• Title/Summary/Keyword: Cartilage disease

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Surgical Management of Trachea Stenosis (기관협착증에 대한 기관 성형술)

  • 김치경
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1508-1515
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    • 1992
  • Between 1975 and 1992, forty five patients with trachea stenosis received tracheoplasty for relief of obstruction. The causes of airway problem are brain contusion[19 cases, 40%], cerebrovascular disease[3 cases, 7%], drug intoxication[8 cases, 18%], psychotic problem[2 cases, 4%], trachea tumor[3 cases, 7%], adult respiratory distress syndrome[9 cases, 20%] and direct trauma[1 case, 2%]. Direct causes of trachea stenosis were complications of tracheostomy[36 cases, 80%], complications of nasotracheal intubation[5 cases, 11%], tumor[3 cases, 6%] and trauma[1 case, 2%]. Thirty one patients underwent the sleeve resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Forteen patients received the Montgomery T-tube for relief of airway obstruction. Four patients have done simple excision of granulation tissue. Two, subglottic stenosis patients were received Rethi procedure[anterior division of cricoid cartilage, wedge partial resection of lower thyroid cartilage and Montgomery T-tube molding] and the other subglottic stenosis patient underwent permanent trachea fenestration. Including cervical flexion in all patients postoperatively, additional surgical techniques for obtain tension-free anastomosis were hyoid bone release technique in two cases, and hilar mobilization, division of inferior pulmonary ligament and mobilization of pulmonary vessel at the pericardium were performed in one case. Cervical approach was used in 39 cases, cervicomediastinal in 12 cases and transthoracic in one case. Complications of tracheoplasty were formation of granulation tissue at the anastomosis site[3 cases], restenosis[9 cases], trachea-innominate artery fistula[2 cases], wound infection[2 cases], separation of anastomosis[2 cases], air leakage[3 cases], injury to a recurrent laryngeal nerve[temporary 8 cases, permanent 2 cases] and hypoxemia[1 case]. Surgical mortality for resection with primary reconstruction was 6.7%, with one death due to postoperative respiratory failure and two deaths due to tracheo-innominate artery fistula.

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SYNOVIAL CHONDROMATOSIS OF THE TEMPOROMANDIBULAR JOINT: A CASE REPORT (악관절에 발생한 활액성 연골종증(Synovial Chondromatosis); 증례보고)

  • Kim, Il-Kyu;Choi, Jin-Ho;Oh, Seong-Sub;Oh, Nam-Sik;Kim, Hyung-Don;Lee, Seong-Ho;Yang, Dong-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.109-113
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    • 2000
  • Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The knee and elbow are the most commonly involved sites and involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) is presented. A 28-year-old women had experienced pain of the left TMJ area and limitation of mouth opening. Radiographs of the left TMJ revealed calcified mass surrounding over the mandibular condyle and under the glenoid fossa. Treatment consisted of removal of calcified mass, reshaping of affected condyle and reconstruction with a auricular cartilage. After surgery, the patient's range of motion improved although deviation to the affected side. Until present after surgery there have been no recurrence of symtoms. We think that findings of this patitent agree with those of synovial synchondrmatosis in many aspects.

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A Case of Endobronchial Chondroma (좌측 주기관지에 발생한 연골종 1예)

  • Kim, Young-A;Jung, Jae-Han;Chang, Yoon-Soo;Kim, Hyung-Jung;Ahn, Chul-Min;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.78-83
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    • 2000
  • Endobronchial chondroma is a cartilaginous benign tumor, which arises from bronchial cartilage. As a rare benign tumor, endobronchial chondroma differs from cartilaginous hamartoma in that it includes cartilage components only, but hamartoma contains lipomatous and lymphoid tissue. The clinical manifestations of endobronchial chondroma are associated with the extent of mechanical obstruction of bronchus. Symptoms of endobronchial chondroma are nonspecific, such as cough, sputum, fever, or dyspnea on exertion. Endobronchial chondroma is often misdiagnosed as other diseases, such as asthma, chronic obstructive pulmonary disease, or pulmonary tuberculosis. The treatment is usually surgical procedures, such as resection of lung segment or lobe by thoracostomy, or resection of tumor by bronchoscopy. We report a case of the patient who was diagnosed to have endobronchial chondroma treated by bronchial resection and end to end anastomosis.

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Molecular Mechanism of Runx2-Dependent Bone Development

  • Komori, Toshihisa
    • Molecules and Cells
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    • v.43 no.2
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    • pp.168-175
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    • 2020
  • Runx2 is an essential transcription factor for skeletal development. It is expressed in multipotent mesenchymal cells, osteoblast-lineage cells, and chondrocytes. Runx2 plays a major role in chondrocyte maturation, and Runx3 is partly involved. Runx2 regulates chondrocyte proliferation by directly regulating Ihh expression. It also determines whether chondrocytes become those that form transient cartilage or permanent cartilage, and functions in the pathogenesis of osteoarthritis. Runx2 is essential for osteoblast differentiation and is required for the proliferation of osteoprogenitors. Ihh is required for Runx2 expression in osteoprogenitors, and hedgehog signaling and Runx2 induce the differentiation of osteoprogenitors to preosteoblasts in endochondral bone. Runx2 induces Sp7 expression, and Runx2, Sp7, and canonical Wnt signaling are required for the differentiation of preosteoblasts to immature osteoblasts. It also induces the proliferation of osteoprogenitors by directly regulating the expression of Fgfr2 and Fgfr3. Furthermore, Runx2 induces the proliferation of mesenchymal cells and their commitment into osteoblast-lineage cells through the induction of hedgehog (Gli1, Ptch1, Ihh), Fgf (Fgfr2, Fgfr3), Wnt (Tcf7, Wnt10b), and Pthlh (Pth1r) signaling pathway gene expression in calvaria, and more than a half-dosage of Runx2 is required for their expression. This is a major cause of cleidocranial dysplasia, which is caused by heterozygous mutation of RUNX2. Cbfb, which is a co-transcription factor that forms a heterodimer with Runx2, enhances DNA binding of Runx2 and stabilizes Runx2 protein by inhibiting its ubiquitination. Thus, Runx2/Cbfb regulates the proliferation and differentiation of chondrocytes and osteoblast-lineage cells by activating multiple signaling pathways and via their reciprocal regulation.

Can herbal drug(s) meet the challenges of genomewide screen results on rheumatoid arthritis

  • Paul, Bholanath
    • Advances in Traditional Medicine
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    • v.5 no.4
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    • pp.251-261
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    • 2005
  • Rheumatoid arthritis (RA) is an autoimmune/inflammatory disorder with a complex genetic component. RA is characterized by chronic inflammation of the synovial membrane in the joint, which leads to the progressive destruction of articular cartilage, ligament and bone. Several cytokines such as tumor necrosis $factor-{\alpha}\;TNF-{\alpha}\;and\;interleukin-1{\beta}\;(IL-1{\beta})$ and interleukin-6 (IL-6) have been implicated in the pathological mechanisms of synovial tissue proliferation, joint destruction and programmed cell death in rheumatoid joint. Genome wide screening of subjects suffering from autoimmune diseases especially arthritis revealed linkage to inflammatory molecules like $TNF-{\alpha},\;IL-1{\beta}$ and IL-6, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor-kappaB $(NF-{\kappa}B)$ and human leucocyte antigen/major histocompatibility complex (HLA/MHC) locus. The status of the pharmacological mechanism of herbal drugs in the light of genome wide screening results has been discussed to reinforce the therapeutic potential and the pharmacological basis of the herbal drugs.

Arthroscopic Treatment of Infectious Chondrolysis of Femoral Head - A Case Report - (대퇴골두 감염성 연골 용해증의 관절경적 처치 - 1례 보고 -)

  • Moon, Young Lae;Yoon, Tae Hyun;Kim, Chan Sang
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.142-145
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    • 1999
  • Chondrolysis of the femoral head s characterized by progressive destruction of the articular cartilage, resulting secondary joint space narrowing and stiffness. It is usually regarded as an idiopathic disease, but it can be produced by sequelae of an infection, trauma, or prolonged immobilization. We report a case of chondrolysis of femoral head in 45-year-old male, caused by infection and treated by arthroscopic management.

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Articular loose body, Synovial Chondromatosis of the Temporomandibular Joint : a Case Report (측두하악관절의 소성체를 동반한 활액성 연골종증 : 증례보고)

  • Choi, Byung-Joon;Lee, Baek-Soo;Kim, Yeo-Gab;Kwon, Yong-Dae;Kim, Young-Ran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.310-311
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    • 2009
  • Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.

Practical Approach of Laryngeal Ultrasonography (후두초음파의 임상적 활용)

  • Cho, Woojin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.19-23
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    • 2018
  • Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.

'MEMIARTHROPLASTY VS. TOTAL SMOULDER ARTHROPLASTY'

  • Bigliani Louis U.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2002.10a
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    • pp.7-7
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    • 2002
  • Historically, the decision to perform a hemiarthroplasty (HHR) versus a total shoulder arthroplasty (TSA) is based on the status of the glenoid and the status of the soft tissues (rotator cuff). In disease processes where the glenoid articular cartilage is relatively well preserved such as avascular necrosis and complex proximal humerus fractures, most orthopaedists recommend performing a HHR while preserving the native glenoid articular surface. At the other end of the spectrum, if the glenoid has excessive bone loss or is unreconstructible, a HHR is the preferred procedure. In patients who have deficient so(t-tissues (rotator cuff) such as rotator cuff tear arthropathy and, occasionally, rheumatoid arthritis, a HHR is the procedure of choice. The indications for HHR in osteoarthritis remain somewhat controversial. There is mounting evidence that performing a HHR for osteoarthritis is inferior to TSA. Recent developments, or 'third generation techniques and materials', in shoulder arthroplasty are expected to improve the longevity of TSA, particularly the glenoid component. In addition, newer designs of reverse-ball prostheses are entering the market with promising early results in patients with deficient rotator cuff mechanisms.

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A Case of Mutational Dysphonia Treated with Type III Thyroplasty (제 3 형 갑상연골성형술에 의한 변성발성장애의 치험 1례)

  • 최홍식;조창현;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.6 no.1
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    • pp.43-45
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    • 1995
  • Type III thyroplasty is a useful surgical procedure reducing the tension of vocal cords by removing the vertical strip of anterior thyroid cartilage and resuturing the cut ends. One of the indications for this procedure is mutational dysphonia, the disease of men who has a childlike vocal pattern even after the process of puberty. We have experienced one case of mutational dysphonia treated with type III thyroplasty. He had high pitched voice from the middle school age and his preoperative fundamental frequency was 272.35 Hz. Two months after the surgery. the fundamental frequency was 129.58 Hz and the patient was also subjectively satisfied with his low-toned voice.

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