• Archives of Pharmacal Research
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• v.26 no.2
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• pp.168-172
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• 2003

Radiation synovectomy is one of the most useful methods for treating patients with refractory synovitis because of its convenience, long-term effects, repeatability and the avoidance of surgery. In this study, we investigated the toxicity, stability and biodistribution of a rhenium-188 ($^{188}$Re)-tin colloid to evaluate its suitability as a synovectomy agent. Twenty four hours after injecting the $^{188}$Re-tin colloids (74 KBq/0.1 mL) into the tail vein of ICR mice, most of the $^{188}$Retin colloidal particles was found in the lungs. In addition, there were no particle size changes at either room temperature or at $37^{\circ}C$ after injecting the $^{188}$Re-tin colloids in human plasma and synovial fluid. In vitro stability tests showed that the $^{188}$Re-tin colloid remained in a colloidal form without a critical size variation over a 2-day period. We investigated the leakage of $^{188}$Retin colloids from the intraarticular injection site with gamma counting in New Zealand white rabbits. The $^{188}$Re-tin colloids (55.5 MBq/0.15 mL) were injected at the cavum articular and the mean retention percentage of the $^{188}$Re-tin colloid was 98.7% for 1 day at the injection site, which suggests that there was neither change in the particle size nor leakage at the injection sites. In the biodistribution study with the SD rats, the liver showed the highest radioactivity (0.0427% ID/organ) except for the injected knees (99.49%). In the SD rats, mild toxicities including the skin or a synovium inflammation were observed as a result of a radioactivity of 15 mCi/kg at the intraarticular injection site. However, there was no systemic toxicity. In the Ovalbumin (OVA)-induced arthritic rabbits, the $^{188}$Re-tin colloid improved the macroscopic, the histological score and reduced the knee joint diameter when compared to the arthritic control. In conclusion, a $^{188}$Re-tin-colloid is considered as a strong candidate for radiation synovectomy with a superior efficacy and safety.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.2 no.1
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• pp.9-19
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• 1996

Type I, II, III are regarded as "true" joint receptors, type IV is considered a class of pain receptor. Type I, II and III mechanoreceptors, via static and dynamic input, signal joint position, intraarticular pressure changes, and the direction, amplitude, and velocity of joint movements. Type I mechanoreceptor subserve both static and dynamic physiologic functions. Type I are found primarily in the stratum fibrosum of the joint capsule and ligaments. Type I receptors have a low threshold for activation and are allow to adapt to changes altering their firing frequency. Type II receptors have a low threshold for activation. These dynamic receptors respond to joint movement. Type II receptors are thus termed rapidly adapting. Type II joint receptors are located at the junction of the synovial membrane and fibrosum of the joint capsule and intraarticular and extraarticular fat pads. Type III receptors have been found in collateral ligaments of the joints of the extremities. Morphologically similar to Golgi tendon organ. These dynamic receptors have a high threshold to stimulation and are slowly adating. Type IV receptors possess free nerve ending that have been found in joint capsule and fat pads. They are not normally active, but respond to extreme mechanical deformation of the joint as well as to direct chemical or mechanical irritation. Small amplitude oscillatory and distraction movements(joint mobilization) techniques are used to stimulate the mechanoreceptors that may inhibit the transmission of nociceptors stimuli at the spinal cord or brain stem levels.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.142-149
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• 2009

Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.51-57
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• 1998

Comminuted fracture of the distal end of the humerus in adults is very rare and difficult to treat. In operative treatment, an implant which can achieve accurate anatoraical reduction and rigid fixation is needed. But the pre­existing Y -shaped plate had wide and thick limbs and some problems in fixation for most distal humeral fractures. So we devised a modified plate which is more narrow and th1n and has a different hole distance and wing length (long lateral wing). The aim of the study was to evaluate the clinical result of this modified anatomical Y -plate. From 1991 to 1997, we treated 23 cases of distal humeral fractures using modified anatomical plate and the results were as follows. 1. Fracture type in 18 patients(78%) was C-type(C1,C2,C3) which were intraarticular and mostly displaced or comminuted. 2. Bony union was obtained in 22 patients(96%) through rigid fixation and observed radiologically at 3.5 months(2-6months) on the average. 3. In 23 patients, 19 patients(82%) showed satisfactory results after 34 months(6-73months) follow-up. So if the modified anatomical Y-plate is used in the treatment of distal humeral fracture, a satisfactory result can be obtained through a more accurate, easy, and rigid fixation than preexisting plate.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.236-239
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• 2017

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.87-91
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• 2013

Diffuse-type giant cell tumor is relatively rare than localized giant cell tumor. Moreover, diffuse type giant cell tumor is common in intraarticular area, rarely occurs at intramuscular or subcutaneous layer. We experienced 1 case of giant cell tumor within the deltoid muscle. So we report this case with review of the literatures.

• Journal of Korean Physical Therapy Science
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• v.9 no.3
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• pp.161-170
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• 2002

knee injuries are among the most common problems confronting patients, physical therapist and physicians. since the bony structure provides little stability, the soft tissues are required to withstand high forces, often resulting in tissue overload and injury immobilization of the knee in the presence of a hemarthrosis usually leads to proliferation of intraarticular connective tissue adhesions and pint fibrosis. the physical basis of treating scar tissue is early controlled motion. the management of the knee with increased instability is to strengthening the muscles to properly treat an soft tissue injuries, physical therapist should know about the anatomic structures and biomechanical function of the knee joint, in this review article, we discuss the physiologic properties of soft tissue, biomechanical observation in fibrous connective tissue, managing soft tissue contractures, principles in treating scar tissue and treatment of the knee with increased instability.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.120-123
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• 2010

An inappropriate insertion of a interference device to fix the graft in the tibial tuunel can cause potential complications. We describe a case of 27-year-old man who underwent anterior cruciate ligament reconstruction using IntraFix device(DePuy Mitek, Raynham, MA). In this report we present a case of migration of IntraFix sheath by inappropriate insertion of IntraFix screw along with a review of the current literature.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.66-71
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• 1997

The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.119-123
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• 1998

In order to obtain a good result in Arthroscopic ACL Reconstruction by immediate postoperative physical therapy, sufficient analgesia was needed. This study analyzes the analgesic effect of the intra-articular injection with ketorolac, Morphine together with bupivacaine in 80 male patients who had Arthroscopic ACL Reconstruction. On completion of the surgery under spinal anesthesia, the knee was injected with 30ml of 0.25% bupivacaine. Each of the study group received ketorolac and/or morphine, either through parenteral or intra-articular. Total amount of the drug used by Patient Controlled Analgesia(PCA) and Visual Analgesia Scale(VAS) for pain were measured and analyzed. The group which received intra-articular ketorolac or Morphine had a better analgesic effect than other group which received none. The group which received both did not do better in analgesic effect. Intra-articular infusion with either ketorolac or Morphine improved postoperative analgesia in Arthroscopic ACL Reconstruction surgery. However, combined injection did not offer more advantage.