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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.
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김용훈,김근우,윤의성,민학진,최형택,김상림,조국형 대한골절학회 1999 대한골절학회지 Vol.12 No.4
Purpose: The goal of treatment in elderly patients with hip fractures is restoration of function to preoperative ambulatory status as early as possible. The dementia patients who live in the asylum for the old need longer rehabilitation program for restoration of function, especially walking ability. The authors compare the modalities of the treatment for the hip fracture in the view point of walking ability. Materials and Methods: The twenty-eight dementia patients were operated due to hip fracture. Femur neck fracture were 7 cases, and femur intertrochanteric fracture were 21 cases. The authors analyze these patient on the recovery of walking ability. One patient who died immediately after operation was excluded in this study. The patients were divided into two groups. Of 27 patients, 13 patients were treated with osteosynthesis (Group I), and remaining 14 patients were treated with hemiarthroplasy(Group II). Results: Fixation loss was treated with hemiarthoplasty in two case of osteosynthesis. The dislocation was treated with open reduction in one case of hemiarthroplasty. In the group I, the walking abilities were significantly different between the preoperative (3.85) and the postoperative at 2 weeks(2.46), at 2 months(2.73) and at the final follow-up (2.55)(P$lt;0.05). In the group II, the walking abilities were not significantly different between the preoperative(2.57) and the postoperative at 2 weeks(2.14) and at the final follow-up(2.29)(P$gt;0.05). Conclusion: Although there is no difference between two groups in final walking ability. The group treated with endoprosthesis showed earlier recovery of walking ability.
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