• Title/Summary/Keyword: and cartilage

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AUTOGENOUS AURICULAR CARTILAGE GRAFT FOLLOWED BY DISCECTOMY OF THE TEMPOROMANDIBULAR JOINT (악관절원판 절제술 후 이개연골 이식)

  • Chung, Hoon;Sung, Choon-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.2
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    • pp.81-91
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    • 1993
  • Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.

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Articular Cartilage Protective Effects of Kangwhaldoche-tang(Qianghuodaozhi-tang) Aqueous Extracts on the Adjuvant-induced Rat Rheumatoid Arthritis (강활도체탕(羌活導滯湯) 물 추출물의 Adjuvant 유발 류마티스 관절염 랫트에 대한 관절연골 보호효과)

  • Kwon, O-Gon;An, Hee-Duk
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.49-61
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    • 2013
  • Objectives : This study was conducted to determine whether or not Kangwhaldoche-tang(Qianghuodaozhi-tang) (KDT) aqueous extracts can protect articular cartilage losses on the Freund's complete adjuvant(FCA)-induced rat rheumatoid arthritis. Methods : 520, 260 or 130 mg/kg of KDT were orally administered once a day for 14 days from 14 days after FCA treatments, and 15 mg/kg of dexamethasone was intraperitoneally administered as reference drug in this experiment. Changes on the body weight, knee circumferences, gross arthritis score, inflammatory tissue prostaglandin(PG) $E_2$ levels were monitored with cartilage collagen components and glucosaminoglycans(GAGs) compositions - chondroitin sulphate, heparin sulphate and hyaluronic acid in the present study. Results : As results of FCA treatment, classic rheumatoid arthritis featuring dramatic decreases of the body weights, cartilage collagen and GAGs contents with increases of the knee circumferences, gross arthritis scores and inflammatory tissue $PGE_2$ levels, were demonstrated in the present study. However, these changes from FCA - induced rheumatoid arthritis were clearly inhibited by treatment of dexamethasone and all three different dosages of KDT. Although overall anti-inflammatory effects of KDT 520 mg/kg were lowered than those of dexamethasone 15 mg/kg treated rats, KDT 520 mg/kg showed more favorable preserve effects on the cartilage GAGs and KDT 260 mg/kg treated rats showed similar preserve effects as compared with dexamethasone 15 mg/kg in this experiment. Conclusions : The present results supported that over 75 mg/kg of KDT showed favorable anti-arthritic effects on the FCA-induced arthritis mediated by suppression of $PGE_2$, representative inflammatory mediator, and may help improve rheumatoid arthritis.

5 Cases of Tracheal Reconstruction (기관성형술 5예)

  • 유홍균;임현호;김종민;신홍수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.14.3-14
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    • 1983
  • In recent years there has been considerable interest in reconstructive surgery of the trachea for cervical tracheal stenosis developed by complication of endotracheal intubation or tracheotomy, or trauma of the neck. The methods used to reconstruct the tracheal defects can be repaired with end-to - end anastomosis, cervical flaps, and autogenous graft materials. Since Grillo had undertaken tracheal reconstruction after circumferential resection in dogs, resection and end - to - end anastomosis was used in cases of circumferential stenosis. And, costal, nasal septal and auricular cartilage have been used for the autogenous graft materials. Since Caputo and Consiglio had undergone tracheoplasty with auricular cartilage, Morgenstein reported successful repair of a tracheal defect with a composite postauricular cartilage graft. The advantages of the auricular cartilage graft are its easy accessibility, availability and familiarity to the otolaryngologist. In past 2 years, We performed the tracheoplasty with auricular cartilage graft and end- to end an astomosis after segmental resection in 5 patients who had suffered from tracheal stenosis. And we obtained good results. So, we reported the cases with review of the literatures.

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The Role of Cartilage Canals in Osteogenesis and Growth of the Vertebrae in the Human Fetuses (인태아 척추 골화과정에서 연골관의 역할)

  • Jung, Sung-Taek;Nam, Kwang-Il;Kim, Baik-Yoon;Yoon, Jae-Rhyong
    • Applied Microscopy
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    • v.31 no.3
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    • pp.287-305
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    • 2001
  • To investigate a role of cartilage canals in osteogenesis and growth of the vertebrae, in human fetuses ranging from 50 mm to 260 mm crown rump length were studied by electron microscopy. The initial appearance of cartilage canals of the vertebral body was observed at 60 mm fetus. In 80 mm fetus, primary ossification center in the vertebral body was first noted. The vertebral body showed calcified chondrocytes surrounded by a tone of hypertrophied chondrocytes and deep canals which terminated in calcified matrix. Most hypertrophied chondrocytes in the centrum showed in various stage of degeneration in disorderly arrangement. At the blind end of deep canal, osteogenic cells, osteoblasts and chondroclasts were observed. Resorption of unmineralized cartilage septa was undertaken by perivascular cells within cartilage canals. The ruffled border of the chondroclast was restricted to resorption site of calcified cartilagenous matrix. The periosteal bone formation was followed by the appearance of primary center of the centrum at 120 mm fetus. The osteoblasts of the perichondrium started to lay down a thin membranous bony lamella on the outer surface of the osseous trabeculae of the centrum. The processes of bone formation in the vertebral bodies were found to possess morphological similarities to that occurring at secondary center of the epiphysis of a long bone. These results indicate that the connective tissue cells within the cartilage canals proliferate and differentiate into osteoblasts at the site of endochondral ossification of the vertebrae.

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The Comparative Study between PLGA and Chitosan Scaffolds for Cartilage Tissue Engineering (연골조직공학에서 Polyactic-Glycolic Acid와 Chitosan 골격의 비교)

  • Lee, Yong Jik;Chung, Ho Yun;Shin, Dong Phil;Kim, Jong Yeop;Yang, Jung Duk;Lee, Dong Gul;Park, Jae Woo;Cho, Byung Chae;Baik, Bong Soo
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.599-606
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    • 2005
  • Clinical application of the cartilage formed by tissue engineering is of no practical use due to the failure of long-term structural integrity maintenance. One of the important factors for integrity maintenance is the biomaterial for a scaffold. The purpose of this study is to evaluate the difference between polylactic-co-glycolic acids (PLGA) and chitosan as scaffolds. Human auricular chondrocytes were isolated, cultured, and seeded on the scaffolds, which were implanted in the back of nude mice. Eight animals were sacrificed at 4, 8, 12, 16, and 24 weeks after implantation respectively. In gross examination and histological findings, the volume of chondrocyte-PLGA complexes was decreased rapidly. The volume of chondrocyte-chitosan complexes was well maintained with a slow decrease rate. The expression of type II collagen protein detected by immunohistochemistry and western blots became weaker with time in the chondrocyte-PLGA complexes. However, the expression in the chondrocyte-chitosan complexes was strong for the whole period. Collagen type II gene expressions using RT-PCR showed a similar pattern. In conclusion, these results suggest that chitosan is a superior scaffold in cartilage tissue engineering in terms of structural integrity maintenance. It is expected that chitosan scaffold may become one of the most useful scaffolds for cartilage tissue engineering.

Autologous Chondrocyte Implantation (자가연골 세포이식)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.159-166
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    • 2008
  • Articular cartilage is a unique tissue with no vascular, nerve, or lymphatic supply. This uniqueness may be one of the reasons why chondral injuries will hardly heal and may progress to osteoarthritis over time. Currently, there are several surgical options for the treatment of articular cartilage lesions. Although there is some discrepancy as to which procedures work best in certain patients. The spectrum of treatment alternatives for articular cartilage defects can range from simple lavage and debridement, drilling, micro-fracturing, and abrasion to osteochondral grafting and autologous chondrocyte implantation. In 1984, for the first time, results of autologous chondrocyte implantation in a rabbit model were presented, showing hyaline cartilage repair. Clinical study using autologous cultured chondrocyte implantation in chondral defects of the human knee has been reported in 23 patients in 1994. In 14 out of 16 patients treated for chondral injuries on the femoral condyles, the results were good to excellent. It is important for the surgeon to understand the autologous chondrocyte implantation technique and to be aware on the postoperative management. Attention to surgical technique and selection of appropriate patient for the autologous chondrocyte implantation will provide with the best results.

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A Case Report of Congenital Spinal Dermal Sinus Tract (선천성 척추 피부동관 증례보고)

  • Shim, Byung-Kwan;Kim, Yong-Bae;Nam, Seung-Min;Choi, Hwan-Jun
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.827-830
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    • 2010
  • Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

Knee Articular Cartilage Segmentation with Priors Based On Gaussian Kernel Level Set Algorithm (사전정보를 이용한 가우시안 커널 레벨 셋 알고리즘 기반 무릎 관절 연골 자기공명영상 분할기법)

  • Ahn, Chunsoo;Bui, Toan;Lee, Yong-Woo;Shin, Jitae
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.39C no.6
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    • pp.490-496
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    • 2014
  • The thickness of knee joint cartilage causes most diseases of knee. Therefore, an articular cartilage segmentation of knee magnetic resonance imaging (MRI) is required to diagnose a knee diagnosis correctly. In particular, fully automatic segmentation method of knee joint cartilage enables an effective diagnosis of knee disease. In this paper, we analyze a well-known level-set based segmentation method in brain MRI, and apply that method to knee MRI with solving some problems from different image characteristics. The proposed method, a fully automatic segmentation in whole process, enables to process faster than previous semi-automatic segmentation methods. Also it can make a three-dimension visualization which provides a specialist with an assistance for the diagnosis of knee disease. In addition, the proposed method provides more accurate results than the existing methods of articular cartilage segmentation in knee MRI through experiments.

An Introduction to the Septal Extension Graft

  • Kim, Myung-Hoon;Choi, Jeong-Hwan;Kim, Min-Su;Kim, Seok-Kwun;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.29-34
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    • 2014
  • The septal extension graft is a very useful method of controlling nasal lengthening and tip projection, rotation, and shape by fixing a graft to the septum, which leads to a strong supporting structure. Enhancing graft stability is important for better long-term outcomes and minimizing complications or relapse, and even more efficient application of these methods is needed for East Asians who lack enough cartilage to be harvested in addition to possessing a weak cartilage framework. In this paper, the methods for overcoming the drawbacks of the septal extension graft, such as instability, a fixed tip, and insufficiency of cartilage, are presented, and the applications of each method for greater satisfaction with surgical outcomes are also discussed.