELING OF EXTRACTION SOCKETS IN RATS)

  • 조성훈;허익;박준봉;이만섭;권영혁
    • Journal of Periodontal and Implant Science
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    • 제25권3호
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    • pp.703-719
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    • 1995
  • The purpose of this study was to observe the effects of the periodontal ligament on the healing and the formation of alveolar bone in the extraction socket, when this ligament had artificially remained in the socket during the tooth removal. Twenty rats aged 4 weeks were used and devided into the control groups (10) and the experimental groups (10) in this study. The maxillary right and left first molars were extracted in both groups. In the experimental groups the periodontal ligament was remained in the extraction sockets using 0.4% ${\beta}-aminopropionitrile$, and in the control the periodontal ligament was completely removed by curettage. At 1, 3, 5, 7 and 14 days after the tooth extraction, rats in both groups were serially sacrificed. And the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows ; 1. On 1 day, the periodontal ligament was only found in the extraction socket walls of the experimental groups, and there was not the distinguishable difference between the control and the experimental groups. 2. On 3 days, there were more collagen fibers and the appearance of higher cellular density in the experimental groups than in the control. And the cells and collagen of the periodontal ligament were so actively proliferated and synthesized that invaded into the connective tissue of the extraction sockets in the experimental groups. 3. In the experimental groups, the trabecular bone was formed on the basal and lateral bone surface on 5 days. However, there was not the new bone forming appearance in the control groups at this time. 4. On 7 days, the trabecular bone was formed in the control groups. 5. On 14 days, the extraction sockets were almost entirely filled with the bony trabeculae in both groups. But, compared to the control group, the experimental groups showed the prominent differences in the amount & the density of the new bone formed. In conclusion, it was suggested that the residual periodontal ligament tissue in the extraction socket will play a major role as the important cell source in the healing and the new bone formation of the extraction socket.

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보존적으로 치료된 급성 단독 후방십자인대 손상의 자연 경과 (Natural History of Conservatively Treated Posterior Cruciate Ligament Injury)

  • 안진환;서희수
    • 대한관절경학회지
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    • 제11권1호
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    • pp.13-19
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    • 2007
  • 목적: 동반 손상이 없는 급성 후방십자인대 손상에 있어서 보존적 치료를 시행 후 자연 경과를 알아보고자 하였다. 대상 및 방법: 1999년 2월부터 2006년 10월까지 본원에서 급성 단독 후방십자인대 손상으로 진단되어 보존적 치료를 시행한21례의 환자를 대상으로 후향적 연구를 하였다. 초기 진찰과 추시 관찰시 이학적 검사, KT-2000TM 관절검사(arthrometer) 및 후방십자인대의 연속성 정도(두께)를 관찰하기 위한 MRI 촬영을 시행하였고, 모든 환자에서 IKDC(International Knee Documentation Committee) knee score와 대퇴 사두근 근력 정도, 수상 전 운동 능력으로의 복귀 여부 등을 조사하였다. 이후 초기 진찰시와 추시 관찰시의 결과를 비교함으로써 보존적 치료를 한 급성 단독 후방십자인대 손상의 자연 경과를 알아보고자 하였다. 본 연구의 평균 추시 기간은 22.7개월이었다. 결과: 초기 진찰시 이학적 검사에서 관찰된 후방 불안정성은 Grade I이 14례, Grade II가 6례, Grade III가 1례였으며, 추시는 Grade I이 18예, Grade II가 3예였다. KT-2000TM 관절검사는 초기 진찰시 건측과 평균 5.7 mm($3{\sim}12\;mm$)의 차이에서 추시에서는 평균 2.7 mm($0{\sim}7\;mm$)의 차이를 보였고, MRI 촬영을 통한 인대의 연속성 정도(두께)는 48.1%에서 69.7%로 증가된 소견을 보였다. 대퇴 사두근 근력은 평균Good등급이었고, 평균 IKDC knee score는 A등급에 가까운 결과를 보였다. 결론: 급성 단독 후방십자인대 손상의 치료에 있어서 급성기 초기에 적극적인 보존적 치료를 시행함으로써 임상적 및 영상의학적으로 만족할 만한 결과를 얻을 수 있었다.

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전기 자극이 치주인대세포와 치은섬유아세포에 미치는 영향 (Effect of the Electrical Stimulation on the Human Periodontal Ligament Cells and Gingival Fibroblasts)

  • 이욱;박준봉;이만섭;권영혁
    • Journal of Periodontal and Implant Science
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    • 제29권4호
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    • pp.821-838
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    • 1999
  • On the basis of the evidences that electrical stimulation could enhance proliferation and differentiation of bone cells and promote healing and regeneration of bone, this study was performed to investigate the effects of electrical stimulation on human periodontal ligament cells and gingival fibroblasts in vitro, which also have important roles in regeneration of periodontium, and to evaluate the potential of clinical application of electrical stimulation. Human periodontal ligament cells and gingival fibroblasts were primarily cultured from the root surface of extracted premolar and the adjacent gingiva without periodontal diseases. In control group, the cells ($5{\times}10^4$ cells/ml)were incubated only in Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum. In test groups, electrical stimulation was given at the current intensity of $0.25{\mu]A$(test group 1), $1.0{\mu}A$(test group 2), and $2.5{\mu}A$(test group 3) for 12 hours to the same culture media with the control group. After 12 hour exposure of electrical stimulation, the cells were incubated for 2 and a half days(60 hours), and then each group of cells was analyzed for cell proliferation, protein level, and activity of alkaline phosphatase. The results were as follows ; 1. The Rate of cell proliferation of every test group increased significantly in both periodontal ligament cells and gingival fibroblasts, and in periodontal ligament cells, test group 3 showed significantly increased proliferation compared to the other test groups(p<0.05). 2. In the protein levels, neither periodontal ligament cell nor gingival fibroblast showed statistically significant differences between control and test groups. 3. The activity of alkaline phosphatase in periodontal ligament cells increased significantly in all test groups(p<0.05), but there were no significant differences between 3 test groups. In gingival fibroblasts, the activity of alkaline phosphatase increased significantly only in test group 3(p<0.05). From the above results, it is concluded that electrical stimulation may have beneficial effects on the regeneration of destructed periodontal tissue in regard of the stimulation of periodontal ligament cells and gingival fibroblasts as well as electrically stimulated bone formation that has been known, and that electrical stimulation may have the potential of clinical application.

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치주인대세포 및 치은섬유아세포의 DNA 합성능에 대한 b-Fibroblast growth factor의 영향 (The Effect of the Basic Fibroblast Growth Factor on Proliferation Rate of the Human Periodontal Ligament Cells and Human Gingival Fibroblasts)

  • 조영준;이재목;서조영
    • Journal of Periodontal and Implant Science
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    • 제26권2호
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    • pp.414-428
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    • 1996
  • The use of basic fibroblast growth factor which function as potent biologic mediators regulating numerous activities of wound healing has been suggested for the promotion of periodontal regeneration. The mitogenic effects of basic fibroblast growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'deoxy-uridine into DNA of the cells in a dose -dependent manner. The cells which were prepared were the primary cultured gingival fibroblasts and periodontal ligament cells from human the fourth or sixth subpassages were used in the experiments. The cells which were seeded DMEM contain 10% FBS. The added concentrations of basic fibroblast growth factor were 0.1, 1, 10, 50, $l00{\eta}g/ml$ and basic fibroblast growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with $10{\mu}l/200{\mu}l$ 5Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follows. : The DNA synthetic activity of human gingival fibroblasts was increased dose dependently by basic fibroblast growth factor at 24 hours, 48 hours and 72 hours. The similar mitogenic effects were at the 24 and 48 hours of basic fibroblast growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells was increased dose dependently to $50{\eta}g/ml$ by basic fibroblast growth factor at 24, 48 and 72 hours, but the DNA synthetic activity decreased at $l00{\eta}g/ml$ of each hour. Generally the maximum mitogenic effects were at the 48 hours application of basic fibroblast growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 72 hours than at 24, 48 hours the application of basic fibroblast growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells, human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the basic fibroblast growth factor.In conclusion, basic fibroblast growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.

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치주인대세포와 치은섬유아세포의 단백질과 교원질 합성능에 대한 Transforming Growth $Factor-{\beta}$의 효과 (The Effect of the Transforming Growth $Factor-{\beta}$ on Collagen Synthetic Activity of the Human Periodontal Ligament Cells and Human Gingival Fibroblasts)

  • 김미정;이재목;서조영
    • Journal of Periodontal and Implant Science
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    • 제26권2호
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    • pp.429-447
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    • 1996
  • Transforming growth factor $-{\beta}$ is one of the polypeptide growth factors that mediate the activity of mesenchymal cells and regulate wound healing process via cell proliferation, migration and extracellular matrix formation. The purposes of this study is to evaluate the effects of transforming growth factor $-{\beta}$ on the protein synthetic activity of human periodontal ligament cells and human gingival fibroblasts. The cells which were prepared were primary cultured gingival fibroblasts and periodontal ligament cells from humans, and the fourth or sixth subpassage were used in the experiments. Cells were seeded and at a confluent state, 0, 0.5, I, 2.5, 5, 10 ng/ml $TGF-{\beta}$ and $2{\mu]Ci/ml\;[^3H]$ proline were added to the cells and cultured for 24 hours. Then, 1 and 5 ng/ml concentrations were selected and added to confluent cells and cultured for 24 and 48 hours. They were labeled with $2{\mu}Ci/ml\;[^3H]$ proline for 24 hours and a collagen assay was done by the Peterkofsky and Diegelman method. The results were presented as the mean disintegration per minute (dpm) per well and S.D. of four determinations, The results were as follows. : The total protein, collagen and noncollagenous protein synthesis in periodontal ligament cells and gingival fibroblasts were increased dose- dependently by transforming growth factor-p to 2.5-5 ng/ml concentration and decreased at 10 ng/ml concentration. The percent of collagen was slightly changed according to the concentration of transforming growth factor-po The effect of transforming growth $factor-{\beta}$ was not specific for collagen synthesis since it increased the total, noncollagenous and collagenous protein, simultaneously. In the comparison of protein synthetic activity between the human periodontal ligament cells and human gingival fibroblasts, the human gingival fibroblasts had higher activities than the human periodontal ligament cells at all times and concentrations of $TGF-{\beta}$. In the comparison of protein synthetic activity between the 24 hour effect and the 48 hour effect of $TGF-{\beta}$, the 48 hour cultured cells' synthetic activity decreased more than the 24 hour cultured cells at human periodontal ligament cells and human gingival fibroblasts. In conclusion, $TGF-{\beta}$ has important roles in the stimulation of protein synthesis in human periodontal ligament cells and human gingival fibroblasts. Thus, it may be useful for clinical application in periodontal regenerative procedures.

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