• Title/Summary/Keyword: 골관절증

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Anti-arthritic Effects of Buthus martensi Karsch Herbal Acupuncture, Inhibiting Interleukin-1-induced Expression of Nitric Oxide Synthase and Production of Nitric Oxide in Human Chondrocytes (전갈 약침액의 인체연골세포에서 nitric oxide synthase의 interleukin-1 유도 유전형질 발현과 nitric oxide의 생산의 억제에 관한 연구)

  • Cho, Hyun-seok;Kim, Kap-sung
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.104-119
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    • 2003
  • 목적 : 면역억제 작용을 지닌 것으로 알려진 전갈약침(BMK)의 IL-1으로 야기된 1차성 골관절염 인체 연골 세포에 대한 항염증 효과 골 기능 효과에 대해 연구하였다. 방법 : 골관절염 연골에서 채취된 인체 연골세포는 ID-1(2ng/ml)에 의해 처리되어졌으며, IL-1과 BMK($10{\mu}g/ml$)를 함께 처리한 연골세포와 비교하였다. 결과 : IL-1 단독처리된 연골세포에 비해 BMK가 함께 처리된 연골세포에서 연골세포의 손실과 퇴화의 중요한 요소인 NO의 생산량이 의미있게 저하되었다. IL-1단독으로 처리된 연골세포보다 IL-1과 BMK가 함께 처리된 연골세포에서 iNOS mRNA의 단백질 합성이 의미있게 감소하였다. 또한, 전사인자로서의 NF-B의 활성화가 IL-1 단독으로 처리된 연골세포에 비하여 BMK가 함께 처리된 군에서 상대적으로 의미있게 억제되었다. 결론: 이상의 결과를 종합하면 BMK가 인제 골관절염 연골에 있어서 NF-B 활성화에 의존한 IL-1 유도염증의 치료상에 효과적인 반응억제제임을 시사하며, 골 세포의 골 재흡수 활동에 효과적임을 시사한다.

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Revision after Instability Surgery (수술 후 재발한 견관절 불안정증의 치료)

  • Kim, Paul Shinil;Jo, Chris Hyunchul
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.374-382
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    • 2020
  • Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Rofecoxib: New Drug Profile

  • 한국임상약학회
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.3
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    • pp.140-144
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    • 2000
  • Reofecoxib는 용량 의존적으로 cyclo-oxygenase-2를 선택적으로 억제한다. 골관절염 환자를 대상으로 하여 이중맹검, 무작위, Western Ontario and McMasters Universi-ties Osteoarthritis Index를 이용하여 평가한 결과, rofecoxib 12.5, 25 mg는 신체적 기능을 크게 향상시키는 것으로 보여졌다. 또한 diclofenac (50 mg, 1일 3회), ibuprofen (800 mg, 1일 3회), nabumetone(1500 mg, 1일 1회)와 유사한 임상효과를 나타내었다. Rofecoxib는 원발성 월경곤란증과 수술 후 치통에 효과적으로 억제하였으며 naproxen sodium과 ibuprofen과 같은 진통 효과를 보였다. Rofecoxib는 안전성 면에서 우수하며 가장 흔한 부작용은 설사, 두통, 오심과 상기도 감염증이다. Rofecoxib 12.5, 25, 50 mg/day를 투여한 골관절염 환자에게서 위장관계 부작용(천공, 궤양, 출혈)은 ibuprofen, diclofenac, nabumetone을 투여한 환자보다 훨씬 낮은 발생빈도를 나타내었다.

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당뇨병과 비만

  • 김성래
    • The Monthly Diabetes
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    • s.148
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    • pp.16-17
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    • 2002
  • 비만과 관련된 질환은 당뇨병, 고혈압, 고지혈증, 죽상경화증(동맥경화증), 심근경색증, 지방간, 담석증, 골 관절염, 통풍, 폐쇄성 수면 무호흡증, 대장암, 직장암, 전립선암, 유방암, 자궁내막암 등의 각종 암, 불안, 우울, 적응장애, 히스테리 등의 심리적 질환 등이 있다. 비만이 있을 때 우리 몸에서는 인슐린 자체에 대한 저항성이 생겨서 말초조직에서의 포도당 이용이 감소된다. 연구에 의하면 표준체중의 45$\%$ 이상을 초과한 비만환자는 당뇨병 발생의 위험도가 30배 증가된다고 알려져 있다. 비만이 있을 때 흔히 동반되는 질환들 중 특히 고혈압, 고지혈증, 죽상경화증 등의 질환은 당뇨가 있을 때 흔히 동반될 수 있는 질환들이고, 인슐린 저항성과 깊은 관계가 있는 질환들로 당뇨인들에게 비만은 매우 중요한 질환이라고 할 수 있겠다.

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Bony Bankart lesion (골성 Bankart 병변)

  • Lee, Seung-Jun;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.50-54
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    • 2011
  • A growing number of people are enjoying sports activity with a rise in national income. In this current, many patients complain of traumatic shoulder dislocation and chronic instability with bony Bankart lesion. Computed tomography arthrography is good diagnostic modality for bony Bankart lesion. It is important to consider the patients' factors such as occupation, sports activity, size of preoperative glenoid bone loss before decision of treatment. As development of arthroscopic treatment, there is no significant difference in the result of bony Bankart repair between arthroscopic surgery and open surgery. However, open surgery should be considered for patients with preoperative glenoid bone loss more than 25% or in need of collision sports activity.

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A Study on Developing an Objective Evaluation Method of the Signs and Symptoms of Temporomandibular Joint Internal Derangement (악관절내장증의 증상과 징후의 객관적 평가법의 개발에 관한 연구)

  • 김영구;이승우;정성창
    • Journal of Oral Medicine and Pain
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    • v.22 no.1
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    • pp.31-44
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    • 1997
  • 저자들은 악관절내장증의 증상과 징후의 객관적 평가법을 개발하기 위하여 서울대학교치과 병원 구강진단과 악안면동통진료실을 내원한 환자중 좌우 양 관절중 한 관절 이상의 관절에 악관절내장이 있는 남자 8명(평균연령 19.9$\pm$2.9세), 여자 34명(평균연령:32.8$\pm$11.8세) 총 42명(84개 관절)에 대하여 VAS 및 압통역치 측정, 악관절조영술, 골신티그래피 검사 및 악관절 활액의 분석을 시행하였다. 악관절 동통의 심도는 VAS로 측정을 하였으며 PPT는 electronic algometer로 평가를 하였다. 악관절조영사진을 얻기 직전 활액을 채취하였으며 그 성분중 Hyaluronic acid, 총단백질, IgG, IgM과 albumin을 분석하여 그 상관관계를 분석한 결과 다음과 같은 결론을 얻었다. 1. 악관절 내장증으로 내원한 환자 42명, 총 84개 관절중, 무통성이고 관절잡음이 없는 경우가 7개 관절, 무통성이고 단순관절음만 존재하는 경우가 18개 관절, 동통 및 단순관절음이 존재하는 경우가 18개 관절, 간헐적인 폐구 과두걸림이 있는 경우가 11개 관절, 급성 폐구성 과두걸림의 경우가 11개 관절, 만성 폐구성 과두걸림의 경우가 3개 관절, 퇴행성 관절질환이 존재하는 경우가 16개 관절이었다. 2. 연구대상중 18명의 환자, 총 36개 관절에 대한 골 신티그래피 검사 결과, 활동성으로 나타난 경우가 33개 관절이었고 이중 23개 관절이 동통성이었으며, 활동 상태 관절의 VAS 항목과 압통역치 항목 및 여러 검사 항목들은 비활동 상태 관절의 항목과 유의한 차이를 나타내지 않았다. 3. 악관절내장의 진행정도에 따른 악관절부위의 동통의 측정에 있어서는 압통역치의 측정보다는 VAS에 의한 방법이 더 유용하며 특히, 후방부의 촉진시에 유의한 정보를 얻을 수 있었다. 4. 악관절 내장즈으이 진행 단계에 따라, VAS항목과 압통역치 항목을 비교해 본 결고, 주기적인 과두걸림(II) 단계에서 가장 높은 VAS 수치와 가장 낮은 압통역치를 나타내었으며 상방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계와 증상 및 징후가 없는(0) 단계 사이와 후방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계 및 퇴행성 관절 질환(V) 단계와 증상 및 징후가 없는(0) 단계 사이에서만 유의성을 나타내었다. 5. 활액내 총단백질량, albumin 량, IgG 및 IgM 농도는 악과?ㄹ 내장증의 진행에 따라 유의성을 나타내지는 않았으나 퇴행성 관절 질환(V) 단계에서 증가되는 양상을 나타내었다. 6. 활액내 hyaluronic acid의 농도는 악관절 내장증의 진행에 따라 유의성을 나타내지는 않았으나 만성 폐구성 과두걸림(IV) 단계에서 감소되는 양상을 나타내었다.

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Complete mouth rehabilitation, using jaw motion tracking and double scan technique in a patient with osteoarthrosis: a case report (골관절증 환자에서 하악 운동 추적 장치와 이중 스캔 기법을 활용한 완전 구강 회복 증례)

  • Seo-Kyung Jeong;Jai-Young Koak;Seong-Joo Heo;Seong-Kyun Kim;Ji-Man Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.82-94
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    • 2024
  • This is a case report of complete mouth rehabilitation in a patient with generalized attrition and loss of posterior support. After analyzing the condition of the temporomandibular joint, multiple implants were placed to restore collapsed occlusion. Fixture/abutment level intraoral scanning was done instead of using conventional impression materials which entail multiple bite registration for cross-mounting. A 'jaw motion tracking'device, 'digital face-bow transfer', and 'double scan technique' which enables duplicating temporary restoration to definitive restoration were used to fabricate definitive prostheses. By using various digital techniques, complete mouth rehabilitation was done with minimal chair time in a patient with unstable occlusion.

The Effects of Chewing Difficulty on the Prevalence of Osteoarthritis in Adults Aged 50 Years and Older (50대 이상 성인의 저작불편감이 골관절염 유병에 미치는 영향)

  • Hwang, Su-Hyun;Han, Sam-Sung;Yoo, Wang-Keun
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.145-152
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    • 2015
  • In this study, PASW Statistics ver. 18.0 was used to analyze the correlation between chewing difficulty and osteoarthritis in the population of 8,498 persons aged 50 years and older who had completed the health related questionnaire in the fifth Korea National Health and Nutrition Examination Survey in 2010~2012. The following conclusion was drawn: The distribution of the chewing difficulty status showed that 38.8% of the respondents had chewing difficulty and that there was no significant difference by gender. Older respondents tended to have significantly greater chewing difficulty 34.3% of the respondents aged from 50 to 64 years and 46.4% of those aged 65 years and older, those who had lower levels of education and income, who were smokers, and who had higher levels of depression and stress suffered from significantly greater chewing difficulty. Chewing difficulty and osteoarthritis were correlated with each other: the respondents having chewing difficulty had 1.44 (95% confidence interval [CI], 1.23~1.70) higher prevalence of osteoarthritis than those with no such difficulty. In addition, such correlation was not found in males: the former had 1.36 (95% CI, 0.98~1.88) higher prevalence of osteoarthritis than the latter, which was not statistically significant. Such correlation was found in females: the former had 1.47 (95% CI, 1.22~1.76) higher prevalence of osteoarthritis than the latter, which was statistically significant. Therefore, the chewing difficulty status affected osteoarthritis for females aged 50 years and older. Therefore, the efforts to solve oral health problems through oral hygiene would help prevent osteoarthritis from worsening and manage the condition.

Partial Resection of Osteosarcoma in Proximal Tibia - A Case Report - (근위 경골 골육종의 부분 절제술 - 증례 보고 -)

  • Song, Won-Seok;Lee, Seung-Jun;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.140-145
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    • 2008
  • After limb salvage operation becomes popular, reconstruction method of epi-metaphyseal osteosarcoma is relatively standardized though it may be operator's matter of preference. Most limb salvage techniques presently used are prosthesis reconstruction and osteoarticular allograft. In the case of prosthesis, it is very stable and shows good postoperative functional score, however, finally, it has a weak point of requirement for removal procedure due to failure. In the long run, allograft reconstruction has a good merit. But, it has a weak point of difficulties in securing the demanded size and shape. Allograft reconstruction should be performed only in the case of safe margin and established indication. In limb salvage operation, intercalary reconstruction is useful method in diaphyseal osteosarcoma, however, in metaphyseal osteosarcoma, the indication is not confirmed. We treated 17 year old osteosarcoma patient with localized in the tibial medial condyle with proximal medial condylectomy and pasteurized bone reconstruction in the conviction of safe surgical margin. We report this case because we guess if this procedure may be applied to premature patients, despite failure hemiarthroplasty can be tried successfully.

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