• Title/Summary/Keyword: Internal derangement

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Discoid Medial Meniscus - case report - (내측 원판형 연골 1례 보고 - 증례 보고 -)

  • Bae, Dae Kyung;Yim, Chang Moo;Chun, Young Soo
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.177-180
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    • 1998
  • Discoid meniscus is an uncommon cause of internal derangement of the knee joint. The discoid medial meniscus is much less common than the discoid lateral meniscus. A 15-year-old male student had a incomplete discoid medial meniscus of right knee combined with a horizontal tear. This was confirmed by magnetic resonance imaging(MRI) and arthroscopic procedure. Partial meniscectomy was performed arthroscopically. An unevenful recovery followed. We report a case of discoid medial meniscus with brief review of literature.

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A STUDY ON TEMPOROMANDIBULAR JOINT DYSFUNCTION WITH MAGNETIC RESONANCE IMAGING AND ARTHROGRAM (자기 공명 영상장치를 이용한 악관절 기능 장애에 관한 연구)

  • Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.1
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    • pp.7-14
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    • 1993
  • The Internal derangement of temporomandibular joint disc was evaluated by using magnetic resonance imaging and arthrogram in 5 patients having reciprocal clicking or locking and in 5 normal subjects. Parasagittal multisections on both closed and open mouth were serially obtained by using a 1.5 Tesla MR system and surface coil with CSMEMP, MPGR. MR images obtained were analized by correlating with images of arthrograms. The obtained results were as follows: 1. Displaced meniscus was clearly delineated as dark structure on MR images other than on arthrograms of closed mouth view of patient having clicking or locking. 2. The deltoid white images of synovial fluid were identified in the glenoid fossa and on the posterior surface of condyle on open mouth view and partly depicted on closed mouth view, of parasagittal sections by MPGR. 3. The greyish image of joint fluid was identified on the posterior surface of condyle on the open mouth view of parasagittal sections by CSMEMP. 4. The structural relationship among condyle, meniscus, and fluid showed the variety of images on each parasagitta1 view.

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The Effects of Endothelin Receptor Antagonist on Hemodynamic and Respiratory Mechanics in Experimental Acute Pulmonary Thromboembolism (실험적 급성 폐색전증에서 Endothelin 수용체 길항제가 혈류 및 호흡 역학에 미치는 영향)

  • Lee, Ji-Hyun;Jeon, Yong-Gam;Choe, Kang-Hyeon;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.210-222
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    • 2000
  • Background: Endothelin(ET) is the most potent vasoconstrictor and bronchoconstrictor. The plasma ET-1 level is elevated in patients with acute pulmonary thromboembolism(APTE). This finding suggest that ET-1 may be an important mediator in the cardiopulmonary derangement of APTE. But whether ET-1 is a pathogenic mediator or a simple marker of APTE is not known. The role of ET-1 in the pathogenesis of cardiopulmonary dysfunction in APTE(delete) was investigated through an evaluation of the effects of $ET_A$-receptor antagonist on APTE. The increase in local levels of preproET-1 mRNA and ET-1 peptide in the embolized lung was also demonstrated. Methods: In a canine autologous blood clot pulmonary embolism model, $ET_A$-receptor antagonist(10 mg/kg intravenously, n=6) was administered one hour after the onset of the embolism. Hemodynamic measurements, blood gas tensions and plasma levels of ET-1 immunoreactivity in this treatment group were compared with those in the control group(n=5). After the experiment., preproET-1 mRNA expression(using Northern blot analysis) and the distribution of ET-1(by immunohistochemical analysis) in the lung tissues were examined. Results: The increases in pulmonary arterial pressure and pulmonary vascular resistance of the treatment group were less than those of the control group. Decrease in cardiac output was also less in the treatment group. Complications such as systemic arterial hypotension and hypoxemia did not occur with the administration of $ET_A$-receptor antagonist The plasma level of ET-1 like(ED: what does 'like' mean?) immunoreactivity was increased after embolization in both groups but was significantly higher in the treatment group. The preproET-1 mRNA and ET-1 peptide expressions were increased in the embolized lung. Conclusion: ET-1 synthesis increases with embolization in the lung and may plays play an important role in the pathophysiology of cardiopulmonary derangement of APTE. Furthermore, $ET_A$-receptor antagonist attenuates cardiopulmonary alterations seen in APTE, suggesting a potential benefit of this therapy.

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Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study

  • Yoon, Chang-Yun;Lee, Misol;Kim, Seung Up;Lim, Hyunsun;Chang, Tae Ik;Kee, Youn Kyung;Han, Seung Gyu;Han, In Mee;Kwon, Young Eun;Park, Kyoung Sook;Lee, Mi Jung;Park, Jung Tak;Han, Seung Hyeok;Ahn, Sang Hoon;Kang, Shin-Wook;Yoo, Tae-Hyun
    • Kidney Research and Clinical Practice
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    • v.36 no.1
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    • pp.48-57
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    • 2017
  • Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

Analysis of the Mandibular Movements in Patients with Internal Derangement of the Temporomandibular Joint According to Diagnostic Subgroups (측두하악관절내장 환자의 진단분류에 따른 하악운동 특성의 분석)

  • 김병연;기우천;최재갑
    • Journal of Oral Medicine and Pain
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    • v.23 no.1
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    • pp.21-36
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    • 1998
  • The purpose of this study was analyse the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified patients with internal derangement of the temporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandibular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandibular movements, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group. The results were as follows : 1. Pain was more frequently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle's classifications had not significant correlations between the experimental groups. 2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experiment groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was no significant difference in the range of the maximum lateral movement between toward affected side and toward unaffected side. 3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to control group. There was no significant difference in maximum opening velocity and maximum velocity of Terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other. 4. In the frontal plane of the MKG, the frequency of complex deviation type(F-2)pattern was significantly increased in the anterior disc displacement with out reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type(S-1)was decreased in the same group. 5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3)in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement with out reduction group, but the frequency of no-peak type (OV-3)was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group. Compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.

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Preliminary study on the effect of inflamed TMJ synovial fluid on the intracellular calcium concentration and differential expression of iNOS and COX-2 in human immortalized chondrocyte C28/I2

  • Choi, Eun-Ah;Lee, Dong-Geun;Chae, Chang-Hoon;Chang, Young-Il;Park, Young-Ju;Kim, Young-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.1
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    • pp.36-41
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    • 2006
  • Objective. The objective of this study was to examine the hypothesis that inflammatory synovial fluid from TMJ internal derangement initiates a transient increase in intracellular calcium concentration ([$Ca^{2+}$]i) in chondrocytes and the induced Ca2+ signaling affects iNOS/COX-2 gene expression patterns following exposure to inflamed synovial fluid. Materials and Methods. Two female adult patients with symptoms of TMD who agreed to participate in the study were selected for this study. Immortalized human juvenile costal chondrocyte C-28/I2 was grown to 80% confluency and synovial fluids from two patients were added respectively to culture media for 24 hours at the concentration of 100ng/10ml. Confocal laser scanning microscope (CLSM) was used to examine changes of intracellular calcium concentration ([$Ca^{2+}$]i). RT-PCR was performed to identify the expression profile of IL-1${\alpha}$, iNOS, COX-2. Results. Increased [$Ca^{2+}$]i was observed in chondrocytes subjected to inflamed synovial fluid compared to control cultures and in respective cultures exposed to inflamed synovial fluids from each patient, IL-1${\beta}$, COX-2 mRNA were detected. However, in neither case iNOS mRNA was expressed. IL-1${\alpha}$, COX-2, and iNOS mRNA were expressed in control culture. Conclusion. Our results show that immortalized chondrocytes cultured with inflamed synovial fluids from patients diagnosed as disc displacement without reduction and limitation in mouth opening showed increased calcium concentration and expression of COX-2 while inhibiting the production of iNOS, which in turn could adversely affect the chondrocytes in at least short term by hindering physiologic role of NO against inflammatory cascades. These findings suggest that inflamed synovial fluid may differentially regulate the transcriptomes of relevant inflammatory mediators, especially iNOS/COX-2 axis in chondrocytes through adjusting calcium transients.

EVALUATION OF MENISCUS PERFORATION IN THE TMJ;CLINICAL, ARTHROGRAPHIC AND SURGICAL FINDINGS (악관절원판 천공의 임상적, 방사선적 및 외과적 비교연구)

  • Kim, Houng-Gon;Park, Kwang-Ho;Kim, Joon-Bae;Joo, Jae-Dong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.1
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    • pp.202-209
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    • 1990
  • A retrospective study of 498 patients (591 joints) who had diagnosed as having internal derangement of the temporomandibular joint by history, clinical examination, and arthrography were evaluated. 66 patients (70 joints) were diagnosed as having meniscus perforation between the joint compartments. In those patients with pain (11 joints : 15.7%), pain and crepitation (24 joints : 34.3%), pain, crepitation and LOM (31 joints : 44.3%), and painless crepitation with LOM (4 joints : 5.7%) complained clinically. All these patients who had perforation showed irregularity in outline of the contrast material, bone contour-contrast material gaps, flattening of cortical layer of articular eminence. On the 20 joints treated surgically, 17 joints were found to have meniscus perforation at the time of surgery which correlated with their pre-operative radiographic and clinical diagnosis. Three joints could not found perforation of meniscus. This study was designed to examine of the incidences of the meniscus perforation in the above patients and to assess the diagnostic accuracy of arthrography by comparing the results with the finding of direct examination at TMJ surgery.

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Intra-articular Synovial Hemangioma of the Knee - A Case Report - (슬관절의 관절내 활액막 혈관종 - 증례 보고 -)

  • Kim, Jin-Wan;Cho, Hyung-Lae;Ku, Jung-Hoei;Ko, Young-Chul;Hong, Seong-Hwak
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.91-94
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    • 2006
  • Synovial hemangioma of the knee joint has been reported as a rare cause of pain, limitation of motion and hemarthrosis, often seen as an internal derangement of the knee. A 39-year-old woman presented with spontaneous hemarthrosis of the left knee joint and physical exam revealed a small painful mass adjacent to the medial side of the patella. Magnetic resonance imaging revealed an intra-articular tumor. Arthroscopic excision was performed and the histology was characteristic of hemangioma. Through this case, we discuss the diagnosis and treatment options for the synovial hemangioma of the knee.

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ESSENTIAL TREATMENT BY REMOVING THE ETIOLOGY OF MYOFASCIAL PAIN DYSFUNCTION SYNDROME AND INTERNAL DERANGEMENT : REVIEW OF LITERATURES & REPORT OF CASES (저작근막동통증후군과 악관절 내장증의 원인치료 : 문헌적 고찰및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Rhee, Byung-In;Choi, Yong-Seok;Kim, Jin-Kwon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.259-272
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    • 1994
  • The authors reviewed the etiology and essential treatment of temporomandibular disorders. The principal etiology was thought to the the myospasm of masticatory musculatures by stress (major cause) and dental irritation. Therefore, we attempted to control the myospasm by stress management, isometric exercise and regular daily physical exercises (walking, Jogging, bycycling, rope skipping, swimming & gymnastic exercise). The result was more favorable (95% success rate) without recurrence in 123 patients, who was referred to our department of dentistry(Oral & Maxillofacial surgery), Wonju Christian Hospital.

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A Rare Case of Solitary Osteochondroma at the Temporomandibular Joint: A Case Report

  • Park, Byungho;Jang, Wan-Hee;Park, Tae-Jun;Lee, Bu-Kyu
    • Journal of Korean Dental Science
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    • v.12 no.2
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    • pp.66-72
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    • 2019
  • Osteochondroma is a bone tumor with cartilaginous growth potential that generally appears near the growth plate of long bones in areas such as hip, knee, and shoulder joints, related to the nature of endochondral ossification and it is known a common benign bone tumor. However, it has been very rare in craniofacial region possibly because craniofacial bone is largely formed by intramembranous ossification. Moreover, reports on the solitary type of osteochondroma in mandibular condyle has been extremely rare. Osteochondroma in mandibular condylar may show various symptoms similar to general temporomandibular joint disorders (TMDs), such as pain in the condylar area during mouth opening, internal derangement, facial asymmetry or posterior open bite. Therefore, it can be disregarded for a long time period without any adequate treatment. Surgical excision has been the treatment option for the solitary osteochondroma with very low recurrence rate reportedly. In this case report, a rare case of solitary osteochondroma developed in unilateral mandibular condyle is presented with emphasis on differential diagnosis with general TMDs.