가토의 연골피막 이식시 접촉억제가 연골신생에 미치는 영향

Abstract

[한글]

연골피막의 연골신생 능력은 1972년 Skoog등에 의해 처음으로 시험, 발표되었으며, 그 후로 연골피막 이식을 이용하여 기관 결손의 재건 (Sohn 과 Ohlsen, 1974)이나 관절 연골의 형성(Skoog 과 Johansson, 1976)등에 대한 실험이 행하여져 왔다. 임상적으로 이러한

연골피막의 연골신생 능력은 이개의 꽂양배추상 기형 (cauliflower deformity)의 치료(Ohlsen 등, 1975), 작은 관절의 재건 (Skoog 과 Johansson, 1976 : Tajima 등, 1978), 그리고 피부-연골피막 혼합이식으로 귀, 코, 안검, 비중격등의 재건 (Brent 와 Ott, 1978)에

이용하였다.

최근 Donski hkd O'B갸두 (1980)은 이개 연골피막 이식시 연골신생 능력은 연골로부터 분리된 연골피막의 접촉억제 상실로 생긴다고 하였으며 또 이러한 결과로 연골의 과다증식이 이루어진다고 하였다.

본 실험은 가토의 이개로부터 분리한 연골피막을 자가이식하되 접촉억제의 변화에 따른 연골신생의 영향을 규명고져, 단순한 연골피막이식의 대조군, 활동면끼리 접합시킨 연골피막의 실험군 Ⅰ, 비활동면끼리 접합시킨 연골피막의 실험군 Ⅱ를 배부의 피하층에 이식

하고 연골신생을 관찰하여 다음과 같은 결론을 얻었다.

1. 연골피막 활동면 상호접합 이식한 실험군 Ⅰ의 연골 신생율(4%)은 연골피막 단순 이식의 대조군(46%) 및 연골피막 비활동면 상호접합 이식한 실험군 Ⅱ(19%)의 경우보다 매우 낮았으며, 또한 신생된 연골관도 매우 엷었다.

2. 연골피막의 활동면의 상호접합은 연골신생에 있어 "접촉억제" 작용으로써 중요한 요인이 되었다.

3. 연골피막 이식시 높은 연골신생율을 얻으려면 "접촉억제"를 꾀하고 연골피막에 손상을 적게 미치는 조작이 필요하다.

The effect of "Contact inhibition" on chondrogenesis in perichondrial gragts of

rabbits.

Han Sik Chin, M.D.

Department of Medical Science, The Graduate School, Yonsei University

(Directed by Prof. Jae Duk Lew, M.D.)

Since 1972 a series of experiments (Skoog, Ohlsen & Sohn, 1972 ; Ohlsen, 1976)

has been performed to elucidate the potential of perichondrial grafts to generate

cartilage. In 1974 Sohn and Ohlsen demonstrated in rabbits that tracheal cartilage

could be reconstructed from free perichondrial grafts. Clinically this potential

was used in the treatment of the cauliflower ear and to correct protruding ears by

perichondroplasty (Skoog, 1974), to reconstruct the small joints (Skoog, 1976 ;

Tajima, 1978) and to repair the defects of ear, nose, eyelid and septum (Brent and

Ott, 1978).

Recently perichondrial microvascular transfer was studied by Donski and O'Brien

(1980). They summarized that there was no any distinct difference in cartilage

formation in the vascularised was resulted from loss of "contact inhibition" and

the over production of cartilage was also resulted from loss of "contact

inhibition".

In the study, various contacts of active surface of the perichondrial grafts were

made and autografted from ear to dorsal retion of the rabbits, and the following

results were obtained.

1. The chondrogenesis of perichondiral gragts with induced "contact inhibition"

was nearly absent and new cartilage if any formed, was very thin.

2. The " contact inhibition" was thought to be a important factor on

chondrogenesis in perichondrial gragts.

3. The agraumatic technique was needed to substantially obtain the new cartilage

from perchondrial gragts.

[영문]

Since 1972 a series of experiments (Skoog, Ohlsen & Sohn, 1972 ; Ohlsen, 1976) has been performed to elucidate the potential of perichondrial grafts to generate cartilage. In 1974 Sohn and Ohlsen demonstrated in rabbits that tracheal cartilage could be reconstructed from free perichondrial grafts. Clinically this potential was used in the treatment of the cauliflower ear and to correct protruding ears by perichondroplasty (Skoog, 1974), to reconstruct the small joints (Skoog, 1976 ; Tajima, 1978) and to repair the defects of ear, nose, eyelid and septum (Brent and

Ott, 1978).

Recently perichondrial microvascular transfer was studied by Donski and O'Brien (1980). They summarized that there was no any distinct difference in cartilage formation in the vascularised was resulted from loss of "contact inhibition" and the over production of cartilage was also resulted from loss of "contact

inhibition".

In the study, various contacts of active surface of the perichondrial grafts were made and autografted from ear to dorsal retion of the rabbits, and the following results were obtained.

1. The chondrogenesis of perichondiral gragts with induced "contact inhibition" was nearly absent and new cartilage if any formed, was very thin.

2. The " contact inhibition" was thought to be a important factor on chondrogenesis in perichondrial gragts.

3. The agraumatic technique was needed to substantially obtain the new cartilage from perchondrial gragts.