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신규 조직공학적 성대주입물의 성대재생 효과분석
- Alternative Title
- The Analysis of Novel Injectable Tissue - Engineered Materials for Vocal Fold Regeneration
- Author(s)
- 김연수
- Advisor
- 김철호
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2017-08
- Language
- eng
- Keyword
- Injection laryngoplasty; Vocal fold palsy; Vocal fold scar; Hyaluronic acid; hepatocyte growth factor
- Alternative Abstract
- Injection laryngoplasty (IL) is one of the most suitable options for treatment of glottic insufficiency, which is caused by vocal fold (VF) paralysis, atrophy, or scarring. The purpose of this study is to demonstrate favorable VF augmentation and regeneration by using a several material such as hyaluronic acid, MPEG-b-(PCL-ran-PLLA) diblock copolymers (C97L3; CL/LA ratio 97:3) incorporating hepatocyte growth factor (HGF). Hyaluronic acid (HA) is a widely used material for VF injection. We intended to evaluate the durability and efficiency of HA of different particle sizes for VF augmentation. An in situ-forming gel system comprised of diblock copolymer formed from polyethylene glycol (PEG) and polycaprolactone (PCL) could be used in controlled drug delivery for tissue remodeling. Gradual release of HGF from C97L3 is detected and biochemical properties of released HGF are maintained. After six and ten weeks, the injected site was evaluated endoscopically, histologically, radiologically, and functionally. None of the 24 rabbits showed any signs of respiratory distress. Computed tomography (CT) images and endoscopic evaluation revealed sufficient augmented volume of the injected VF in all treated groups 6 weeks after the injection. Histological data at week 10 showed that unequal particle-sized HA did not migrate from its original injection site, while other HAs migrated into the arytenoid cartilage. Videokymographic analysis showed more favorable vibrations of unequal particle-sized HA injected VF mucosa 10 weeks post-injection, compared to the other treatment groups. A scar is made with microscissors on both VFs in 32 rabbits, followed by injection of HGF-only, C97L3-only, or HGF-C97L3 composite gel in the left side VF, while the right side VF is left untreated. In vivo fluorescence live imaging system demonstrates that C97L3 enables the sustained release of injected HGF in the scarred VF for 12 weeks. The histological analysis shows increased glycosaminoglycan including hyaluronic acid accumulation and decreased collagen deposition. Videokymographic analysis shows more favorable vibrations of HGF-C97L3 treated VF mucosa, compared to other treatment groups. In conclusion, the controlled HGF release helps to regulate extracellular matrix synthesis, and leads to the eventual functional improvement of the scarred VF.
- Fulltext
- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 4. Theses(Ph.D)
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