• 제목/요약/키워드: 완관절

검색결과 122건 처리시간 0.027초

수부에서 발생한 건초의 거대 세포종 (Giant Cell Tumor of Tendon Sheath in Hand)

  • 강호정;김기학;신규호;한수봉;강응식
    • 대한골관절종양학회지
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    • 제7권1호
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    • pp.20-27
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    • 2001
  • 목적 : 건초에서 생긴 거대세포종은 수부에서 발생하는 종양 중 두 번째로 흔하나 절제술 후에 재발이 드물지 않으며 국내에서의 연구는 많지 않다. 이에, 저자들은 완관절부를 포함한 수부에 생기는 건초의 거대세포종의 임상적 특성과 수술적 치료후 결과를 분석하여 문헌고찰과 함께 보고하고자 한다. 대상 및 방법 : 1991년부터 1998년까지 수부에서 발생한 종물로 절제생검술을 시행받은 환자 중 조직병리학적으로 건초의 거대세포종으로 진단받은 총 38명, 41예에 대해 성별, 나이, 증상, 증상발현기, 종양이 발생한 부위, 발생한 건, 크기, 다발성 여부, 양측성 여부, 방사선학적 소견 및 골 침범, 재발여부 등에 대해 분석하였으며, 추시기간은 평균 13.1개월(5~40개월)이었다. 결과 : 38명 중 여자에서 29명으로 빈발하였고, 발생연령은 6세에서 66세까지 다양하였으나 50대에서 12례로 가장 호발하였으며 평균연령은 40.1세였다. 지배수지와 비지배수지의 발생경향은 비슷하였고(17례:21례), 모두 일측성이었다. 신전건(17례)보다 굴곡건(24례)에서 더 호발하였으며 증상발현기는 2개월에서 120개월(평균 23.4개월)이었다. 증상으로 대부분 무통성 종물을 호소하였으나, 5례에서 압통, 36례에서 운동장애, 5례에서 압박에 의한 신경증상을 호소하기도 하였다. 재발을 주소로 내원한 경우가 3례였다. 부위별 발생빈도는 수지에서 36례, 수장부에서 3례, 완관절부위 장측에서 2례 순으로 빈발하였으며, 수지별 발생빈도는 인지에서 14례(34%)로 가장 많았고, 엄지가 10례(24%), 중지는 9례, 환지는 5례, 소지는 3례의 빈도순을 보였다. 수지상 발생부위는 원위지골간 관절부 및 중위지골부에서 20례(48.8%), 근위지골 및 근위지골간 관절부가 9례, 중수지절관절부가 7례 순으로 호발하였다. 방사선학적 소견상 연부조직에 방사선 비투과적인 균일한 연부조직 음영을 보이고 있었고 3명에서 피질골 미란을 보였다. 37명에서 종양은 단발성 병변이었으나 이 중 4명에서 다엽상으로 넓게 분포하였고, 1명에서 다발성 병변을 보였다. 변연부 절제술후 재발된 경우가 2명으로 재발율은 5.1%였다. 결론 : 수부에서 발생한 건초의 거대 세포종은 호발조건으로 50대, 여성, 인지, 굴곡건, 수지 원위부를 추정해 볼 수 있었으며, 불완전한 변연부 절제술을 시행하거나, 수술 후 재발한 경우, 다발성, 다엽상 소견을 보인 경우 재발이 잘 되므로 이 경우 광범위 절제술이 필요할 것으로 사료된다.

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완관절(腕關節) 결정종(結節腫)에 대한 배담(排痰)·양자침구치료(揚刺鍼灸治療)의 임상적(臨床的) 관찰(觀察) (Clinical Study on Wrist Ganglion by Newly Transformed Centro-Square Acupuncture·Moxibustion)

  • 김기현
    • Journal of Acupuncture Research
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    • 제17권4호
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    • pp.113-119
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    • 2000
  • Objectives : Wrist ganglion is one of the most common diseases on the wrist joint. So far acupuncture, medication, drainage and local anesthetic excision therapy have been used for this disease, but the development of more effective treatment method is being expected because of frequent recurrence and side effect. Considered that most ganglion is polycystic, on the basis of classic centro-square acupuncture, newly transformed centro-square acupuncture was applied to this report. Methods : All the patients with wrist ganglion was divided into two groups. Newly transformed centro-square acupuncture was app(ied to one group composed of 11 patients and classic centro-square acupuncture to the other group with 19 patients. Classic centro-square acupuncture is made up of slanting and straight insertion. the former is a method that tips of 4 needles are inserted from the outersurface of wrist ganglion oriented to the center of the ganglion, the latter is that tip of one needle is inserted on the center of the ganglion straightly. In the newly transformed centro-square acupuncture, straight insertion of dry needle was taken place of by syringe needle in order to drain phlegm. In this report, classic and newly transformed centro-square acupuncture were used somewhat differently from original ones. Moxibustion was applied after removing all the needles. In newly transformed centro-square acupuncture, moxibustion was also applied after drainage of phlegm and slanting insertion. Results : 1. Wrist ganglion was frequently developed around the acupoint of Tae-Yeon(Tai Yuan, LU9) and Yang-Ji(Yang Chi, TE4) and the difference between occurrence of development on the left and right hand had no significancy. 2. The mean number of treatment for recovery : The newly transformed centro-square acupuncture had fewer treatment than classic one. 3. The newly transformed centro-square acupuncture was more effective than classic one. 4. As a result of following up 6 to 72 months after wrist ganglion had been eliminated, there was no recurrence. Conclusion : In the treatment of wrist ganglion, newly transformed centro-square acupuncture can be regarded as more useful method in the clinical practice, because it has comparatiely shorter duration of treatment and is more effective.

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하악에서 완압형 자성 어태치먼트를 부착한 임플란트-자연치 피개 의치: 10년 증례보고 (Mandibular implant-natural tooth retained overdenture using magnetic attachment with stress breaker)

  • 박은철;이수연;김희중
    • 구강회복응용과학지
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    • 제31권4호
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    • pp.378-386
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    • 2015
  • 피개 의치는 의치의 안정과 유지력 증가라는 장점을 갖지만 지대치가 우식 또는 치주질환에 이환되기 쉬우며 의치의 두께가 얇아짐으로써 의치가 파절되기 쉽다는 단점도 갖고 있다. 자성 어태치먼트 피개 의치는 수직적 유지력은 크지만 수평적 유지력은 작으므로 지대치나 임플란트에 덜 위해한 힘을 가하며, 다른 기계적 유지장치에 비해 마모나 파손 등이 적다는 장점이 있다. 피개 의치에서 나타나는 의치의 파절은 의치상의 두께가 얇아져서 발생하기도 하지만, 연조직과 경조직, 임플란트와 자연치의 압하량 차이로 인해 발생하기도 한다. 이를 보상하기 위해 silicone ball이 자석 안에 삽입되어있는 자성 어태치먼트가 개발되었으며, 이를 이용해 피개 의치를 제작한 증례에서 우수한 결과가 나타나 보고하고자 한다.

개에서 발생한 주관절 탈구와 완관절 아탈구의 방사선학적 진단 (Radiological Diagnosis of Elbow Luxation and Subluxation of Carpal Joint in the Dog)

  • 김상기;이정길;박인철
    • 한국임상수의학회지
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    • 제11권1호
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    • pp.369-376
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    • 1994
  • The purpose of this report Is to discribe the radiological findings of traumatic elbow luxation and subluxation of carpal joint which were caused by being hit by a wild animal and forced hyperextension of carpus in two hunting dogs. In case 1, carniocaudal and mediolateral radiographic examination of the elbow joint revealed that the radius that the radius and ulna were completely luxated laterally. The lateral projection showed the humeral condyles overlying the radial head with an absent joint space, but displacement is apparent on the craniocaudal projection. Incidence of collateral ligament rupture in conjunction with elbow luxation was not recognized on physical examination of the limb after closed reduction. Radiographic examination of the elbow made 5 months after closed reduction revealed only mild degenerative joint disease. Radiographic examination of the carpus in case 2 demonstrated palmar subluxation of most carpal joints including antebrachiocarpal, mediocarpal carpometacarpal joints, and some intercarpal joints, and avulsion fracture of the palmar surface of the accessory carpal bone. However, the mediocarpal and carpometacarpal joints were most severely affected by tensile forces of hyperextension, and it was concluded that the ligaments of the middle ca,pal joints and carpometacarpal joints as well as the palmar fibrocartilage were ruptured based on clinical and radiographic findings. In elbow luxation and subluxation of carpal Joints of the dog, differentiation of the joint or joints involved, and ligamentous structures damaged is important in determining whether surgery Is necessary and which procedure is most appropriate. And the radiographic findings of these conditions would be of help to practitioners.

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완관절 초음파통과속도를 이용한 골연령 측정값과 X-ray영상을 이용한 골연령 측정값의 비교 (A study on growth and development of children by Ultrasound transonic velocity of inferior radiocarpal joint)

  • 고덕재;유한정;이진용;김덕곤;윤경희
    • 대한한방소아과학회지
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    • 제19권2호
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    • pp.165-174
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    • 2005
  • Objectives : The purpose of this study was to suggest a new method for measurement of children's growth development Ultrasound transonic velocity of inferior radiocarpal joint has some advantages that it is harmless to human body and apply a new analysis algorithm, it can be used for the diagnosis of bone age. Methods: This clinical study have been carried out with the 117 case(male 68, female 49) of the children aged 5 to 16 years old who visited in Department of Pediatrics, ${\bigcirc}{\bigcirc}$ university Oriental Hospital. Bone maturity is measured by Ultrasound transonic velocity and X-ray image of growth plate in inferior radiocarpal joint. This study were designed to investigate the relationship of the bone age by Ultrasound transonic velocity and X-ray image. Result & Conclusion : The maturity of growth plate of inferior radiocarpal joint was correlated with age, height, weight, BMI in this study(P<0.001). The Ultrasound transonic velocity of inferior radiocarpal joint are sufficient diagnostic worth as an index to predict bone maturity.

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민들레 뿌리 물 추출물의 류마티스 관절염 동물 모델에 대한 개선 효과 (Water Extract of Taraxaci Radix Improves Rheumatoid Arthritis Induced by Type-II Collagen in Animal Models)

  • 노종현;이현주;장지훈;양버들;김아현;우경완;황태연;서재완;조현우;정호경
    • 한국약용작물학회지
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    • 제27권1호
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    • pp.38-44
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    • 2019
  • Background: Taraxacum platycarpum has been used in traditional medicine in Korea to treat intoxication and edema and as a diuretic. According to previous reports, it has anti-cancer, anti-gastritis, and anti-inflammation effects. However, the improvement effect of T. platycarpum on rheumatoid arthritis has not been investigated. The anti-oxidative and anti-inflammation effects of the aerial parts of T. platycarpum are different from those of its subterranean parts. Thus, we evaluated the effect of the water extracts of Taraxaci radix (WTR) on type II collagen-induced rheumatoid arthritis (CIA) in animal models. Methods and Results: Rheumatoid arthritis was induced by type II collagen. WTR (100 mg/kg and 500 mg/kg) was administered to the animal models. Methotrexate was used as the positive control. The levels of interleukin-6, TNF-alpha, and type II collagen IgG in the animals were measured by using enzyme-linked immunosorbent assay. Treatment with 500 mg/kg WTR decreased the serum levels of interleukin-6, TNF-alpha, and collagen IgG in the CIA models. Moreover, treatment with WTR diminished the arthritisinduced swelling of the hind legs and monocyte infiltration in the bloodvessels of the animal models. Conclusions: These results indicate that WTR has the potential to improve rheumatoid arthritis by reducing the levels of inflammatory cytokines such as interleukin-6 and TNF-alpha. However, further experiments are required to elucidate the influence of WTR on signal transduction in vitro and in vivo.

앉았다 일어나는 동작동안 단축회전반경 무릎인공관절 수술자와 다축회전반경 무릎인공관절 수술자의 운동역학적 비교분석 (A Biomechanical Comparative Analysis between Single-Radius and Multi-Radius Total Knee Arthroplasty for Sit-to-Stand Movement)

  • 진영완
    • 생명과학회지
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    • 제16권5호
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    • pp.773-779
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    • 2006
  • 단축범위 무릎인공관절 수술자와 다축범위 무릎인공관절 수술자를 대상으로 앉았다 일어나는 동안 운동학적 및 운동역학적 요인들을 비교분석한 결과는 다음과 같다. 앉았다 일어나는 동작은 다축범위 수술자 집단이 단축범위 수술자 집단보다 0.19초(p= 0.033) 빠르게 나타났다. 최대상체 굴곡각도는 다축범위 수술자 집단이 단축범위 수술자집단 보다 $10^{\circ}(p=0.014)$정도 크게 나타났다. 상체굴곡 각속도는 다축범위 수술자 집단이 단축범위 수술자 집단보다 $7^{\Omega}{\cdot}S^{-1}$(p= 0.058)빠르게 나타났다. 단축범위 수술자 집단과 다축범위 수술자 집단의 ADD와 ABD의 차이는 거의 없었다. 대퇴사두근의 근전도분석은 내측광근은 무릎굴곡각 $60^{\Omega}-15^{\Omega}$(p<0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 외측광근은 무릎굴곡각 $60^{\Omega}-45^{\Omega}$(p<0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 대퇴직근의 값은 무릎굴곡각 $60^{\Omega}-30^{\Omega}$(p<0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다. 대퇴이두근의 값은 무릎굴곡각 $75^{\Omega}-15^{\Omega}$(p<0.05)에서 단축범위 수술자 집단 근전도 값이 다축범위 수술자집단 근전도값 보다 작게 나타났다.

측두하악관절의 초음파영상과 자기공명영상에서 하악과두 외측면과 관절낭간 거리 측정치 비교 (Comparison of the capsular width measured on ultrasonogrape and MR image of the temporomandibular joint)

  • 이태완;유동수;한원정;김은경
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.41-48
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    • 2006
  • Purpose : To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). Materials and Methods : Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. Results : The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were $2.0{\pm}0.7mm,\;1.8{\pm}0.5mm$, respectively (p<0.05). On the ultrasonographs, the distances at open mouth position were $1.2{\pm}0.5mm$ (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were $1.3{\pm}0.3\;mm\;and\;0.9{\pm}0.2\;mm$ (p<0.05). Conclusion : The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.

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상완골 간부 골절에 동반된 요골신경손상에 대한 치험 1례 (A case study of radial nerve injury associated with humerus shaft fracture)

  • 이재은;이정민;오민석
    • 혜화의학회지
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    • 제23권1호
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    • pp.157-166
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    • 2014
  • 상완골 간부 골절에 동반된 요골신경 손상을 가진 1명의 환자를 대상으로 "내경(內經)"의 독취양명치법(獨取陽明治法)에 따라 침구치료, 약침치료, 물리치료와 한약치료를 병행하였다. 손목관절의 하수 및 근력약화에 대한 치료성적으로 평가하기 위해 완관절의 운동범위와 능동저항검사를 통한 상대적인 지수를 평가하였으며, 요골신경마비로 인한 장악력의 약화정도는 악력측정기를 사용하여 평가하였다. 수지의 비증의 정도는 Numeric Rating Sclae(NRS) 사정법에 따라 평가하였다. 환자는 발병일로부터 약 6주째에 첫 회복징후를 보이기 시작하였으며, 발병이로부터 약 11.5주째에 가벼운 물건에 대한 집게운동이 가능하며 일상생활을 하는데에 큰 지장이 없는 수준으로 회복되었다. 이는 상완골 간부 골절이 동반된 요골신경손상의 자연회복시기보다 빠른 것으로, "내경(內經)"의 독취양명치법(獨取陽明治法)에 따른 한방치료요법이 상완골 골절에 동반된 요골신경손상의 치료에 효과가 있음을 알 수 있었다.

원위부 중족골 쉐브론 절골술을 이용한 무지 외반증의 치료 (Treatment of Hallux Valgus with Distal Chevron Metatarsal Osteotomy)

  • 안재훈;최원식;김하용;이도현;배경완
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.124-128
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    • 2009
  • Purpose: The authors intended to analyze the operative results of mild to moderate hallux valgus treated with distal chevron metatarsal osteotomy. Materials and Methods: Twenty six feet of twenty three patients were followed for more than 1 year after the distal chevron metatarsal osteotomy. Biplanar osteotomy with wedge resection was done when the distal metatarsal articular angle (DMAA) was increased. The mean age was 39 years, and the mean follow up period was 27 months. Clinically preoperative and postoperative AOFAS hallux MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, the 1st intermetatarsal angle, DMAA and sesamoid position before and after the operation were analyzed. Results: Distal chevron osteotomy was done in 15 cases and biplanar osteotomy was done in 11 cases. Clinically AOFAS scale was increased from 65.3 points preoperatively to 92.2 points postoperatively. Two patients were not satisfied with the results. Radiologically hallux valgus angle was decreased from $21.9^{\circ}$ preoperatively to $8.5^{\circ}$ postoperatively. The first intermetatarsal angle was decreased from $11.8^{\circ}$ preoperatively to $6.7^{\circ}$ postoperatively. DMAA was decreased from $11.8^{\circ}$ preoperatively to $5.5^{\circ}$ postoperatively. There was one case of minor wound infection. Conclusion: Distal chevron metatarsal osteotomy appears to be safe and satisfactory procedure for mild to moderate hallux valgus.

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