2013-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/701638摘要：研究背景：膝關節半月軟骨板損傷是常見的骨科問題，雖然可以用手術修補，但是修補後的癒合能力卻因損傷部位不同而有異。傳統上，這種現象被歸因於半月板上的血流狀況不均：靠半月板外圍的區域有較好的血管灌注，因此癒合能力較佳。不幸的是，位於「血流較少、癒合較差」的內緣部位損傷，占了損傷的相當大比率；儘管手術技術不斷進步，此種損傷的復原狀況仍不理想。晚近的一些研究顯示，除了血流分布不同外，半月板的內緣與外圍還有著不少差異，像是：組織結構、細胞分佈、和細胞特性等等。一些研究顯示內緣部細胞在細胞特性和表徵上很近似於透明軟骨內的軟骨細胞。由於透明軟骨是已知修補能力極差的一種組織，因此半月板外緣部的修補能力差，可能某程度上是肇因於其內的這種細胞行為，而不是單純因為血流的關係（註：半月板組織為一種纖維軟骨，因此其內的細胞大體而言是一種介於軟骨細胞與纖維母細胞之間的細胞）。而如果此假設為真，那麼近幾年細胞分子生物學度對透明軟骨癒合能力提升的進展，也許也可以套用到半月板外緣部損傷的修補上，提升術後的癒合率。 研究目的：驗證半月板不同區域（包括外圍、過渡區、內緣三個區域）內細胞特性的差異性，主要是它們的細胞表徵，與軟骨細胞、或纖維母細胞兩個極端相近的程度。我們的假說是：外圍細胞特性較趨近纖維母細胞、而內緣細胞特性較趨近於軟骨細胞。 Study design: An experimental model in human menisci. 研究方法：在人工膝關節置換手術當中，有時可以發現膝關節中的半月板損壞情形尚不嚴重。由於在置換手術中，這些殘存半月板一般也是切除丟棄的廢棄組織，因此我們計畫把它們留置作為本研究的材料。將這些半月板切割成外圍、過渡區、內緣三個等分區域，然後分別萃取收集不同區域的細胞。將細胞分別培養後，分析其蛋白質表現的異同，包括其對第一型、第二型膠原蛋白、醣蛋白等的表現差異，以及分析其細胞物理特性（例如表面機械特性，這代表了細胞膜上物質與細胞膜下微骨幹結構的不同）的差異等等。<br> Abstract: Background: Meniscal injury is a common orthopaedic problem. The prognosis of treatment depends on zone of injury that related with a vascular supply. In the past, if injury occurs in avascular area it would be consider to be un-repairable. Unfortunately, most of menisucal injuries presented in central avascular area. To achieve healing in this area is challenging among orthopaedic surgeon. There are many advance technique for meniscal repair but not satisfied. To solve this problem, some basic researches have been conducted to figure out whether molecular biology technology will enhance healing in this area or not. Currently we gain more information about meniscal basic histology and realize that the different between vascular and avascular areas of the meniscus is not only in blood supply but also in ultrastructure; cellular component and extracellular matrix. Some studies showed avascular zone of meniscus has chondrocyte liked cells and matrix production mimic to hyaline cartilage. From this information we have hypothesized that if avascular zone of the meniscus has the same property as hyaline cartilage, the cell from this area should have ability to proliferate under chondrogenic treatment. And if the central avascular zone of the meniscus is hyaline cartilage then treatment of this area tear will be changed to the same way of hyaline cartilage injury treatment. Propose: To compare the capability of cell proliferation among three areas of the meniscus, peripheral vascular, middle and central avascular zones to the articular hyaline cartilage. Study design: An experimental model in human menisci. Methods: The human menisci and articular cartilage specimens from total knee arthroplasty will be collected. Separately extracts the cells from peripheral vascular, middle and central avascular area of the meniscus as well as articular cartilage from the femoral condyle. Culture these cells under chondrogenic treatment condition and compare the proliferation property, immunohistochemistry and gene expression among different areas cells.BS69gliomatumorigenesis