• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
• /
• pp.90-90
• /
• 1993

후두암의 치료계획에 있어 어려운 점들로는 종양의 3차원적 위치, 점막하를 통한 전파, 후두연골의 침윤 여부 등이다. 특히 후두연골 침윤은 국소재발과 경부전이의 빈도가 높아 예후가 좋지 않다. 저자들은 후두암의 전파와 후두연골에의 침윤 양상을 이해하고 술전 임상적 진단의 정확도를 높여 치료방향을 설정하는데 도움을 얻고자 1991년 4월부터 1992년 11월까지 후두암으로 혹은 전적출술을 시행했던 예중 18례의 후두표본을 대상으로 연속 대절편을 제작하여 병리조직학적 관찰을 하고 다음과 같은 결과를 얻었다. 1. 후두연골 침윤의 양상은 주로 연골의 골화된 부위를 침범하였고 골화되지 않은 연골의 침윤은 매우 드물었다. 2. 침윤된 골화연골에서는 연골막이 건전하더라도 골수를 통해 전파하였다. 3. 연골막은 종양전이의 아주 강한 방어벽이었다. 4. 후두연골 침윤의 빈도는 갑상연골, 피열연골, 윤상연골, 후두개연골 순이었고 횡성문암에서는 후두연골 침윤이 88.9 % 로 상당히 높았다. 5. 후두연골 침윤여부에 대한 술전 CT의 민감도는 100%, 특이도 62.5%, 정확도 82.3%이다.

• 대한기관식도과학회지
• /
• 제7권1호
• /
• pp.66-70
• /
• 2001

Supracricoid partial laryngectomy (SCPL) has been performed in selected patients with transglottic carcinoma of larynx who are not amenable to classically conservative Partial laryngectomy. We have applied this procedure for the complete removal of carcinoma and the satisfactory recovery of function in 74 supraglottic laryngeal cancer Patient with thyroid cartilage invasion. The 65-year-old man with supraglottic squamous carcinoma with thyroid cartilage invasion (74 stage) was treated by SCPL with bilateral lateral neck dissection. The part of larynx and whole thyroid cartilage with tumor invasion was completely removed with covering thyrohyoid muscle and fascia. External perichondrium of the thyroid cartilage containing carcinoma was not exposed from the overlying muscle and fascia on postoperative pathological examination. We confirmed the invasion of thyroid cartilage histopathologically. Tumor was confined in the specimen and the safety margin was proved in all direction. Postoperative course and functional results were uneventful. SCPL can be applied in selected cases of locally advanced 74 laryngeal cancer.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1991년도 제25차 학술대회 연제순서 및 초록
• /
• pp.24-24
• /
• 1991

기관협착증은 이비인후과 영역에 있어서 치료가 어려운 질환중의 하나로 이의 재건에는 여러가지 자가조직이 각각의 장점에 따라 사용되어 왔지만 완전하고 만족할만한 결과를 얻지 못하는 실정이다. 저자들은 가토의 자가 늑연골 (1군) 및 늑연골막 (2군)을 이용한 기관 재건술을 시행하여 다음과 같은 결과를 얻었다. 1) 이식편은 술후 10주 (1군) 및 12주 (2군)에 흡수나 섬유조직으로의 대치는 없었으며, 기관강의 크기는 직상 하부의 정상기관과 큰 차이가 없었다. 2) 늑연골을 이식한 부위는 연골막의 내세포층에서 연골세포가 분화, 이동되어 절단된 연골사이로 이동하여 새로운 연골을 형성하였다. 3) 늑연골막을 이식한 부위는 연골막에서 형성된 연골세포 및 연골기질이 절단된 연골사이로 이동하여 새로운 연골을 형성하였다. 4)) 이식한 부위의 점막층은 점막재생이 이루어져 원주상피로 피복되었다. 5) 기관 전벽의 결손부위는 늑연골 및 늑연골막을 이용하여 성공적으로 재건되었다.

• Journal of Chest Surgery
• /
• 제34권10호
• /
• pp.784-786
• /
• 2001

계명대학교 의과대학 동산의료원에서는 심방중격결손증을 동반한 누두흉 환자를 동시 교정하였다. 수술은 앙와위에서 정중피부절개후 흉근판을 만들고 변형된 늑연골을 절제한후 흉골을 90$^{\circ}$로 세움으로써 개심술을 위한 시야를 확보하여 심방중격결손을 동시에 교정하였다. 술 후 2시간 뒤 인공호흡기를 제거하였으며, 환아는 합병증없이 회복되어 술 후 6일째 퇴원하였다.

• 한국임상수의학회지
• /
• 제28권5호
• /
• pp.486-496
• /
• 2011

조직공학적 인공연골재생에 대한 관심이 증가함에 따라 많은 연구들이 활발히 수행되고 있으나 임상적인 적용의 한계를 극복하기위한 고효능을 보유한 양질의 연골조직생산의 필요성이 증가되고 있다. 인공연골은 자연연골과는 달리 '연골막(perichondrium)'을 포함하고 있지 않기 때문에 장기간 생체 내에 삽입된 후에 서서히 흡수 또는 변형으로 임상적 활용에 한계가 있다고 있다. 이에 본 연구는 양질의 연골조직생산을 목적으로, 세포판 제작기법(cell sheet engineering technique) 을 기반으로 한 인체유래의 배양 연골막(cultured perichondrium)을 이용하여 만든 인공연골막 세포판(cultured perichondrial cell sheet)의 생체 내 특성을 비교 분석하고, 배양된 연골막을 피복하여 고효능화를 유도한 인공연골복합체의 생체내 재생효능 및 조직특성을 비교 평가하고자 하였다. 본 연구에서는 Athymic nude mouse의 피하이식모델(study 1, n = 12)을 이용하여 담체로 hydrogel을 이용한 배양연골막 복합체의 생체내 효능을 분석하였고, 중대형동물의 대량연골 결손시의 재생효능을 평가하기 위하여 개의 무릎연골에 $1{\times}2cm$의 대량연골 결손모델(study 2, n = 12)을 통하여 인공배양세포판을 이식하였다. 이식12주 후 이식편을 회수하여 생화학, 분자생물학 및 면역조직학 분석을 시행한 결과, 배양연골막 복합체의 생체내 효능이 단독이식군에 비해 변형이나 과증식 없이 우수한 결과를 나타내었다. 본 연구의 결과로 토대로 배양연골막을 피복한 인공연골막의 관절내 효과를 규명하여 실제 임상적용을 조기화하는 기반을 제공하고 인공연골의 문제점이었던 변형과 흡수를 줄인 고효능 인공연골 제작기법을 제공하는데 유용할 것으로 기대된다.

• 대한수의학회지
• /
• 제31권2호
• /
• pp.143-154
• /
• 1991

The present study was undertaken to provide basic data on fetal endochondral ossification for the native Korean cattle femur. This study was determined to the both earliest stages of chondrification and ossification by histochemical methods. The forty-five pairs of femur, from a series of embryos and fetuses ranging from 11 to 100mm in crown-rump(C-R) length, were used. These samples were divided into 9 groups. The groupings were based on C-R length, as the first grouping being 11~20mm, the second grouping being 21~30mm and so on. The results were as follows: 1. Alcianophility and PAS reaction were markedly increased in the perichondrium and interterritorial matrix in the 3rd group(C-R length 31~40mm). These reactions were decreased in the territorial matrix and in the adjacent area to the cartilage canal in the 5th group(C-R length 51~60mm). 2. Calcium deposits and collagen substances were observed initially in the 3rd group(C-R length 31~40mm). The calcium deposits and calcified cores were observed in the trabeculae of the proximal epiphyseal plate of the femur in the 8th group(C-R length 81~90mm).

• Journal of Chest Surgery
• /
• 제20권1호
• /
• pp.161-170
• /
• 1987

Fifty-nine cases of congenital chest wall defects experienced in the department of thoracic surgery of Seoul National University Hospital were analyzed and the relevant literatures were reviewed. They are 52 cases of funnel chest, 3 cases of pigeon breast, one case of superior sternal fissure, one case of costochondral incurvation, one case of Cantrell`s pentalogy, and one case of Poland`s syndrome. Funnel chest affected males more frequently than females by 44 to 8. All of the funnel deformities were corrected by Ravitch operation or its modification except one which was the first case of this series and was corrected by a sterno-turnover. Two cases required a mechanical ventilation for 3 days and 5 days respectively. Four minor complications which were two cases of skin wound infection and 2 cases of fluid accumulation were noted. Skin would infection was repaired by a secondary closure and fluid accumulation was treated by aspiration only. The result are all excellent without recurrence or reoperation. In 3 cases of pigeon breast, they were treated by subperichondrial resection of all of the involved costal cartilages and shortening their course with reefing sutures in the perichondrium with excellent result. The superior sternal fissure which was combined by a ventricular septal defect was treated by a simple wire closure with a good result. The costochondral incurvation was corrected by subperichondrial resection of deformed cartilages and a rib graft removed from the contralateral normal side. The Poland syndrome and the Cantrell`s pentalogy was already presented previously.

• Journal of Chest Surgery
• /
• 제49권3호
• /
• pp.214-217
• /
• 2016

Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully.

• 한국임상수의학회지
• /
• 제4권2호
• /
• pp.499-504
• /
• 1987

Two cases of congenital hyperostosis at a pig farm were observed and examined pathologically in Landrace piglets. Twenty two piglets from 2 litters: 10 alive piglets in a litter and 2 stillborn and 10 alive piglets in another, were born with thickened forelimbs and some of them with thickened hindlimbs too. These piglets stowed symptoms of staggering and incoordination. Only one of these piglets could be reared normally and all the others died within 3 days of age. The thickened parts of their limbs were felt firm and not well pitted by finger pressing. An apparent ossification was identified on the central regions of the cross sections of the thickened limbs, and some pale, gray and ossiferous signs were found in the peripheral soft areas. On histopathological examination of the thickened limbs, it was found that the bone trabeculae were newly proliferated in a concentric form in central regions and in a radiated form in peripheral regions. The peripheral regions of the periosteum and perichondrium of new bone were proliferated with connective tissue and the edematous muscle bundles were atrophic and degenerative. Both the sows which produced piglets of congenital hyperostosis were mated with a different boar at next breeding and farrowed normal piglets. It was concluded that the swine congenital hyperostosis in the present cases was expressed by autosomal recessive gene of first mating boar.

• 대한수의학회지
• /
• 제35권1호
• /
• pp.19-28
• /
• 1995

The histological and histochemical study of the axis body of piglet was performed in order to clarify the ossification process. These experimental animals collected from after birth to 52 days were used for this study. The results were summarized as follows; 1. The epiphysis, the intercentrum 2 and the centrum of proatlas were appeared in the axis body and dens of piglet after birth. 2. In 39 days of age piglet, the ossification of the intercentrum 2 was first observed but the epiphysis was already initiated. The centrum of proatlas was observed cranioventral part of the dens of the 52 days piglet axis. 3. The notochordal remnants revealed distinctively in the part between the centrum 1 and the centrum2, in the apical cartilaginous tissue of dens and in the caudal cartilaginous part of body of axis. 4. Intramembranous ossification occurred in the adjacent area of perichondrium of centrum 2. These ossified trabeculae show the woven bone configuration.