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인체 무릎관절 윤활포식세포 cluster designation 표지에 관한 면역전자현미경적 연구
임형수,조국형,김용욱,박경한,황영일,장가용,황덕호,Lim, Hyoung-Soo,Cho, Kook-Hyeung,Kim, Yong-Wook,Park, Kyeong-Han,Hwang, Young-Il,Chang, Ka-Young,Hwang, Douk-Ho 한국현미경학회 2000 Applied microscopy Vol.30 No.2
사람 무릎관절 윤활막을 구성하는 윤활세포 중 윤활포식세포(phagocytic synovial cell, type A cell)의 기원에 대한 논의는 형태적으로 큰포식세포의 모습을 하고 있는 단핵포식체 계 (mononuclear phagocyte system)의 한 일부로서 아마도 골수(bone marrow)에서 기원되어졌을 것이라고 알려져 있다. 기능적으로도 LCA, HLA-DR과 Ia 항원에 양성반응을 보여 큰포식세포의 일부로 알려졌으나 아직 연구가 부족한 실정이다. 본 연구는 CD14와 활성화된 큰포식세포의 표지물로 알려진 CD105(endoglin)를 이용하여 윤활포식세포의 세포 내 발현부위를 규명하고, 기능적으로 활성화된 큰포식세포와 포식작용의 역할을 수행하는지 여부를 확인하기 위해 사람의 무릎관절에서 윤활세포들을 냉동초미세박절법을 이용한 면역조직화학 기법으로 CD14와 CB105에 대한 금표지를 하여 투과전자현미경으로 관찰한 결과 다음과 같은 결론을 얻었다. 1. CD14는 윤활포식세포의 과립세포질세망과 세포질및 가장자리, 공포 주변 부위에서 표지 되었으며 공포내에서는 표지 되지 많았다. 2. CD105(endoglin)는 윤활포식세포의 세포막 가장자리와 세포질 돌기를 따라 표지 되었으며 공포 주변 부위에서도 표지 되었으나, 공포 내에서는 표지 되지 많았다. 이상의 결과로 보아 사람 무릎관절 윤활세포층에 위치하는 윤활포식세포는 CD14와 CD105의 항원에 대한 표지를 보이므로 활성화된 큰포식세포나 포식작용의 역할을 수행하는 것으로 생각된다. This study was designed to observe the ultrastructural localization of synoviocytes, which are concerned with the function of phagocytic synovial cells (type A synoviocytes, macrophage-like synoviocytes), in the knee joint of the human for CD14 and CD105 by cryo-immune-electron microscopic technique. The synovium were dissected and fixed for two hours (in 4% paraformaldehyde and 0.1% glutaraldehyde mixture), and were immerged in 2.3 M sucrose and 20% PVP solution. Finally, they were cut with the cryoultramicrotome and labelled with primary antibodies (monoclonal mouse anti-human CD14, monoclonal mouse anti-human CD105 (endoglin) and secondary (donkey anti-mouse IgG) tagged with 6 nm colloidal gold particles. The tissues were observed under transmission electron microscope. This study was resulted as follows. 1. In the synovium of the human knee joint, CD14+ cells were identified. These cells showed phagocytic synovial cell's features. In the phagocytic synoviocyte, the distributions of CD14 were marked in the cytoplasm, around vacuoles, and in cytoplasmic process, but not detected inside of vacuoles. 2. In the synovium of the human knee joint, CD105+ cells were identified. These cells were recognized endothelial cells and phagocytic synovial cells. In the phagocytic synovial cells, the distributions of CD105 (endoglin) were marked in cytoplasic process, around vacuoles, and in cell membrane, but not detected inside of vacuoles. On the basis of above findings, it is obvious that phagocytic synovial cells were marked at CD 14 and CD 105, and might be play the role of activated macrophages or phagocytes in the synovial membrane.
대퇴 골수강 내에 남겨진 수술 기구 부위에 발생한 대퇴 스템 주위 골절 - 증례 보고 -
김용훈,김근우,이민섭,김상림,민학진,조국형,윤의성 대한골절학회 2000 대한골절학회지 Vol.13 No.2
Postoperative periprosthetic fracture of the femur after hip arthroplasty is a serious complication that can be difficult to treat. Moreover, it has become more common in recent years, as the cases of hip arthroplasty and revisional hip arthroplasty increase. We have experienced a postoperative periprosthetic fracture of the femur probably caused by a surgical instrument left in the medullary canal during hip arthroplasty. We report this case with reference to other related articles.
동종 건 및 골 이식을 이용한 관절경적 전방 십자 인대 재건술
김용훈,김일명,김근우,윤의성,민학진,조국형,민수기 대한슬관절학회 1997 대한슬관절학회지 Vol.9 No.1
From June 1994 to December 1995, we performed arthroscopic anterior cruciate ligament reconstruction using B-T-B alIograft in nineteen patients and postoperative aggressive rehabilitation program including early range of motion(ROM) exercise and muscle strengthening exercises in all cases. Except six cases of loss of follow-up, thirteen cases were analyzed. Postoperative results were evaluated by Lysholm knee score and Mu¨ler's criteria at average 14 months(range from 6months to 24 moths). The average Lysholm score improved from 56 to 79. According to the Mu¨ller's criteria, the results were excellent in 7 cases, good in 5 cases and fair in 1 case. We concluded that the reconstruction of the anterior cruciate ligament using B-T-B allograft could be an effective method with many benefits in treatment of anterior cruciate ligament rupture and that the results using B-T-B allograft was as good as those using autograft. But, further evaluation and long teim follow-up should be needed.
견봉쇄골 관절 분리와 동반된 오구 돌기 골절 - 2례 보고 -
김용훈,김일명,김근우,윤의성,민학진,조국형,금기승 대한골절학회 1997 대한골절학회지 Vol.10 No.3
Acromioclavicular dislocation with a concomitant coracoid process fracture occurs infrequently, as only several cases have been reported in the literature. This injury usually occurs in the second or third decade of life. The mechanism of injury were sports, motor vehicle and direct trauma. An axillary lateral radiograph of the shoulder often is needed to detect this fracture. The authors present two cases of coracoid process fracture associated with acromioclavicular dislocation. Satisfactory function with minimal residual cosmetic deformity may be achieved by nonoperative measures. Also surgical treatment can produce good result in complete third degree acromioclavicular separation combined with the significantly displaced coracoid fracture.