• Journal of Chest Surgery
• /
• v.28 no.2
• /
• pp.156-161
• /
• 1995

Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.

• Biomaterials Research
• /
• v.22 no.4
• /
• pp.271-278
• /
• 2018

Background: The chondrogenic differentiation of mesenchymal stem cells (MSCs) is regulated by many factors, including oxygen tensions, growth factors, and cytokines. Evidences have suggested that low oxygen tension seems to be an important regulatory factor in the proliferation and chondrogenic differentiation in various MSCs. Recent studies report that synovium-derived mesenchymal stem cells (SDSCs) are a potential source of stem cells for the repair of articular cartilage defects. But, the effect of low oxygen tension on the proliferation and chondrogenic differentiation in SDSCs has not characterized. In this study, we investigated the effects of hypoxia on proliferation and chondrogenesis in SDSCs. Method: SDSCs were isolated from patients with osteoarthritis at total knee replacement. To determine the effect of oxygen tension on proliferation and colony-forming characteristics of SDSCs, A colony-forming unit (CFU) assay and cell counting-based proliferation assay were performed under normoxic (21% oxygen) or hypoxic (5% oxygen). For in vitro chondrogenic differentiation, SDSCs were concentrated to form pellets and subjected to conditions appropriate for chondrogenic differentiation under normoxia and hypoxia, followed by the analysis for the expression of genes and proteins of chondrogenesis. qRT-PCR, histological assay, and glycosoaminoglycan assays were determined to assess chondrogenesis. Results: Low oxygen condition significantly increased proliferation and colony-forming characteristics of SDSCs compared to that of SDSCs under normoxic culture. Similar pellet size and weight were found for chondrogensis period under hypoxia and normoxia condition. The mRNA expression of types II collagen, aggrecan, and the transcription factor SOX9 was increased under hypoxia condition. Histological sections stained with Safranin-O demonstrated that hypoxic conditions had increased proteoglycan synthesis. Immunohistochemistry for types II collagen demonstrated that hypoxic culture of SDSCs increased type II collagen expression. In addition, GAG deposition was significantly higher in hypoxia compared with normoxia at 21 days of differentiation. Conclusion: These findings show that hypoxia condition has an important role in regulating the synthesis ECM matrix by SDSCs as they undergo chondrogenesis. This has important implications for cartilage tissue engineering applications of SDSCs.

• Journal of the Korean Society of Physical Medicine
• /
• v.9 no.2
• /
• pp.151-159
• /
• 2014

PURPOSE: The purpose of this study was to evaluate whether light-emitting diodes (LED) irradiation could be effective in a noninvasive, therapeutic device for the treatment of osteoarthritis(OA). METHODS: Twenty-four male Sprague-Dawley rats were divided into four groups: Vehicle control (saline); monosodium iodoacetate-injection (MIA); LED irradiation after MIA injection (MIA-LED); indomethacin-treatment after MIA injection (MIA-IMT). OA was induced by intra-articular injection of 3 mg MIA through the patellar ligament of the right knee. Vehicle control rats were injected with an equivalent volume of saline. The LED was irradiated for 15 min/day for a week after 7 days of MIA treatment. To compare with the effect of LED irradiation, the indomethacin was administrated 20 mg/kg twice a week orally after 7 days of MIA treatment. Knee joints were removed and fixed overnight in 10% neutral buffered formalin and decalcified by EDTA for 2 week before being embedded in paraffin. The assessment of OA induction were monitored by knee movement and radiographic finding. Histologic analysis were performed following staining with hematoxylin and eosin, safranin O-fast green, or toluidine blue, picrosirius red, and histologic changes were scored according to a modified Mankin system. Apoptotic cell in tissue sections was detected using TUNEL method. RESULTS: Radiographic examination could not show the differences between the MIA-treated and the MIA-LED-treated rats. In the histologic analysis, however, LED irradiation prevented cartilage damage and subchondral bone destruction, and significantly reduced mononuclear inflammatory cell infiltration and pannus formation. LED irradiation also reduced apoptosis of cartilage cells, but it prevented apoptosis of infiltrated inflammatory cells in synovium. In addition, LED irradiation showed an increase of collagen production in the meniscus. CONCLUSION: These results suggest that the 840 nm LED irradiation would be a suitable non-thermal phototherapy for the treatment of OA, as a cartilage protection and anti-inflammatory modality.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.563-569
• /
• 2006

Purpose: In the correction of cleft lip, there have been various methods to minimize recurrence of the nasal deformity after primary nasal surgery. After cheiloplasty and primary nasal surgery, we tried to elongate the columella of the cleft side, to stretch the vestibular lining of cleft side, and to elevate the alar cartilage of the cleft side with a molding prong. Methods: We had fifteen cleft lip patients; 12 unilateral cases(6.3-8.2 months), and 3 bilateral cases(3 - 7.5 months). Immediately after primary repair of the cleft lip, the toboggan shaped molding prong was located to deep inside of vestibular web of the cleft side. It was persistently suspended by a silicone tube which was connected to the prong and the frontal scalp. The results were analyzed with $Photoshop^{(R)}$ photogrammetrically for 6 - 48 months with on average of 20.6 months. We measured the proportion index of columellar length-interalar distance for three times(preoperation, immediate postoperation, and postoperation) on the nasal base views. Results: In unilateral, the index had a significant increase statistically between preoperation(10.73) and immediate postoperation(23.96). It is supposed that columellar length was reconstructed to 105.80% of normal side. But, it was decreased to maintain 87.7% of normal side in postoperation(20.54). The results were similar in bilateral. The linear scars by suture penetrating nose skin were not discernable. Conclusion: In summary, placement of the molding prong could elongate the reconstructed columella with some relapse postoperatively.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.9
• /
• pp.1204-1208
• /
• 2000

Objectives : At the closure of the transsphenoidal approach(TSA), the proper sellar floor reconstruction plays an important role in preventing postoperative complications. The septal cartilage, perpendicular plate of nasal septum, and the sphenoid sinus bone are usually used to repair the sellar floor as a bone splint. The authors evaluate the usefulness of a silicone plate as a substitute for bone splint to close a defect of the sellar floor. Materials and Methods : A silicone plate was used to repair the sellar floor in 7 patients with sellar lesions which included four pituitary adenomas, two Rathke's cleft cysts and one metastatic tumor. Among seven cases, five cases underwent a standard TSAs and two received a extended TSAs. The trajectories of the approach were sublabial in four cases and endonasal routes in three cases. The silicone plate for implantation was cut to a size of slightly larger than that of bone window and inserted with a three-pronged fork, and then adjusted precisely. Results : In six patients, there were no complications which related to sellar floor reconstruction. A postoperative cerebrospinal fluid(CSF) rhinorrhea was observed in one patient with pituitary macroadenoma. Conclusions : From the authors' experience, the advantages of the silicone plate are its simplicity of molding to fit any size of sellar floor defects, and easy detection of previously created bone window at reoperation.

• Korean Journal of Cleft Lip And Palate
• /
• v.3 no.2
• /
• pp.41-50
• /
• 2000

The alar base on the cleft side in unilateral complete cleft lip, alveolus and palate is markedly displaced laterally, caudally and dorsally, By incising the pyriform margin from the cleft margin of the alveolar process, including mucosa of the anterior part of the inferior turbinate, to the upper end of the postnasal vestibular fold, the alar base is released from the maxilla, A physiological correction of nasal deformity can be accomplished by careful reconstruction of nasolabial muscle integrity, functional repair of the orbicular muscle, raising and rotating the displaced alar cartilage, and finally by lining the lateral nasal vestibule, The inferior maxillary head of the nasal muscle complex is identified as the deeper muscle just below the web of the nostril, The muscle is repositioned inframedially, so that it is sutured to the periosteum that overlies the facial aspect of the premaxilla in the region of the developing lateral incisor tooth, And then, the deep superior part of the orbicular muscle is sutured to the periosteum and the fibrous tissue at the base of the septum, just in front of the anterior nasal spine, The nasal floor is surgically created by insertions of the nasal muscle complex in deep plane and of the orbicular muscle in superficial one, The upper part of the lateral nasal vestibular defect is sutured by shifting the alar flap cephalically, The middle and lower parts of this defect are closed by use of cleft margin flaps of the philtral and lateral segments, respectively, Authors stress the importance of nasal floor reconstruction at primary surgery and report the technique and postoperative results.

• Journal of the Korean Arthroscopy Society
• /
• v.10 no.1
• /
• pp.70-76
• /
• 2006

Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

• Asian-Australasian Journal of Animal Sciences
• /
• v.22 no.10
• /
• pp.1447-1460
• /
• 2009

Myogenic satellite cells have been isolated and identified by several recently elucidated molecular markers. Furthermore, knowledge about the precise function of these markers has provided insight into the early and terminal events of satellite cells during proliferation, differentiation, transdifferentiation, specification and activation. Recently, quiescent myogenic satellite cells have been associated with possession of Pax 3 and 7 that represent pluripotent stem cells capable of differentiating into other lineages. However, the mechanism by which myogenic satellite cells attain pluripotent potential remain elusive. Later, transdifferentiating ability of these cells to another lineage in the absence or presence of certain growth factor/ or agents has revolutionized the scope of these pluripotent myogenic satellite cells for manipulation of animal production (in terms of quality and quantity of muscle protein) and health (in terms of repair of skeletal muscle, cartilage or bone).

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2008.03a
• /
• pp.178-178
• /
• 2008

In order to improve static stability and healing of reattached labrum, we combined the advantages of suture bridge and transosseous technique. Using the conventional 3 portal for anterior instability, check stability of bony Bankart and preparation of glenoid bed in 3 way including removal, reshaping or mobilization of bony fragment. Two anchors were inserted to the superior and inferior portion and medial edge of bony Bankart lesion. It usually corresponded to the area of IGHL. Medial mattress sutures were applied around IGHL complex to get enough depth of glenoid coverage using suture hook. Make 3.5mm pushlock anchor hole to the articular edge of glenoid cartilage. Proximal suture bridge was applied at first and then distal suture bridge was inserted to mobilize the labrum in proximal direction. These construction can provide more stable labral repair with wide contact and compression in case of deficient bony stability. It not only avoids technical disadvantage of point contact with anchor fixation, but also decreasing gap formation through cross compression of labrum that couldn't gain even with the transosseous fixation which affords linear compression effect. Additional bony stability could be gained if the the bony fragment was mobilized to the glenoid margin with potential healing bed or reshaped for the good contact with reattached labrum.

• Archives of Pharmacal Research
• /
• v.29 no.2
• /
• pp.165-171
• /
• 2006

Osteoarthritis is thought to be induced by the ageing-related loss of homeostatic balance between degeneration and repair mechanism around cartilage tissue in which inflammatory mediators such as reactive oxygen species, cytokines and prostaglandins are prone to overproduction under undesirable physiological conditions. Phlorotannins are unique polyphenolic compounds bearing dibenzo-1,4-dioxin skeleton which are not found in terrestrial plants but found only in some brown algal species such as Ecklonia and Eisenia families. Phlorotanninrich extracts of Ecklonia cava including LAD103 showed significant antioxidant activities such as DPPH radical scavenging, ferric ion reduction, peroxynitrite scavenging, and inhibition of LDL oxidation, indicating their possible antioxidative interference both in onset and downstream consequences of osteoarthritis. LAD103 also showed significant down regulation of $PGE_2$ generation in LPS-treated RAW 246.7 cells, and significant inhibition of human recombinant interleukin-$1{\alpha}$-induced proteoglycan degradation, indicating its beneficial involvement in pathophysiological consequences of osteoarthritis, the mechanism of which needs further investigation. Since LAD103 showed strong therapeutic potentials in arthritic treatment through several in vitro experiments, it is highly encouraged to perform further mechanistic and efficacy studies.