• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.241-252
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• 1997

본 연구는 임상검사 및 방사선 사진상 악관절장애로 진단된 환자중 물리치료,악관절 안정장치 등의 보존적 치료방법을 시행하였으나 증상의 개선이 별로 없는 퇴행성 관절질환이나 중등도의 개구제한을 가진 환자를 대상으로하여 aspirin을 이용한 활액성분 분석 및 악관절 도약술과 sodium hyaluronate의 주입을 시행한후 이에 따른 치료결과를 평가하기 위하여 시행되었다. 평균연령이 31.2세(21-42세)인 11명의 악관절 장애환자를 대상으로 하였다. 악관절 도약술과 sodium hyaluronate의 주입은 악관절의 동통과 개구제한의 해소를 위해 시행되었으며 그 결과를 시술전, 시술 즉시, 시술 1주후 및 4주후로 나누어 분석하였으며 활액 채취시 생리식염수의 희석에 의한 활액성분의 농도 변화에 따른 오차를 막고자 활액과 혈액내의 aspirin의 농도차를 이용하여 정확한 활액 성분농도를 측정하였다. 이상의 연구를 통하여 다음과 같은 결론을 얻었다. 1. 전체 환자의 생리식염수에 의한 악관절 활액의 희석계수는 1.4-12.9(5.5$\pm$4.2)로 상당히 넓은 범위를 나타내었다. 2. 만성 폐구성 과두걸림 환자군(n=7)의 생리식염수에 의한 활액의 희석계수 (6.2$\pm$3.5)는 퇴행성 관절질환을 갖는 환자군(4.4$\pm$5.7, n=4)과 유의한 차이가 없었다. 3. 만성폐구성 과두걸림군과 퇴행성 관절 질환군간의 활액성분의 농도는 유의한 차이가 없었으나 희석계수를 이용한 수정된 Hyaluronic acid와 총단백질의 농도는 만성 폐구성 과두걸림군의 경우에서 유의하게 더 높게 나타났다. 4. 악관절 도약술과 sodium hyaluronate의 주입 직후 만성 폐구성 과두걸림 환자군의 경우 평균 8.3mm의 추가적인 개구 증가로 유의한 차이가 관찰되었고 퇴행성 관절질환의 경우 평균 1.3mm의 추가적인 개구증가가 있었으나 유의한 차이가 관찰되지 못했다. 5. 시술전, 시술 1주후 및 4주후의 여러 검사항목을 비교한 결과 두 군에서 모두 시간의 경과에 따라 기능이상 및 동통 감소의 경향을 나타내었으나 유의하지는 않았으며 만성 폐구성 과두걸림의 경우 기능장애지수(dysfunction index) 와 최대개구시 동통의 정도는 시술전과 시술 4주후간에 유의한 차이가 관찰되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.292-295
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• 2008

Temporomandibular joint cysts usually occur between the second and fourth decade of life. There is a female predominance to male of approximately 3 to 1. The patients complain of swelling, pain and sometimes decreased mouth opening. Synovial cysts of the temporomandibular joint seem to develop by an increase of intraarticular pressure due to trauma or inflammation which causes capsular herniation. However, if inflammatory synovial cysts develop by an increase of synovial fluid into inflammation tissue in the capsule without capsular herniation, a differential diagnosis should include synovial chondromatosis and synovitis. This is a case report of a synovial cyst developed in a capsule of the temporomandibular joint.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.15-20
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• 2010

Purpose: The goal of this study is to find out how useful ultrasonography is in measuring amount of effusion within the knee joint in comparison with physical examination and simple radiography. Materials and Methods: We evaluated total 60 cases which were suspicious for joint effusion. Average age was 61.3 years. The group was consisted of 22 males and 38 females, and 24 obese people and 36 non-obese people. Stroke test and patella floating test were done as physical examination. Amount of joint effusion was classified into 3 groups in simple lateral radiographic view and ultrasonography was used for recheck-up. Results: 39 cases were found positive in stroke test, and patella floating was shown in 20 cases. In simple lateral radiographic view, 47 cases of grade I, 7 cases of grade II and 3 cases of grade III were checked. Average $7.67{\pm}2.90mm$ amount of effusion was checked by ultrasonography. Amount of fluid in stroke test, patella floating test and simple lateral radiographic view showed close correlation with ultrasonography. Gender did not seem to affect physical examination, but strong correlation was found in female in simple radiography. Obese group showed closer relationship with all 3 exams compared with non-obese group. Physical examination was relatively effective with nonobese group, but not with obese group. And it was not easy to measure the amount of fluid with simple radiographic view, but we could obtain objective data from ultrasonography by measuring the amount of effusion dynamically. Conclusion: We concluded that more objective data was obtained with ultrasonography in comparison with physical examinations and simple radiography in the aspect of measuring amount of joint fluid.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.144-149
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• 2009

Chondrocytes and synovial fluid derived markers are used to monitor for osteoarthritis(OA). Specific inhibitors, known as tissue inhibitors of metalloproteinases(TIMP), regulate the proteolytic activity of matrix metalloproteinases(MMP). This study investigated whether MMP and TIMP levels were altered in synovial fluid and cartilage following the experimental induction of OA in canines. Twenty mature beagle dogs underwent a unilateral surgical transection of the cranial cruciate ligament and the medial collateral ligament as well as a medial meniscectomy. Matrix metalloproteinase-2 and MMP-9 levels were assayed using Western blot and TIMP-2 levels were measured with enzyme-linked immunosorbent assays four weeks after OA induction. Increased MMP-2 expression was observed in chondrocytes isolated from cartilage following OA induction, but MMP-9 expression decreased. Matrix metalloproteinase-2 and MMP-9 levels in synovial fluid from the OA induced joint significantly increased compared to those of the sham group. Tissue inhibitors of metalloproteinase-2 concentrations were higher in chondrocytes from the OA cartilage, yet TIMP-2 remained lower in the synovial fluid of OA. This suggests the elevated release of MMP-9 over MMP-2 into the synovial fluid following the cartilage degradation-related death of chondrocytes after OA. Osteoarthritis can be further deteriorated by increased MMP activity in the synovial fluid because TIMP-2 exist low concentration into the extracellular matrix. As a result, MMP activity, particularly MMP-9 activity, can be useful as a biomarker in diagnosing and monitoring the early stages of canine OA.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.7-12
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• 2007

Purpose: The purpose of our study was to determine the concentrations of cytokines in ACL deficient knee, the changes of cytokines from injury as the time progressed, and changes of cytokines after ACL reconstruction. Materials and Methods: Twenty-five patients with ACL-injured knee were enrolled. Synovial fluid lavages were collected at the time of surgery. Before surgery, twenty-five patients were aspirated synovial fluid from their injured and uninjured knees. Twelve patients were aspirated synovial fluid after 9 months postoperatively. The samples were analysed for $IL-1{\beta},\;TNF-{\alpha}$, MMP-3, IL-6 and TIMP-1 using ELISA. Results: The $IL-1{\beta}\;and\;TNF-{\alpha}$ concentrations were below detectable ranges in all uninjured knees and ACL ruptured knees. There were no significant difference between the mean concentrations of the uninjured and ACL injured knees for TIMP-1 and IL-6. The mean concentration of MMP-3 in ACL injured knees was significantly higher than in the uninjured knees. In the 12 cases after 9 months postoperatively, the mean concentration of MMP-3 was no significant difference between preoperative cytokine levels. Conclusion: The concentration of MMP-3 was only higher in the ACL injured knee than uninjured knee and no significant change was examined after 9 months postoperatively.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.16-19
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• 2006

Synovial sarcoma is rare soft tissue tumor mesenchymal origin. Osseous involvement of synovial sarcoma is rare. A 24-year-old man presented with pain and swelling of the lower extremity. MRI of the lower extremity demonstrated a large mass encircling tibia with osseous involvement. Surgical excision of the mass was done and the mass was diagnosed as biphasic synovial sarcoma with bone marrow involvement. We also discuss the other imaging findings of synovial sarcoma on MRI.

• Journal of Acupuncture Research
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• v.19 no.5
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• pp.161-175
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• 2002

봉독은 거풍습(祛風濕), 지통(止痛), 해경평천(解痙平喘), 소종강압(消腫降壓)의 효능으로 오랫동안 통증과 염증성 질환을 치료하는데 이용되어져 왔는데 최근에는 면역관련질환치료에 응용하여 좋은 결과가 보고되고 있다. 본 연구는 Rheumatoid arthritis와 유사한 형태의 대표적 실험모델로 알려진 실험용 쥐의 Type II collagen 유발 관절염(Type II collagen induced arthritis : CIA)의 활액에서 봉독약침이 단백분해효소와 유리기 손상에 미치는 면역억제효과를 알아보기 위해 실행되었다. 본 실험에서는 CIA가 유발된 실험용 쥐에 봉독약침($5{\mu}l/kg$)을 처리한 실험군과 대조군으로서 CIA 유발 쥐에 생리식염수를 처리한 군(CIA군), 정상적인 쥐에 생리식염수로 처리한 군(정상군)으로 구분하여 각 군들의 일련의 표본에서 세포질, 리소좀, 간질성 단백분해효소의 활성과 유리기로 인한 단백질 손상정도를 (carbonyl 유도체를 측정하여)서로 비교하였다. 그 결과 각 군의 활액표본에서는 많은 종 류의 단백분해효소가 정산군보다 CIA군에서 유의하게 활성이 높았으며, 봉독약침($5{\mu}l/kg$)을 처리한 군에서 효소들의 활성이 유의하게 감소하였다. 그러나 각 군들의 혈장표본에서는 이 효소들의 활성은 서로 유의한 차이가 없었다. 이는 혈장속의 면역반응과 연관되리라고 추측되는 단백분해효소들의 활성변화는 병인적 측면에서 RA와 같은 염증성관절 질환과는 큰 상관성이 없다는 것을 의미한다. Carbonyl 유도체 측정으로 평가한 유리기 손상은 활액과 현장표본에서 모두 봉독약침($5{\mu}l/kg$)을 처리한 군에서 유의성 있게 감소하였다. 이상의 결과로 볼 때 단백분해효소와 유리기의 활성은 RA의 병인학적 측면에서 모두 잠재적인 중요성을 가지고 있으므로 향후 새로운 RA치료법은 이들 단백분해효소의 활성저해와 유리기의 소거능을 포함해야 한다고 사료되며 봉독약침은 이러한 2가지 효능을 포함한 효과적인 치료라고 평가된다.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.162-172
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• 2021

Purpose We retrospectively evaluated the technical success rate and long-term efficacy of fluoroscopy-guided synovial cyst rupture followed by an intra-articular steroid injection at the post-laminectomy lumbar facet. Materials and Methods We selected subjects who had undergone a fluoroscopy-guided synovial cyst rupture with simultaneous intra-articular steroid injection within 6 months of MRI and demonstrated a symptomatic facet joint synovial cyst at the level of a previous lumbar laminectomy. Fourteen patients were enrolled, and we determined whether cyst rupture and symptom improvement were achieved after each procedure. The degrees of symptom improvement were categorized into 4: 1) symptoms improved (30% or more reduction, based on pre-procedural and post-procedural Numerical Pain Rating Scale scores), 2) symptoms not improved, 3) patient underwent surgery after injection, and 4) loss of follow-up. Results The success rate of percutaneous synovial cyst rupture decreased with repeated procedures (62.5% for the first procedure and 0% to 33.3% for additional procedures). However, 80% of the patients had symptom improvement with the procedures, overall. The surgery rate was 14.3% in 14 patients. Conclusion For patients with post-laminectomy symptomatic lumbar facet joint synovial cysts, fluoroscopy-guided synovial cyst rupture with intra-articular steroid injection may be an effective and less invasive treatment before considering a surgical approach.

• Journal of the Korean Society for Precision Engineering
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• v.25 no.10
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• pp.137-143
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• 2008

The objective of this study was to characterize the role of synovial fluid and hyaluronan in the frictional response of bovine articular cartilage. Seven cylindrical cartilage specimens were harvested from three fresh bovine humoral heads (4-6 months old). Reciprocal sliding motion (1mm/s) was provided by a custom-made friction testing apparatus with a normal load of 22.3 N. From the measured time-dependent normal and frictional forces, the minimum and maximum frictional coefficients were calculated. Synovial fluid reduced the minimum frictional coefficient by ${\sim}75$ % and maximum frictional coefficient by ${\sim}11%$, while the reduction of the minimum and maximum frictional coefficients with hyaluronan was ${\sim}42%$ and ${\sim}24%$, respectively. To the best of our knowledge, this experimental study investigates the first such comparisons of frictional response of articular cartilage with and without synovial fluid and hyaluronan, and provides significant insights into their role in the articular cartilage friction and lubrication.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.454-457
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• 1996

The Incidence of synovial sarcoma Is very low but sarcoma Is a well-defined entity, which occurs primarily around large Joints and usually in association with tendon sheaths, bursae or the capsule. Recently we experienced a case of synovial sarcoma which invaded the right femoral vein of 433 5-year-old man. The tumor was widely excised incl ding the invaded femoral vein, and vein reconstruction was done using saphenous vein graft. The postoperative course was uneventful without intractable edema nor disability.