• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.84-91
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• 1995

Many clinical and laboratory tests have been employed to evaluate disease activity in rheumatioid arthritis. $^{99m}Tc$-labelled polyclonal IgG(HIG) has been demonstrated to accumulate in focal sites of infection or inflammation in both animals and human subjects. The purpose of this study was to distinguish arthritis with active inflammation from those without active inflammation and to correlate relative intensities of $^{99m}Tc$-labelled HIG uptake of the rheumatoid arthritis with clinical and MR indices of the joint inflammation. This study included twelve patients with active rheumatoid arthritis, two with ankylosing spondylitis and one with degenerative osteoarthritis without active inflammation. A Whole-body and spot images were obtained 4 hours after intravenous injection of 20mCi of $^{99m}Tc$-labelled HIG. Scintigrams were assessed visually by 3 experienced radiologists, and graded as normal or mildly and markedly increased uptake within the joints, and the degree of uptake was compared with clinical and radiologic severity of synovial inflammation. MRI studies were done on the involved joints consisted of wrist(n = 11), knee(n = 2) and hip joint(n= 2). Active synovitis was defined when marked elevation of ESR and gadolinium enhancement of synovium on MRI were demonstrated. Markedly increased radiotracer uptake was seen in 10 of 11 rheumatoid arthritic patients with active synovitis whereas normal or mildly increased uptakes were noted in others, including rheumatoid arthritic patient(n=1) and non-rheumatoid patients(n = 3) without active synovitis. This study showed that the localization of involved joints in rheumatoid arthritis could be detected with $^{99m}Tc$-labelled HIG and that the degree of uptake correlated well with the degree and activity of inflammation. In conclusion, $^{99m}Tc$-labelled HIG scan is a useful method in the evaluation of active inflammation in rheumatoid arthritis.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.77-82
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• 2006

Purpose: The purpose of this study was to analyze the clinical results of symptomatic lateral discoid meniscus found in adults over 40 years old. Materials & Methods: From March 1994 to March 2004, 53 cases treated for lateral discoid meniscus in 48 patients aged over 40 years with the mean age $48.4(40{\sim}62)$ who were followed up more than 1 year, were analyzed by physical findings, simple X-ray, MRI and arthroscopic exam. Results: Most of the cases (42 cases, 79.2%) had symptoms for less than 1 year duration. 26 cases(49.1 %) out of 53 had trauma history. Simple radiologic evaluation showed that lateral condylar abnormality such as the flattening of lateral femoral condyle, marginal osteophytes, and subchondral sclerosis was seen in 37cases(69.8%). Also medial condyle showed degenerative changes in 16 cases (30.2%). Tear of discoid meniscus in 45 cases(84.9%) were examined by arthroscope and tear was not detected in 8 cases(15.1%). Type of tear was complex(18 cases), longitudinal(12 cases), horizontal(11 cases) and transverse(4 cases). Concomitant medial meniscal rupture was found in 7 cases(13.2%). The simple procedure done was reshaping(46 cases), subtotal resection(5 cases), total resection(1 case) and meniscal repair after reshaping in 6 cases, and arthroplasty was performed after arthroscopic examination in 1 case. Conclusion: Onset of symptom in adult lateral discoid meniscus is usually traumatic in origin. Most cases showed radiologic abnormality such as degenerative change in lateral condyles as well as medial condyles and the results of preservative surgical treatment was the most preferred option in most patients.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.112-117
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• 2008

Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.

• The Journal of Korean Physical Therapy
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• v.15 no.2
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• pp.19-51
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• 2003

To demonstrate the effect of massages on the skeletal muscles of immobilization ddY mice models induced by right side sciatic nerve neurectomy, the cross sectional histological profiles of the muscularis (M) gastrocnemius, M. tibialis cranialis and M. tibialis caudalis were observed after 28 days of treatment of massages with the changes of body weight, thickness of hind limb and individual muscle weights. In addition, changes of serum aspartate amino- transferase (AST) and creatine phosphokinase (CK) levels were also demonstrated with diameter of individual muscle fiber and muscle fasciculata, and number of muscle fiber in each of three types of muscles located in the calf. The experimental groups were divided into five groups, 1) Sham-operated group (Sham), 2) Neurectomized but not massage control group (Control), 3) Neurectomized and massage at knee joint regions (T1), 4) Neurectomized and massage at calf regions (T2), and 5) Neurectomized and massages at achilles tendon regions (T3). The experimental animals were used 5 per groups. The results are as follow: 1. No significant changes of body weight were demonstrated in this groups during whole experimental periods compared to that of Sham group. In addition, no significant changes of body weight gains during experimental periods (Day 0 - Day 27: 28 days of treatment) were also observed. 2. The thickness of intact left side hind limb was not changes in all tested groups compared to that of Sham group. However, the thickness of right side hind limb were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of thickness of hind limb between right and left sides were also significantly increased in Control and massage groups (T1, T2 and T3) compared to that of Sham group. However, the thickness of right side of hind limb were significantly increased and the differences of thickness between both sides of hind limb were dramatically decreased in massage groups compared to that of Control group in followed order: T1 > T3 > T2. 3. Absolute and relative weight of M. gastrocnemius in the intact left side of hind limb was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. gastrocnemius between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. gastrocnemius were significantly increased and the differences of weight between both sides of M. gastrocnemius were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 >. 4. Absolute and relative weight of M. tibialis cranialis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis cranialis between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. tibialis cranialis were significantly increased and . the differences of weight between both sides of M. tibialis cranialis were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 > T2. 5. Absolute and relative weight of M. tibialis caudalis in the intact left side was not changes in all tested groups compared to that of Sham group. However, the weight of right side M. tibialis caudalis were remarkedly decreased in Control, T1, T2 and T3 groups compared to that of Sham group. In addition, the differences of weight of M. tibialis caudalis between right and left sides were also significantly increased in Control and massage groups compared to that of Sham group. However, the weight of right side M. tibialis caudalis were significantly increased and the differences of weight between both sides of M. tibialis caudalis were dramatically decreased in massage groups compared to that of Control group in followed order: T3 > T1 > T2. 6. A significant increase of serum AST levels were demonstrated in Control group. However, serum AST levels of massage groups were significantly decreased compared to that of Control group in followed order: T3 > T1 > T2. In case of 73 group, the values decreased into similar levels compared to that of Sham group. 7. A significant increase of serum CK levels were demonstrated in Control group. However, serum CK levels of massage groups were significantly decreased compared to that of Control group in followed order: T3 > T1 > T2.

• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.29-44
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• 2005

The purpose of this study is to reveal the effects of two different kicks, the drop kick and the punt kick, into the kicking motion, through the kinetic comparative analysis of the kicking motion, which is conducted when one kicks a soccer goal. To grasp kinetic changing factors, which is performed by individual's each body segment, I connected kicking motions, which were analyzed by a two dimension co-ordination, into the personal computer to concrete the digits of it and smoothed by 10Hz. Using the smoothed data, I found a needed kinematical data by inputting an analytical program into the computer. The result of comparative analysis of two kicking motions can be summarized as below. 1. There was not a big difference between the time of the loading phase and the time of the swing phase, which can affect the exact impact and the angle of balls aviation direction. 2. The two kicks were not affected the timing and the velocity of the kicking leg's segment. 3. In the goal kick motion, the maximum velocity timing of the kicking leg's lower segment showed the following orders: the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.018sec) in the drop kick, and the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.015sec) in the punt kick. It showed that whipping motion increases the velocity of the foot at the time of impact. 4. At the time of impact, there was not a significant difference in the supporting leg's knee and ankle. When one does the punt kick, the subject spreads out his hip joint more at the time of impact. 5. When the impact performed, kicking leg's every segment was similar. Because the height of the ball is higher in the punt kick than in the drop kick, the subject has to stretch the knees more when he kicks a ball, so there is a significant affect on the angle and the distance of the ball's flying. 6. When one performs the drop kick, the stride is 0.02m shorter than the punt kick, and the ratio of height of the drop kick is 0.05 smaller than the punt kick. This difference greatly affects the center of the ball, the supporting leg's location, and the location of the center of gravity with the center of the ball at the time of impact. 7. Right before the moment of the impact, the center of gravity was located from the center of the ball, the height of the drop kick was 0.67m ratio of height was 0.37, and the height of the punt kick was 0.65m ratio of height was 0.36. The drop kick was located more to the back 0.21m ratio of height was 0.12, the punt kick was located more to the back 0.28m ratio of height was 0.16. 8. There was not a significant difference in the absolute angle of incidence and the maximum distance, but the absolute velocity of incidence showed a significant difference. This difference is caused from that whether players have the time to perform of not; the drop kick is used when the players have time to perform, and punt kick is used when the players launch a shifting attack. 9. The surface reaction force of the supporting leg had some relation with the approaching angle. Vertical reaction force (Fz) showed some differences in the two movements(p<0.05). The maximum force of the right and left surface reaction force (Fx) didn't have much differences (p<0.05), but it showed the tendency that the maximum force occurs before the peak force of the front and back surface (Fy) occurs.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.163-171
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• 2008

Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.69-76
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• 2003

Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

• Journal of Biomedical Engineering Research
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• v.19 no.6
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• pp.617-622
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• 1998

A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.10
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• pp.1510-1518
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• 2014

This study investigated the effects of calcium citrate on papain-induced osteoarthritis in C57BL/6J mice. Osteoarthritis was induced by injecting $6{\mu}L$ of papain into the knee joints of mice. Calcium citrate was made by crushing the centrifuged precipitate after reacting 0.5 M citric acid with 1 kg of oyster shell extract. The mice were divided into five groups (n=8). The normal group was untreated, whereas the papain group was induced to have osteoarthritis and treated with $200{\mu}L$ of water per day. The papain+DS group was treated with diclofenac sodium. The papain+calcium citrate groups were treated with calcium citrate at 150 and 300 mg/kg/bw for 28 days. Proteoglycan contents in articular cartilages were measured by safranin O/fast green staining and hematoxylin & eosin staining. Histopathological changes in cartilages were analyzed by the Rudolphi score approach. Contents of pro-inflammatory cytokines including TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 in plasma, were measured by the ELISA method. Body weights among the treated groups were not significantly different compared with that of the normal group. Cartilage loss and joint instability in the calcium citrate group improved significantly (P<0.05) in a dose-dependent manner compared with the papain group. Further, proteoglycan content of the calcium citrate group was considerably (P<0.05) higher than that of the papain group. Osteoarthritis scores in the calcium citrate group were considerably (P<0.05) reduced compared with the papain group. In the group treated with calcium citrate, contents of TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 in plasma were significantly (P<0.05) reduced in a dose-dependent manner in comparison with the normal group. Based on these results, we suggest that calcium citrate is effective for treatment of osteoarthritis.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.1
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• pp.1-8
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• 2013

Purpose: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. Materials and Methods: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. Results: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. Conclusion: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.