• Title/Summary/Keyword: 무릎관절증

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Clinical Application of Autologous Adipose Tissue Derived Mesenchymal Stem Cells in Five Dogs with Stifle Joint Osteoarthrosis (무릎 골관절증을 보이는 개에서 자가지방유래 중배엽성 줄기세포 치료 다섯 증례)

  • Yoon, Hun-Young;Kang, Dong Jun;Lee, Soo-Han;Jeong, Soon-Wuk;Chung, Byung-Hyun
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.253-257
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    • 2014
  • Five dogs presented with a history of pelvic limb lameness. On physical examination of the stifle joints, five dogs had pain, lameness, patellar luxation, or ligamentous instability. Craniocaudal and mediolateral radiographic projections revealed osteophytes or subchondral cystic lesions on the stifle joints. Based on a previously described Osteoarthrosis (OA) scoring technique, five dogs showed high OA scores. Combination of surgery and implantation of autologous adipose tissue derived mesenchymal stem cells (aAT-MSCs) or percutaneous injection of aAT-MSCs was determined with informed consent. $1{\times}10^6$ aAT-MSCs suspended in PBS was injected in the stifle joints. The follow-ups were completed 12 months after surgery. The follow-up information was based on physical examination by veterinarians. The lameness, pain on manipulation, and OA scores improved six or 12 months after implantation of aAT-MSCs. There was a radiographic evidence of decreased osteophytes and subchondral cystic lesions. These results suggest that implantation of aAT-MSCs can be considered an option for management of cases of OA in the stifle joints.

Diagnostic Criteria to Differentiate Medial Meniscal Injury from Degenerative Changes on $^{99m}Tc-MDP$ Knee SPECT in Patients with Chronic Knee Pain (만성 무릎관절 통증환자에서 내측 반월상연골 손상과 관절 퇴행성 변화의 감별을 위한 $^{99m}Tc-MDP$ 무릎관절 SPECT의 진단기준)

  • Paeng, Jin-Chul;Chung, June-Key;Jeong, Hwan-Jeong;Yoo, Jae-Ho;Kang, Won-Jun;So, Young;Lee, Dong-Soo;Lee, Myung-Chul;Seong, Sang-Cheol;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.103-109
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    • 2003
  • Purpose: In patients with chronic knee pain, the diagnostic performance of $^{99m}Tc-MDP$ knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake is increased in medial compartment. Materials and Methods: A total of 49 knee SPECT of the patients with chronic (more than 3 months) knee pain, which showed increased $^{99m}Tc-MDP$ uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. Results: The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improved diagnostic performance, especially, specificity. Conclusion: In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.

Long-term Follow-up after Implantation of Autologous Adipose Tissue Derived Mesenchymal Stem Cells to Treat a Dog with Stifle Joint Osteoarthrosis (골관절증을 보이는 개에서 자가지방 유래 줄기세포 치료 증례)

  • Yoon, Hun-Young;Lee, Jung-Ha;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.82-86
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    • 2012
  • A 5-year-old castrated male Chihuahua weighing 1.54 kg was examined because of a several month history of progressive right hind limb lameness. Physical examination of the stifle joints revealed pain and a grade IV medial patellar luxation on the right stifle joint. The right and left stifle joints were associated with a lameness of grade 2 and grade 0, respectively. Radiography revealed osteophytes or subchondral cystic lesions on the right and left stifle joints. Osteoarthrosis (OA) scores for the right and left stifle joints were 20 and 12 respectively. Combination of surgery and implantation of autologous adipose tissue derived mesenchymal stem cells (aAT-MSCs) was determined with informed consent. $1{\times}10^6$ aAT-MSCs suspended in PBS and 0.6 mL of hyaluronic acid were injected in the right stifle joint postoperatively. Osteoarthrosis scores and the lameness grade for the right and left stifle joints were 19 and 13, and 0 and 0 19 months after treatment, respectively, and 14 and 15, and 0 and 0 five years after treatment, respectively. This case report shows radiographical evidence of a decrease in osteophytes and subchondral cystic lesions on the stifle joint with OA after aAT-MSCs injection.

침치료에 대한 환자진료 평가 프로그램-독일 보험회사들의 침효과에 대한 검증-

  • Melchart, Dieter
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.33-34
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    • 2003
  • 배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

Systematic Diagnosis and Long-term Care of Cardiopulmonary Disease (심폐기 질환의 체계적인 진단과 장기-치료 관찰)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.171-178
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    • 1998
  • K14 patient with chronic dyspnea, who is senile female, early had suffered from radical mastectomy, radiotherapy, autoplastic transplantation, and knee arthritis. Abnormalities of cardiopulmonary function such as obesita, hypertension, mild left ventricular hypertrophy, and chronic pulmonary disease were found from K14 patient's clinical datas, which based on medical history and diagnosis, as well as evaluation of blood pressure, obesity, clinical diagnosis, chest PA, electrocardiogram, ultrasonocardiograph, and spirometery test. Diagnostic results were exactly analyzed, also long-term cares of K14 patient were discussed with related to the clinical literatures.

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The Effect of Radiation Therapy on hemophilic Athropathy (혈우병성 관절증에 대한 방사선 치료의 역할)

  • Kang Jin Oh;Hong Seong Eon;Kim Sang Gi;Shin Dong Oh
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.106-110
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    • 2005
  • Purpose : Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. Materials and Methods : From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at Kyung Hee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. Results : There was a tendency of frequent bleeding for the Patients younger than 11 (p=0.051) but there was also a tendency for more improvement in this group (p=0.057). The number of joint bleedings was related with joint pain (p=0.012) and joint swelling (p=0.033) but not with the Arbold-Hilgartner stage (p=0.739), cartilage destruction (p=0.718) and synovial hypertrophy (p=0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy (p=0.017). Conclusion : Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.

Comparison of Postural Alignment and Foot Pressure Balance according to the Dysmenorrhea Degree in 20's Women (20대 여성의 월경곤란증 정도에 따른 자세 정렬과 족저압 균형에 대한 비교)

  • Park, Sieun;Kim, Da-Jeong;Choi, Yoo-Rim
    • The Journal of the Korea Contents Association
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    • v.22 no.3
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    • pp.576-585
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    • 2022
  • In determining the cause of dysmenorrhea, it is necessary to investigate postural alignment and balance. The purpose of this study is to compare and analyze whether there is a difference in posture alignment and foot pressure balance according to the dysmenorrhea degree. The subjects were twenty female students in their 20s, who had pain caused by dysmenorrhea. According to the degree of dysmenorrhea, the subjects were divided into mild and severe groups. In the results, there was a significant difference only in shoulder height asymmetry angle between the mild and severe groups (p<0.05), and there was no significant difference in pelvic and knee joint alignment. In the correlation analysis, there was a significant positive correlation between the dysmenorrhea score (MDQ) and shoulder height asymmetry angle was found. These results indicate that dysmenorrhea symptom and asymmetric alignment of shoulder are related. To analyze these factors, further research will need to investigate the correlation between dysmenorrhea and spinal alignment.

Effects of Radiation Mutant Perilla frutescens var. crispa in Preventing and Alleviating Symptoms in a Monosodium Iodoacetate-Induced Osteoarthritis Rat Model (MIA로 퇴행성관절염을 유도한 랫드에 방사선 형질전환 차조기가 증상 예방 및 완화에 미치는 효과)

  • Sim, Boo-Yong;Joo, In-Hwan;Kim, Sung-Kyu;Ji, Joong-Gu
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.4
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    • pp.830-838
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    • 2020
  • The present study aimed to evaluate the effect of radiation mutant Perilla frutescens var. crispa on bone metabolism and the inflammatory response in a monosodium iodoacetateinduced rat model of osteoarthritis. radiation mutant Perilla frutescens var. crispa was administered orally at doses of 25, 50 or 100 mg/kg/day for 2 weeks before direct injection of monosodium iodoacetate (3 mg/50 μl of 0.9% saline) into the intra-articular space of the rats' right knees. The rats subsequently received the same doses of oral radiation mutant Perilla frutescens var. crispa for another 4 weeks. It was evaluated that the treatment effects based on serum biomarkers, and morphological and histopathological analysis of the knee joints. Compared with those in control rats, the radiation mutant Perilla frutescens var. crispa treatments significantly reduced the serum levels of inflammation, bone metabolism markers (i.e., COX-2, LTB4, MMP-3, and COMP), and the amount of fibrous tissue. Otherwise, it was significantly increased the concentration of TIMP-1 and calcitonin. In addition, the radiation mutant Perilla frutescens var. crispa treatments effectively preserved the knee cartilage and synovial membrane. As a result, it indicates that radiation mutant Perilla frutescens var. crispa prevented and alleviated osteoarthritis symptoms. Thus, radiation mutant Perilla frutescens var. crispa can be used in food and drug material for the management of osteoarthritis.

Evaluation of the Usefulness of Assist Device for Rosenberg View Test (Rosenberg View 검사를 위한 보조기구의 유용성 평가)

  • Kong, Chang gi;Song, Jong Nam;Kim, In Soo;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.2
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    • pp.129-138
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    • 2020
  • Due to the nature of the Rosenberg Method, the patient needs to maintain posture for a certain period of time, and the joint space is observed in various forms depending on the angle of knee flexion, which causes difficulties in examination. In order to solve these problems, Image quality was evaluated in order to evaluate the usefulness of the assistive device by making the assistive device itself. SNR and CNR analysis about the presence or absence of an assistive device using the extremity phantom and the angle of the assistive device itself were not statistically significant(p < 0.05). As a result of measuring the distance between the right and left edges of the medial condyle based on the presence or absence of an assist device, and the absence of assist device (96.00±40.6 mm) and presence of an assist device (134.86±17.68 mm) were statistically significant (p <0.05). To find the aLDFA relationship about the femur and tibia, we measured the right and left aLDFA based on the presence or absence of assist device. As a result, the absence of the right-side aLDFA assist device (74.63°±4.87) and the presence of assist device (79.64°±3.65) were statistically significant (p <0.05). The absence of the left-side aLDFA assist device (76.39°±4.62) and the presence of assist device (79.64°±3.65) were statistically significant (p < 0.05). but, As a result of measuring the distance of the overlapping parts of the right and left proximal tibiofibular joint and the lateral condyle, There were no statistically significant differences between the right and left sides. In conclusion, we confirmed that we can obtain Diagnostically valuable images with a constant knee-to-knee spacing using an assist device we self-created. In addition, we could learn through aLDFA relationship between femur and tibial that the smaller the angle, the more medial condyle overlaps with JSW, We also confirmed the significance by deriving similar values on the normal range values of aLDFA using assist devices. However, it is considered necessary to pay attention to internal and external rotations in order to obtain good quality images by evaluating the distance of overlapping parts between proximal tibiofibular joint and lateral condyle.

Factors affecting the Length of Stay in Patients with Total Knee Arthroplasty (슬관절 전치환술 환자의 재원일수에 영향을 주는 요인)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.201-208
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    • 2020
  • The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.