• Journal of muscle and joint health
• /
• v.9 no.1
• /
• pp.5-17
• /
• 2002

The purpose of this one group pre and post test study was to evaluate the effect of self-help programs(SHP) which has been conducted from 1997 to 2000. The SHP was held by Korean Rheumatology Health Professionals Society(KRHP) once a week for 6 weeks for chronic arthritis patients in Korea. Eight hundred fifty five subjects completed the program at 43 sites. The effect of SHP were evaluated by flexibility, pain, activities of daily living(ADL), fatigue, depression and self-efficacy. After SHP, followings were found: 1. Participants' characteristics of SHP were most common in living in Seoul, women, sixties, high school graduates, house wifes, osteoarthritis, completed in 1999. 2. The flexibility of arm, knee, ankle joint were significantly increased, but the flexibility of the shoulder was not changed. 3. Level of pain was decreased significantly from 5.21 to 3.99, and the number of painful joints were decreased from 4.96 to 4.18 significantly. 4. The score of ADL was increased from 53.74 to 54.97 significantly. 5. The score of depression and self-efficacy was not changed. In conclusion, SHP was clearly proved to be an effective nursing intervention to Increase the flexibility of arm, knee, ankle joint and enhanced ADL. Also SHP decreased pain and fatigue. More research is needed to determine the role of self-efficacy and depression in the SHP, use of a randomized design and longer follow up period to understand more about the effects of the program.

• Journal of the Institute of Electronics Engineers of Korea SP
• /
• v.47 no.6
• /
• pp.75-81
• /
• 2010

The segmentation of cartilage is crucial for the diagnose and treatment of osteoarthritis (OA), and has mostly been done manually by an expert, requiring a considerable amount of time and effort due to the thin shape and vague boundaries of the cartilage in MR (magnetic resonance) images. In this paper, we propose a fully automatic method to segment cartilage in a knee joint on MR images. The proposed method is based on a small number of manually segmented images as the training set and comprised of an initial per patch segmentation process and a global refinement process on the cumulative per patch results. Each patch for per patch segmentation is positioned by classifying the bone-cartilage interface on the pre-segmented bone surface. Next, the shape and intensity priors are constructed for each patch based on information extracted from reference patches in the training set. The ratio of influence between the shape and intensity priors is adaptively determined per patch. Each patch is segmented by graph cuts, where energy is defined based on constructed priors. Finally, global refinement is conducted on the global cartilage using the results of per patch segmentation as the shape prior. Experimental evaluation shows that the proposed framework provide accurate and clinically useful segmentation results.

• The Korean Journal of Physiology and Pharmacology
• /
• v.21 no.1
• /
• pp.19-26
• /
• 2017

We investigated whether betulin affects the gene expression, secretion and proteolytic activity of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as in vivo production of MMP-3 in the rat knee joint to evaluate the potential chondroprotective effect of betulin. Rabbit articular chondrocytes were cultured and reverse transcription-polymerase chain reaction (RT-PCR) was used to measure interleukin-$1{\beta}$ ($IL-1{\beta}$)-induced gene expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), ADAMTS-5 and type II collagen. Effect of betulin on IL-$1{\beta}$-induced secretion and proteolytic activity of MMP-3 was investigated using western blot analysis and casein zymography, respectively. Effect of betulin on MMP-3 protein production was also examined in vivo. The results were as follows: (1) betulin inhibited the gene expression of MMP-3, MMP-1, MMP-13, ADAMTS-4, and ADAMTS-5, but increased the gene expression of type II collagen; (2) betulin inhibited the secretion and proteolytic activity of MMP-3; (3) betulin suppressed the production of MMP-3 protein in vivo. These results suggest that betulin can regulate the gene expression, secretion, and proteolytic activity of MMP-3, by directly acting on articular chondrocytes.

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.176-183
• /
• 1999

Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

• Journal of Acupuncture Research
• /
• v.30 no.5
• /
• pp.117-123
• /
• 2013

Objectives : The purpose is to review large-scale clinical researches, the acupuncture randomized trials(ART) and the acupuncture in routine care(ARC), concerning efficacy and effectiveness of acupuncture performed in Germany. Methods and Results : We have reviewed the studies that were searched by keyword 'acupuncture' as the title and'Witt CM' as one of the main authors in PubMed. Sixteen clinical reports focused on the ART and ARC studies were analyzed among all thirty six were searched. Six studies were related with the ART and eight were focused on the ARC, and other two were on both. Finally, across all researches except osteoarthritis of knee trials in the ART, compared the acupuncture group with the control were significantly improved. On the other hand, ARC showed that additional acupuncture plus routine care was more effective than routine care alone and the response to treatment of the non-randomized group did not differ the one of the randomized acupuncture group. Conclusions : The results may suggest that acupuncture treatment has obvious clinical effectiveness. These results are expected to inspire domestic research and clinical applications in Korea, and more rigorous research on the efficacy of acupuncture should be guaranteed.

• Journal of muscle and joint health
• /
• v.7 no.2
• /
• pp.227-240
• /
• 2000

The purpose of this article was to identify trend in Arthritis research and to provide ba an approach of Arthritis research. The results of analysis of 69 Arthritis articles public year of between 1970-1999 found that most articles(27.6%, n=19) were published since few(10.1%, n=7) were before 1994. Vast majority of articles(79.8%, n=55) were printed in The Journal of Rheumatology Health, and 79.8%(n=55) of those were quantitative research, 8.7%(n=6) were qualitative research, and 14%(n=1) was methodological research. 29.0%(n=20) of quantitative research were carried in experimental design and over half(50.8%, n=35) in nonexperimental design. Having concerned the types of treatment(or intervention) used in experimental study, the most common treatment was 'exercise' (45.0%, n=9), and other less common were 'self-help education(15.0%, n=3), home care(10.0%, n=2) supportive care(10.0%, n=2), flexibility exercise combined with local heat therapy(5.0%, n=1), relaxation training(5.0%, n=1). Of the types of exercise, aquatic exercise was 30.0%(n=6). The effect of exercise on outcome variable was found to be most strong among the other types of treatment. 18 articles of nonexperimental research were correlational research. From the analysis of correlational research, 29 concepts were identified, and the relationship between depression and other variable were strongly reported. In descriptive studies, most commonly physiological variables were examined in 5 articles(29.5%). Only one study(5.9%) explored patient's perception of the causal factors and those causality. In qualitative researches, two study were carried out by the means of grounded theory. Majority of those subjects were RA patients, and the largest number of sample were 23 and the smallest was 1 In two studies, patient's perceived causality of RA was identified as a research problems, and an experience of ADL, fatigue Phenomenon, an experience of having a total knee replacement with osteoarthritis were each found in one study. Methodological research was carried out to test validity and reliability of the RA Fatigue Scale.

• Journal of muscle and joint health
• /
• v.4 no.1
• /
• pp.74-86
• /
• 1997

This investigation has been conducted based on the medical chart of 344 patients who have been diagnosed of fibromyalgia syndrome during Oct. 9, 1996 through Nov. 20 at the Rheumatism Hospital of H. University located in Seoul. 280 which have been included in the analysis. 1. Only one patient was male in 280 patients, age distribution was from 28 to 76, in which the average age was 52.4. 2. Percentage of treatment duration was 6 months in 46.1%, 3 years in 22.1% and 2 years in 12.5%. Considering these results, it can be predicted that the number of patients might be increased and accumulated in the future. 3. Percentage of patients having primary fibromyalgia syndrome was 39.3%, having combination with osteoarthritis was 36.7% and the rest case have combination with rheumatoid arthritis at the same time. 4. The percentage of cases having patients 10-12 tender points was 37.1%, while the most of cases have pain at 12-19 tender points. The common locations of the tender point were at lateral epicondyle of elbow in 92.0%, at midpoint of upper border Trapezius in 84.8%, at upper part of scapula Supraspinatus in 82.9%, at medial fat pad proximal to the joint line knee in 81.85%, at intertransverse of $C_{5-7}$ Low cervical in 73.4% and at 2nd distal costochondral Junction 2nd rib in 72.0%. And most of the patients had joint functional disability at all in 47.1% with average 2.41 joint functional disability. 5. Age was not a variable influencing the number of tender points and the number of joint functional disability.

• The Korean Journal of Physiology and Pharmacology
• /
• v.20 no.2
• /
• pp.221-228
• /
• 2016

We investigated whether prunetin affects the proteolytic activity, secretion, and gene expression of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as in vivo production of MMP-3 in the rat knee joint to evaluate the potential chondroprotective effect of prunetin. Rabbit articular chondrocytes were cultured in a monolayer, and reverse transcriptionpolymerase chain reaction (RT-PCR) was used to measure interleukin-$1{\beta}$ (IL-$1{\beta}$)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and ADAMTS-5. In rabbit articular chondrocytes, the effects of prunetin on IL-$1{\beta}$-induced secretion and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of prunetin on MMP-3 protein production was also examined in vivo. The results were as follows: (1) prunetin inhibited the gene expression of MMP-3, MMP-1, MMP-13, ADAMTS-4, and ADAMTS-5; (2) prunetin inhibited the secretion and proteolytic activity of MMP-3; (3) prunetin suppressed the production of MMP-3 protein in vivo. These results suggest that prunetin can regulate the gene expression, secretion, and proteolytic activity of MMP-3, by directly acting on articular chondrocytes.

• Journal of Korean Foot and Ankle Society
• /
• v.23 no.3
• /
• pp.110-115
• /
• 2019

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

• Biomaterials Research
• /
• v.22 no.4
• /
• pp.271-278
• /
• 2018

Background: The chondrogenic differentiation of mesenchymal stem cells (MSCs) is regulated by many factors, including oxygen tensions, growth factors, and cytokines. Evidences have suggested that low oxygen tension seems to be an important regulatory factor in the proliferation and chondrogenic differentiation in various MSCs. Recent studies report that synovium-derived mesenchymal stem cells (SDSCs) are a potential source of stem cells for the repair of articular cartilage defects. But, the effect of low oxygen tension on the proliferation and chondrogenic differentiation in SDSCs has not characterized. In this study, we investigated the effects of hypoxia on proliferation and chondrogenesis in SDSCs. Method: SDSCs were isolated from patients with osteoarthritis at total knee replacement. To determine the effect of oxygen tension on proliferation and colony-forming characteristics of SDSCs, A colony-forming unit (CFU) assay and cell counting-based proliferation assay were performed under normoxic (21% oxygen) or hypoxic (5% oxygen). For in vitro chondrogenic differentiation, SDSCs were concentrated to form pellets and subjected to conditions appropriate for chondrogenic differentiation under normoxia and hypoxia, followed by the analysis for the expression of genes and proteins of chondrogenesis. qRT-PCR, histological assay, and glycosoaminoglycan assays were determined to assess chondrogenesis. Results: Low oxygen condition significantly increased proliferation and colony-forming characteristics of SDSCs compared to that of SDSCs under normoxic culture. Similar pellet size and weight were found for chondrogensis period under hypoxia and normoxia condition. The mRNA expression of types II collagen, aggrecan, and the transcription factor SOX9 was increased under hypoxia condition. Histological sections stained with Safranin-O demonstrated that hypoxic conditions had increased proteoglycan synthesis. Immunohistochemistry for types II collagen demonstrated that hypoxic culture of SDSCs increased type II collagen expression. In addition, GAG deposition was significantly higher in hypoxia compared with normoxia at 21 days of differentiation. Conclusion: These findings show that hypoxia condition has an important role in regulating the synthesis ECM matrix by SDSCs as they undergo chondrogenesis. This has important implications for cartilage tissue engineering applications of SDSCs.