• 제목/요약/키워드: Degenerative change

검색결과 208건 처리시간 0.031초

실험가토의 악관절원판 변위시 후방부착조직의 변화 (HISTOLOGIC CHANGE OF THE POSTERIOR ATTACHMENT IN ANTERIOR DISC DISPLACEMENT OF THE TEMPOROMANDIBULAR JOINT-A NEW MODEL OF INTERNAL DERANGEMENT IN RABBITS)

  • 김태우;고재승;장영일
    • 대한치과교정학회지
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    • 제23권4호
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    • pp.503-527
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    • 1993
  • This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

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비행운동 제한에 따른 비둘기 심근세포의 퇴행성 변화 (Degenerative Changes of Myocytes Induced by Restriction of Flight in Doves)

  • 문혜정;이용덕;박원학
    • 대한의생명과학회지
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    • 제6권4호
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    • pp.269-279
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    • 2000
  • 격렬한 운동유형으로 분류되는 비행이 습성화 되어 있는 조류를 대상으로, 인위적으로 비행을 제한시켰을 떼 나타나는 심근의 퇴행성 변화를 살펴봄으로써, 운동량 감소가 심근에 미치는 영향에 대하여 검토하고자 하였다. 서식환경의 제한을 위해 자연상태에서 서식하는 비둘기를 1 $m^3$ 공간에 2달 동안 서식시킨 군 (confined type)과 자연상태의 군 (wild type)으로 나누어 심근의 변화양상을 미세구조적, 세포화학적 방법 및 입체해석학적 방법으로 분석하였다. 체중은 confined type에서 증가되어 상대적으로 심장의 무게는 감소되었고, 흉근의 무게는 6.5% 감소 (p<0.05) 되었다. Confined type은 wild type과 비교해 볼 때, 미세구조적으로 더 적은 빈도의 심근의 파동형 변화와 지방소적의 침적이 관찰되었고, 근절의 길이는 길게 관찰되었다. Cytochrome oxidase의 활성을 알아보기 위해 실시한 세포 화학적 반응 결과, confined type에서 활성이 15% 감소되었다. 또한 입체해석학적 분석 결과, confined type의 관원섬유 체적밀도는 높게 나타났으나, 근형질내세망의 체적밀도와 사립체 내막의 표면밀도는 각각 23%, 25% 낮게 (p<0.05, p<0.01) 나타났다. 사립체의 체적밀도는 confined type에서 낮게 나타난 반면, 수적 밀도는 wild type과 비교하여 17% 높게 (p<0.05) 나타났다. 이러한 결과를 종합해보면 비행이라는 고에너지를 요구하는 격렬한 운동인 비행이 습성화 되어 있는 비둘기에서 비행을 제한시키면, 심근은 운동량의 감소에 따른 퇴행성 변화를 겪게 되므로, 운동의 지속성 여부는 심근기능유지에 매우 중요한 요소로 판단된다.

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기계판막을 판륜상연에 위치시킨 대동맥판 치환술 (Alternative Technique of Aortic Valve Replacement -Implantation of Mechanical Aortic Valve at a Supra-Annular Level-)

  • 최종범;이삼윤
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.504-509
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    • 1996
  • 대동맥 판 치환술시 봉합법으로써 단순봉합(simple interrupted suture), 8자형 봉합(figure of eight su- ture), 수평 석상봉합법 (horizontal mattress suture method) 등이 이용되고 있다. 그러나 심내막염에 의 해 판륜이 손상되거나 퇴행성 변성으로 판륜이 약화된 환자들에서는 본봉합법으로대동맥판 치환이 어려 울 수 있고,치환후 판막주위 누출등의 합병증이 발생할수 있다. 저자들은 1993년 6월부터 1995년 6월 까지 심내막염에 의한 대동맥판 환자 4례,퇴행성 판막환자 3례,류마티스성 판막병변 환자 1례에서 수직 석상봉합법 (vertical mattress suture method)으로 기계판막(mechanical valve)을 판륜 상연에 위치시 키는 술식을 시행하였다. . 2례에서 농양으로 판륜이 결손되어 자가심막편을 이용하여 결손부위를 봉합하였다. 판막 치환을 위 해 2-0 polyester 봉합사를 이용했고, 봉합사를 지지하는 테프론 조각을 심실쪽에 위치시키고 침사가 심 실쪽에서 발살바동쪽으로 통과하도록 하는 수직 석상봉합법을 이용하였다. 본 수술방법으로 최소한 19mm기계판막의 사용은 완전히 배제할 수 있었다. 술후 평균 13.3개월에 심에코 검사로 추적 관찰한 \ulcorner과, 판막운동의 이상은 발생하지 않았으며, 판막자체에서 발생하는 압력 경사는 3례에서 6mmHg이 하였고 5례에서 20내지 40mmHg였다 이와같은 결과에서 판륜이 손상되거나 약화된 대동맥판 환자에 서 판막치환술시 수직 석상 봉합법을 이용하여 기계판막을 판륜상연에 위치시키므로써 수술이 용이하 고 술후 합병증을 감소시킬 수 있을 것으로 사료된다.

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앞십자인대 및 내측 곁인대 절제와 내측 반월판 절제술을 한 뒤 수술후 운동을 실시하지 않은 개의 무릎 관절의 평가 (Evaluation of the Canine Stifle Joint after Transection of the Cranial Cruciate Ligament and Medial Collateral Ligament, and Medial Meniscectomy without Postoperative Exercise)

  • 이해범;정창우;김남수
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.325-330
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    • 2007
  • 본 연구는 개에서 수술적으로 짧은 기간 동안 관절의 불안정성을 최대로 유도하여 수술후 운동 없이 관절의 퇴행성 변화의 유무 및 정도와 골관절염 모델로 적합한지를 평가 하였다. 10두의 비글견을 본 실험에 사용하였다. 실험군은 오른쪽 무릎관절의 앞십자인대 및 내측 곁인대의 절제와 내측 반월 연골 절제술을 시행하였으며, 왼쪽 무릎관절을 대조군으로 사용하였다. 수술 12주 후 연골의 손상, 윤활막의 염증 정도와 윤활액의 생화학적 변화를 평가 하였다. 조직 검사에서 연골의 비후, 연골 세포의 분화, 프로테오글리칸의 소실 및 윤활막의 염증이 대조군과 비교하여 유의성 있는 증가가 관찰되었다. 윤활액의 생화학적 검사에서 유의성 있게 증가된 MMP-2, -9의 농도를 실험군에서 관찰 하였다. 이상의 결과로부터 본 연구에 수행한 관절염 모델은 골관절염 유도가 가능하며, 술후 운동으로 소모되는 시간 및 비용을 줄 일수 있는 장점 있어 골관절염 모델로서 유용하게 활용될 것으로 판단된다.

요추 고정수술 후 인접척추 운동범위의 변화 (The Change of Motion Ranges of Adjacent Vertebral Joints after Lumbar Fusion Operation)

  • 여상준;박승원;김영백;황성남;최덕영;석종식;정동규;민병국
    • Journal of Korean Neurosurgical Society
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    • 제29권11호
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    • pp.1456-1460
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    • 2000
  • Objectives : Transpedicular screw fixation has become an important method for internal fixation in variety of disorders. However, acceleration of degeneration at the adjacent segment in any follow. The goal of this study is to review the change of motion ranges of vertebral joints adjacent to fused level in lumbar spine. Methods : This study consists of 22 patients with degenerative spinal instability. Treatment of spinal instability includes posterior fusion with transpedicular screw fixation or transpedicular screw fixation with posterior lumbar interbody fusion. The flexion-extension angle(FEA) was measured from dynamic views of lumbar spine taken both at preoperative and post operative period. Results : The FEA of upper vertebral joint adjacent(FEA-u) to a fused L4-5 level was increased(p=0.010). The FEA-u was increased in case of L5-S1 fusion(p=0.025). The change of FEA-u in case of L5-S1 fusion was greater than that in L4-5 fusion(p=0.013). Conclusion : After L4-5 fusion, there seems to be more meaningful increase in FEA of L3-4 than that of L5-S1. The reason may be due to the damage of L3-4 facet joints during the operation, the other possible explanation may be the anatomical stability of L5-S1 vertebral joint. The change of FEA-u of L5-S1 fusion is increased more than that of L4-5 fusion. Because there are compensations in the adjacent vertebrae both above and below the fused L4-5, the compensatory motion in FEA-u of L5-S1 fusion was greater than that of the L4-5 fusion.

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가토 악하선 도관 절단술 및 결찰술 후 근상피세포의 변화 (THE CHANGE OF MYOEPITHELIAL CELL AFTER LIGATION AND CUT OF SUBMANDIBULAR GLAND DUCT IN RABBIT)

  • 윤원석;김철환;김경욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권2호
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    • pp.81-93
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    • 2006
  • Obstructive sialadenitis is one of common disease in salivary gland, and most common histologic features are loss of acinar cell and ductal dilatation associated with fibrosis, and infiltration of inflammatory cells. Although many experimental studies has been accomplished for the salivary acinar cell change in obstructive salivary gland disease, studies for myoepithelial cell were deficient. This study is designed for salivary gland tissue change, especially myoepithelial cell when nonspecific chronic sialadenitis or salivary duct injury by duct obstruction or cut can be occurred that is common encounted clinically. After ligation and cutting of submandibular gland of rabbit, groups of aminmal were sacrificed at 1, 2, 4 weeks postoperatively, submandibular gland were removed. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining with ${\alpha}$-smooth muscle actin, characteristics of myoepithelial cell were examined. With transmission electron microscopy, ultrastructure of myoepithelial cell were examined for distribution and ultrastructure of myoepithelial cell. The results were obtained as follows: 1. In the histopathologic evaluation, ligation and cutting group of 1 week, linkage of myoepithelial cell associated with acinar atrophy and degeneration were disappeared in both group. 2. More prominent squamous metaplasia was seen in acinar cells of ligation group of 2 weeks experimental rabbit than cutting group. 3. Acinar cells are nearly disappeared in both ligation and cutting group of 4 weeks, and myoepithelial cell also disappeared associated with acinar cell atrophy, and duct-like structure composed by squamous cells by squamous metaplasia in acinar cells were distributed. 4. In immunohistochemical study, both ligation and cutting group ${\alpha}$-SMA distribution were diminished at 1 week experimental rabbits, but myoepithelial cell was more diminished in ligation group than cutting group, which were distributed around cells of squamous metaplasia. 5. Nuclear condensation, chromosome margination, and cytoplasmic vaculoation were appeared in myoepithelial cell of both cutting and ligation group after 1 week with transmission electron microscopy. But degenerative substance were seen in cytoplasm of myoepithelial cell of ligation group of 4 weeks. From the results obtained in this study, atrophy and degeneration of myoepithelial cell was more prominent in duct ligation group than duct cutting group, and myoepithelial cells were seen around cells squamous metaplasia of acinar cell.

요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가 (Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain)

  • 이승훈;최윤영;조석신
    • 대한핵의학회지
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    • 제35권6호
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    • pp.371-377
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    • 2001
  • 목적: 요통을 호소하는 암환자에서 골스캔을 시행하여 척추골의 섭취증가를 보이는 경우, 골전이와 양성 골질환의 구분이 모호한 경우가 많다. 이에 척추골 SPECT를 추가로 시행하는 것이 악성과 양성 골질환을 감별하는데 도움이 되는지 알아보고자 섭취양상을 분석하였다. 대상 및 방법: 3년간 척추골 SPECT를 시행한 108명의 환자중 SPECT에서 이상 섭취 병변을 보이고 임상적으로 추적이 가능하였던 45명의 환자의 67개의 병변의 척추골 SPECT소견을 다음과 같이 구분하고 임상소견 및 방사선학적 소견과 비교하였다. 1. 척추체: A. 전반적인 섭취증가, B. 추간판에 연한 선상의 섭취증가, C. 냉소의 동반, D. 분절상 섭취증가, 2. 척추후면체 A. 척추체 후면(lamina, pedicle 등), B. 추간판후면(후관절 등), C 극돌기 결과: 골전이 병변(18)은 척추체의 냉소동반(6), 분절상 섭취증가(5)가 특징적이었으며, 퇴행성변화(28)는 추체연의 선상 섭취증가(12), 추간판후면의 후면체 섭취증가(15), 압박골절(21)은 전반적인 척추체 섭취증가(9) 및 추체연의 섭취증가(9), 냉소동반(1), 분절상 섭취증가(1)와 극돌기의 섭취증가(3)을 보였다. 결론: 척추골 SPECT의 섭취증가 양상은 냉소동반, 분절상 섭취증가를 보이는 경우에 골전이 병변의 가능성이 크지만 압박골절에서도 같은 소견을 보일 수 있으므로 주의하여야 할 것이며, 퇴행성 질환은 특징적인 소견을 보이므로 감별이 가능하였다. 그러므로 골스캔 후 척추골 섭취 이상이 있는 암환자에서 추가 SPECT검사가 도움이 될 것으로 생각된다.

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외이전기경혈자극과 경피전기신경자극이 슬관절 전 치환슬 환자의 수술 후 통증조절에 미치는 효과 (The Effects of Auricular Electroacustimulation and Transcutaneous Electrical Nerve Stimulation on Postoperative Pain Control in Total Knee Replacement Patients)

  • 김태열;황태연;허춘복
    • 대한물리치료과학회지
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    • 제1권1호
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    • pp.145-163
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    • 1994
  • This study was done to determine differences in effect of postoperative pain control in patients receiving auricular electroacustimulation vs transcutaneous electrical nerve stimualtion following total knee replacement surgery. Thirty-one cases referred to physical therapy department after treated by total knee replacement surgery by orthopedic surgery department at the Pohang St. Mary's Hospital from January 1993 through June 1994. Of 31 total knee replacement cases, 13 cases were auricular electroacustimulation group, 11 cases were transcutaneous electrical nerve stimulation group, and 7 cases were control group. The results of the study summerized are as follows: Thirty-one total knee replacement cases(male in 12 cases, female in 19 cases), ranging in age from 34 to 61 years(mean${\pm}$SD=49.90 7.56) with diagnoses of degenerative arthritis(20 cases), rheumatoid arthritis(9 cases), and other(2 cases). In auricular electroacustimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In transcutaneous electrical nerve stimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In control group, did not show significant pre-posttreatment differences in pain intensity, unpleasantness, active range of motion(p>0.05). The mean change in pain intensity and unpleasantness, active range of motion from pretreatment baseline for the 3 groups. Auricular electroacustimulation group showed the large magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. Transcutaneous electrical nerve stimulation group showed small magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. No significant changes were observed in control group. Highly significant differences in pain intensity, unpleasantness, and active rage of motion were found using an ANOVA measures between treatment groups and control group(p<0.01). The squares correlation coefficients of pain and function measures pretreatment-posttreatment differences for each group. In treatment group, there was significant correlation between pain scale and function(p<0.001). In control group, there was no correlation between the pain scale and function (p>0.05). The continuous study is needd for many interesting issues of auricular electroacustimulation in new future.

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측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성 (The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis)

  • 노창세;정연화;태일호;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제34권1호
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    • pp.81-90
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    • 2009
  • 2005년부터 2007년까지 진주 OOO치과의원 턱관절/구강안면통증클리닉에 내원한 측두하악장애환자 95명, 190개의 관절을 대상으로 한 명의 검사자가 측두하악관절장애 분석검사와 파노라마영상검사를 엄격히 시행하고, CBCT영상을 촬영하여 구강내과 전문의와 치과방사선과 전문의가 각각 영상진단 하였으며, 임상적 진단과 CBCT영상의 결과를 비교하여 다음과 같은 결과를 얻었다. 1. 구강내과 전문의와 치과방사선과 전문의에 의한 CBCT의 영상진단의 일치도(Kappa: 0.681)가 높았다. 2. 파노라마영상과 CBCT의 영상진단과의 일치도(Kappa: 0.169)가 낮으며, 파노라마영상에서 골변화의 위음성이 높았다. 3. 임상적으로 비퇴행성골관절염으로 진단된 관절 중 CBCT의재진단시 54.2%에서 골변화가 관찰되었으며, 퇴행성골관절염으로 진단된 관절 중 CBCT의 재진단시 15.3%에서 골변화가 없는 것으로 관찰되었다. 4. 관절통은 침식성 골변화에서 높게 나타났으며, 골증식체의 골변화에서 염발음이 가장 많이 나타났으며 병력기간도 가장 길었다.

Correlation between Obesity and Lumbar Lordosis in Obese Pre-Menopausal Korean Females

  • Song Mi-Yeon;Chung Won-Suk;Kim Sung-Soo;Shin Hyun-Dae
    • 대한한의학회지
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    • 제25권4호
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    • pp.43-50
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    • 2004
  • Objective : Obesity is associated with degenerative arthropathy giving stress on joints. It also amplifies loads of weight bearing joints by changing the gravity line of the body. Our aim is to investigate the correlation between obesity and lumbar lordosis in obese pre-menopausal Korean females. The hypothesis was tested that there is a correlation between obesity and lumbar lordosis. Methods : A cross-sectional evaluation of 44 Females (baseline age 30.77 ± 6.46) with BMI 31.53 ± 3.82 (kg/㎡) was done. Body composition was measured using bio-impedance analysis (BIA), and anthropometry was done by the same observer. A lateral whole spine X-ray was taken in standing position to measure the lumbar lordotic angle (LLA), Ferguson angle (FA) and lumbar gravity line (LGL). A Pearson correlation was used to measure the correlation between obesity and lumbar lordosis (SPSS 10.0 for windows). Results : Body mass index (BMI kg/㎡) had a negative relationship with LLA((equation omitted)=-0.469), FA((equation omitted) =-0.347) and LGL((equation omitted)=-0.389). Body fat rate had a negative relationship with LLA only(γ=-0.385). Waist circumference had a negative relationship with LLA((equation omitted)=-0.345) and LGL((equation omitted)=-0.346). WH ratio had no relationship with lumbar lordosis. Conclusion : These data show that obesity is related to mechanical structures, such as lumbar lordosis. BMI was the most useful index, which reflects a change of mechanical structure of lumbar, more than other variables in this study.

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