• 대한족부족관절학회지
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• 제11권2호
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• pp.130-134
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• 2007

Purpose: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. Materials and Methods: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. Results: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001). Conclusion: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.66-74
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• 2018

Objective : The aim of this study was to identify the susceptibility genes responsible for lumbar spondylosis (LS) in Korean patients. Methods : Data from 1427 subjects were made available for radiographic grading and genome wide association studies (GWAS) analysis. Lateral lumbar spine radiographs were obtained and the various degrees of degenerative change were semi-quantitatively scored. A pilot GWAS was performed using the AffymetrixGenome-Wide Human single-nucleotide polymorphisms (SNPs), 500K array. A total of 352228 SNPs were analyzed and the association between the SNPs and case-control status was analyzed by stepwise logistic regression analyses. Results : The top 100 SNPs with a cutoff p-value of less than $3.7{\times}10^{-4}$ were selected for joint space narrowing, while a cutoff p-value of $6.0{\times}10^{-4}$ was applied to osteophytes and the Kellgren-Lawrence (K-L) osteoarthritis grade. The SNPs with the strongest effect on disc space narrowing, osteophytes, and K-L grade were serine incorporator 1 (rs155467, odds ratio [OR]=17.58, $p=1.6{\times}10^{-4}$), stromal interaction molecule 2 (STIM1, rs210781, OR=5.53, $p=5{\times}10^{-4}$), and transient receptor potential cation channel, subfamily C (rs11224760, OR=3.99, $p=4.8{\times}10^{-4}$), respectively. Leucine-rich repeat-containing G protein-coupled receptor 4 was significantly associated with both disc space narrowing and osteophytes (rs1979400, OR=2.01, $p=1.1{\times}10^{-4}$ for disc space narrowing, OR=1.79, $p=3{\times}10^{-4}$ for osteophytes), while zinc finger and BTB domain containing 7C was significantly and negatively associated with both osteophytes and a K-L grade >2 (rs12457004,OR=0.25, $p=5.8{\times}10^{-4}$ and OR=0.27, $p=5.3{\times}10^{-4}$, respectively). Conclusion : We identified SNPs that potentially contribute to the pathogenesis of LS. This is the first report of a GWAS in an Asian population.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.33-38
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• 2009

목적: 중년 이후에서 흔히 일어나는 내측 반월상 연골판 후각 부착 부에 발생하는 방사상 파열의 임상적 특성과 관절경적 소견을 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 2005년 1월부터 2007년 4월까지 본원 정형외과에 내원하여 슬관절 내시경 수술을 시행 받은 환자 중 관절경상 내측 반월상 연골판 후각 부착 부 파열이 관찰되었던 환자 40명, 40례에 대해 의무 기록을 통한 후향적인 검사를 시행하였다. 남자 7명, 여자 33명이고, 평균 연령61(47~80)세이며, 외상 병력의 유무, 동반된 관절염의 등급 및 통증 발생 후부터 수술까지의 기간(유병기간), 자기공명영상 소견, 임상 증상 및 파열단의 모양과 치료법 등을 검토하였다. 결과: 외상 병력이 있었던 경우가 6례며, 34례는 외상 병력이 없었다. 단순 방사선 사진상 Kellgren-Lawrence 분류는 0-II형이 31례, III형은 9례 였으며, 관절경상 대퇴골 내과의 관절 연골 상태는 Outerbridge grade IV 형이 17례, III 형이 4례, II 형이 9례, I 형이 9례이었다. 유병기간은 평균 5.3개월이었으며, MRI 소견으로는 전례에서 축상면 또는 관상면에서 틈(cleft)나 시상면에서 유령 징후(ghost sign) 중 1개 이상이 관찰되었다. 파열단의 모양은 18례가 뭉툭한 형태, 12례가 수평 파열, 10례가 퇴행성 파열이었으며 수술법으로는 연골판 아전 절제술을 16례, 부분 절제술을 10례, 봉합술을 14례에서 시행하였다. 결론: 중년 이후의 연령에서 반월상 연골판 후각 부착부 파열은 외상 병력이 드물게 발생하며 심한 기계적 증상을 호소하며, 관절염을 동반하는 경우가 많다. 치료로 절제술 뿐만 아니라 봉합술을 시도해 볼만한 파열이 있었으며, 추후 그 치료 결과에 대한 연구가 필요하다.

• 대한의용생체공학회:의공학회지
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• 제36권2호
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• pp.43-47
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• 2015

Osteoarthritis is the most common chronic joint disease in the world. With its progression, cartilage thickness tends to diminish, which causes severe pain to human being. One way to examine the stage of osteoarthritis is to measure the cartilage thickness. When it comes to inter-subject study, however, it is not easy task to compare cartilage thickness since every human being has different cartilage structure. In this paper, we propose a method to assess cartilage defect using MRI inter-subject thickness comparison. First, we used manual segmentation method to build accurate atlas images and each segmented image was labeled as articular surface and bone-cartilage interface in order to measure the thickness. Secondly, each point in the bone-cartilage interface was assigned the measured thickness so that the thickness does not change after registration. We used affine transformation and SyGN to get deformation fields which were then applied to thickness images to have cartilage thickness atlas. In this way, it is possible to investigate pixel-by-pixel thickness comparison. Lastly, the atlas images were made according to their osteoarthritis grade which indicates the degree of its progression. The result atlas images were compared using the analysis of variance in order to verify the validity of our method. The result shows that a significant difference is existed among them with p < 0.001.

• IMMUNE NETWORK
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• 제3권2호
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• pp.145-149
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• 2003

Background: Apoptosis has been implicated in pathogenesis of various disease. Apo-1/Fas (CD95) is one of the main pathway of apoptosis. To examine the possible relationship between Apo-1/Fas (CD95) and primary knee osteoarthritis, MvaI restriction length polymorphism (RFLP) in human Apo-1/Fas (CD95) gene was assessed. Methods: Genotype and allele frequencies in promoter region in the Apo-1/Fas (CD95) gene were studied by PCR-RFLP in 226 Korean controls and 148 Korean patients with primary knee osteoarthritis. Results: No statistically significant difference in the genotypic distribution and allelic frequencies was found between the control and the knee oateoarthritis patients. But in the severe grade (grade 3, 4) Kellgren-Lawrence score patients, the frequency of $MvaI^*1$ (G) allele was significantly decreased (P=0.0392) and the of $MvaI^*2$ (A) allele frequency was significantly increased (P=0.0473) compared to the normal controls. Conclusion: Apo-1/Fas (CD95) gene polymorphism is a part a determinant factor of severity in knee osteoarthritis, the patients with $MvaI^*2$ (A) allele is more severe radiologic progression. Further substantiation studies are needed in larger patient samples and various other apoptosis related genes to elucidate the mechanism of osteoarthritis, including the Fas ligand gene analysis.

• 한국전문물리치료학회지
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• 제14권1호
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• pp.55-63
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• 2007

This study was designed to examine the relationship between clinical symptoms, self-efficacy, and performance of women with osteoarthritis. It is a survey study of 60 women who were diagnosed as osteoarthritis and given medical treatments from September, 2005 to October, 2005 in hospital 'H' located in Yongin-si. For clinical symptoms, radiographs of the subjects' knees were taken and evaluated the pathology grade by the Kellgren-Lawrence grade. Pain and stiffness was measured by the measure of WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and functional reach test was measured in order to examine balancing abilities. Self-efficacy was measured by a tool which has revised the ASES (Arthritis Self-Efficacy Scale), and performance was measured by recording the difficulty of the WOMAC measurements themselves, and the time taken for 20 m walking, going up and down 9 stairs, and 5 sit-down and stand-up repetitions. The resulting differences in the other variables according to performance and the relationship between performance with variables are the following. First, an increase in pain in women with osteoarthritis led to decreased functional ability. Second, an increase in stiffness in women with osteoarthritis led to a decrease in functional ability. Third, a decrease in balance in women with osteoarthritis led to a decrease in functional ability. Fourth, a decrease in self-efficacy in women with osteoarthritis led to a decrease in functional ability. Fifth, the variables for estimating the performance by self-report were pain and self-efficacy. The variables for estimating the performance by recording the time taken was balance and self-efficacy. As a result factors such as pain, balance and self-efficacy in women with osteoarthritis were closely related to performance. Based on the results, it seems that physical therapy programs to decrease pain and to increase the balance in women with osteoarthritis, and psychological approaches to increasing self-efficacy are needed. I hope that the results of this study will be useful data for clinical management and intervention for women with osteoarthritis.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.67-74
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• 2017

Objective : The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender. Methods : This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied. Results : Of 4261 subjects aged 40-79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ${\geq}2$ osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ${\geq}2$ spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender. Conclusion : Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.

• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.285-293
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• 2022

Background: This study was conducted to analyze the effects of low skeletal muscle mass index (SMI) and obesity on aging-related osteoarthritis (OA) in the Korean population. Methods: A total of 16,601 participants who underwent a dual-energy X-ray absorptiometry and 3,976 subjects with knee X-rays according to the modified Kellgren-Lawrence (KL) system were enrolled. Knees of ≥KL grade 2 were classified as radiologic OA. The severity of joint space narrowing (JSN) was classified by X-rays as normal, mild-to-moderate, and severe JSN in radiologic OA. The subjects were grouped as normal SMI (SMI of ≥-1 standard deviation [SD] of the mean), low SMI class I (SMI of ≥-2 SDs and <-1 SD), and low SMI class II (SMI of <-2 SDs). Obesity was defined as a body mass index (BMI) of ≥27.5 kg/m². Results: The modified KL grade and JSN severity were negatively correlated with the SMI and positively correlated with BMI and age. The SMI was negatively correlated with age. JSN severity was significantly associated with a low SMI class compared to a normal SMI, which was more prominent in low SMI class II than class I. Obesity was significantly associated with more severe JSN, only for obesity with a low SMI class. Furthermore, patients with a low SMI class, regardless of obesity, were prone to having more severe JSN. Conclusion: This study suggested that a low SMI class was associated with aging and that an age-related low SMI was more critically related to the severity of JSN in OA.

• Clinical Pain
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• 제19권2호
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• pp.120-123
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• 2020

Rapidly destructive arthrosis is a rare syndrome characterized by narrowing of the joint space and rapid joint destruction within 6~12 months. A 62-year-old woman with anaplastic lymphoma kinase rearranged non-small-cell lung cancer presented with both knee pain and varus deformity. She was treated with crizotinib 500 mg/day for more than 2 years, with partial tumor response. Initial plain radiography showed Kellgren and Lawrence (K-L) grade 1. After 10 months, varus deformity was worsened and plain radiography aggravated to K-L grade 4 despite conservative treatment including activity modification. Diffuse synovitis with massive joint effusion and destruction of anterior cruciate ligament, medial meniscus, medial collateral ligament, and lateral collateral ligament were shown in magnetic resonance imaging. The patient was diagnosed with rapidly destructive arthrosis of knee and underwent a both total knee arthroplasty.

• 대한관절경학회지
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• 제12권2호
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• pp.107-111
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• 2008

목적: 50세 이상 환자에서 반월상 연골 절제술 후 최소 3년 이상 추시시 임상적 및 방사선적 결과를 알아보고자 하였다. 대상 및 방법: 1997년 12월부터 2003년 12월까지 반월상 연골 절제술을 시행 받았던 50세 이상 환자 36명, 36예의 슬관절을 대상으로 하였다. 평균 나이는 56.4세, 평균 추시 기간은 5년 3개월이었다. 술전 Kellgren and Lawrence 분류 상 Grade I 16예, II 12예, III 6예, IV 2예, Outerbridge 분류상 Grade I 16예, II 10예, III 7예, IV 3예이었다. 술후 Lysholm 점수, 환자의 주관적인 만족도, 방사선학적 변화 등을 후향적으로 비교, 분석하였다. 결과: Lysholm 점수는 24예(66.7%)에서 양호 이상의 결과를 보였으며, 26예(72.2%)의 환자들이 술후 결과에 만족하는 것으로 조사되었다. 대퇴 경골간 각이 술전 평균 외반 3.9도에서 술후 평균 외반 2.6도로 변화하였으며, 술후에 관절염이 진행한 경우가 22예(61.1%)로 나타났다. 결론: 50세 이상 환자에서 반월상 연골 절제술 후 최소 3년 이상 추시시 72.2%의 환자에서 만족할만한 임상적인 호전을 보였으나 방사선적으로 술전 관절염 변화나 관절경적 관절 연골 손상이 심한 경우 임상적 결과가 좋지 못한 것으로 나타났다.