• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권3호
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• pp.262-267
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• 2006

The term temporomandibular disorders is used to describe a group of conditions that involve the temporomandibular joint, masticatory muscles, and associated structures. Many modalities have been proposed for treating temporomandibular disorders, including medication, physical therapy, occlusal stabilization splints with or without manual repositioning, surgery, and arthrocentesis. Temporomandibular disorders are treated in a step-wise manner. Initially, conservative treatment is used. Depending on the response, more aggressive interventions may be necessary. This usually takes the form of arthrocentesis. Arthrocentesis is used in the treatment of not only acute, closed, and locked TMJs but also various other temporomandibular disorders. Recently, the intra-articular injection of sodium hyaluronate after arthrocentesis was shown to have long-term palliative effects on TMJ symptoms. Synovial fluid consists of plasma and glycosaminoglycan, including hyaluronic acid derived from synovial cells. Sodium hyaluronate, the sodium salt of hyaluronic acid, is a high-molecular-weight polysaccharide and a major component of synovial fluid. This highly viscous substance has analgesic properties, lubricant effects, and anti-inflammatory actions; it causes cartilage formation and plays a role in the nutrition of avascular parts of the disc and condylar cartilage. We conclude that the intra-articular injection of sodium hyaluronate is effective for treating temporomandibular disorders.

• Biomolecules & Therapeutics
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• 제7권4호
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• pp.347-353
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• 1999

Osteoarthrosis was induced in rabbit knees through resecton of anterior cruciate ligament. Sodium hyaluronate (1%) was administerated into articular space at the dose levels of 0.1 mg/kg once a week using 1ml sylinge and 26G needle for test groups. Saline was administrated for control groups. After 6 and 12 weeks, animals were sacrificed to conduct macroscopic observation and histopathologic examination. The articular lesions were evaluated and test groups were compared with control groups. No significant differencies were showed between test groups and control groups at macroscopic observation in both 6- and 12- week groups. In histopathologic examination, control groups showed higher osteoarthrosis than test groups. The articular surfaces of control groups showed fibrillation, denudation, pannus formation and hypocellularity. The articular surfaces of test groups showed fibrillaton and hypercellularity. These indicate that sodium hyaluronate has inhibitory effects on osteoarthrosis at least in rabbit and could be used for treatment of osteoarthrosis.

• 한국임상수의학회지
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• 제20권3호
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• pp.351-356
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• 2003

The aim of this experiment was to study the calcium sulfate on early bone consolidation in distraction osteogenesis in the canine mandible. Twelve dogs were used and divided into control group (group A, 4 heads), sodium hyaluronate injection group (group B, 4 heads), mixture of calcium sulfate and sodium hyaluronate injection group (group C, 4 heads). Each group were subdivided into 3 weeks testing group (totally 6 heads) and 5 weeks testing group (totally 6 heads). Mandibular distraction was started at the 5th day after the mandibular osteotomy and continued for 10 days by 1 mm a day. After the distraction on the 10th day of mandibular distraction, 0.5 m1 saline in group A, 0.5 m1 sodium hyaluronate in group B, and 0.5 ml mixture of calcium sulfate and sodium hyaluronate in group C were each injected in mandibular distraction lesion. And X-ray examination, bone mineral density, and histopathological findings were examined. The radiological findings were the most radiopaque in group C, and the most radiolucent in group A in both 3 and 5 week testing group. The level of bone mineral density was also the highest in group C, and the lowest in group C in both 3 and 5 week testing group. The histopathological findings of new bone formation were the most remarkable in group C in both 3 and 5 week testing group. New bone formation of group A was not present in both 3 and 5 week testing group. In conclusion, calcium sulfate is a kind of material that can stimulate early bone formation and can shorten the duration of bone consolidation. And it can be effective in clinical usage.

• 동의생리병리학회지
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• 제34권6호
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• pp.285-298
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• 2020

This study aimed to review clinical studies about Acupotomy used for Knee Osteoarthritis. We searched the following 12 online databases (KISS, NDSL, RISS, OASIS, Earticle, Kmbase, MEDLINE/Pubmed, Cochrane library, Ebscohost, Ovid, CNKI, Wanfang), to find randomized controlled trials that used Acupotomy for knee osteoarthritis. The methodological quality of randomized controlled trials were assessed by using the Cochrane risk of bias tool and meta-analyses were performed. 16 randomized controlled trials were included. Total number of patients was 1169. The average duration of treatment was 3.14 weeks and most of the patients were treated once a week. The major treatment sites were ligaments, muscles, and tender nodules and the most used evaluation tool was the efficiency. We selected 4 studies and meta-analyzed them. All of the studies performed Acupotomy+sodium hyaluronate injection as a treatment group, and sodium hyaluronate injection as a control group. Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of efficiency rate compared to sodium hyaluronate injection. Also Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of WOMAC (pain, stiffness, function) compared to sodium hyaluronate injection. In this study, we reviewed studies about Acupotomy used for knee osteoarthritis. The studies showed that Acupotomy can significantly effective on knee osteoarthritis. But according to Cochrane Risk of Bias (RoB) evaluation method, most of the study's risk of bias was unclear. Threrefore, more high-quality studies will be needed.

• Journal of Korean Neurosurgical Society
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• 제50권5호
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• pp.409-414
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• 2011

Objective : The aim of this study was to evaluate the impact of sodium hyaluronate-sodium carboxymethyl cellulose (HA-CMC), an anti-adhesive material for spinal surgery, on bone fusion by applying it to rat spinal models after lumbar posterolateral fusion. Methods : Lumbar posterolateral fusion was performed at L4-5 using bone graft substitutes in 30 rats. HA-CMC was injected in 15 rats at a dose of 0.2 cc (HA-CMC group) and a saline solution of 0.2 cc in the other 15 rats (control group). Simple radiographs were taken until postoperative 9 weeks with an interval of one week. At postoperative 4 and 9 weeks, three dimensional computed tomography (3D CT) scanning was performed to observe the process of bone fusion. At 9 weeks, bone fusion was confirmed by gross examination and manual palpation. Results : There were no statistically significant differences in bone fusion between the two groups. 3D CT scanning did not reveal significant differences between the groups. The gross examination and manual palpation after autopsy performed at 9 weeks confirmed bone union in 93.3% of both groups. Conclusion : The anti-adhesive material used for spinal surgery did not have adverse effects on spinal fusion in rats.

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.241-252
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• 1997

본 연구는 임상검사 및 방사선 사진상 악관절장애로 진단된 환자중 물리치료,악관절 안정장치 등의 보존적 치료방법을 시행하였으나 증상의 개선이 별로 없는 퇴행성 관절질환이나 중등도의 개구제한을 가진 환자를 대상으로하여 aspirin을 이용한 활액성분 분석 및 악관절 도약술과 sodium hyaluronate의 주입을 시행한후 이에 따른 치료결과를 평가하기 위하여 시행되었다. 평균연령이 31.2세(21-42세)인 11명의 악관절 장애환자를 대상으로 하였다. 악관절 도약술과 sodium hyaluronate의 주입은 악관절의 동통과 개구제한의 해소를 위해 시행되었으며 그 결과를 시술전, 시술 즉시, 시술 1주후 및 4주후로 나누어 분석하였으며 활액 채취시 생리식염수의 희석에 의한 활액성분의 농도 변화에 따른 오차를 막고자 활액과 혈액내의 aspirin의 농도차를 이용하여 정확한 활액 성분농도를 측정하였다. 이상의 연구를 통하여 다음과 같은 결론을 얻었다. 1. 전체 환자의 생리식염수에 의한 악관절 활액의 희석계수는 1.4-12.9(5.5$\pm$4.2)로 상당히 넓은 범위를 나타내었다. 2. 만성 폐구성 과두걸림 환자군(n=7)의 생리식염수에 의한 활액의 희석계수 (6.2$\pm$3.5)는 퇴행성 관절질환을 갖는 환자군(4.4$\pm$5.7, n=4)과 유의한 차이가 없었다. 3. 만성폐구성 과두걸림군과 퇴행성 관절 질환군간의 활액성분의 농도는 유의한 차이가 없었으나 희석계수를 이용한 수정된 Hyaluronic acid와 총단백질의 농도는 만성 폐구성 과두걸림군의 경우에서 유의하게 더 높게 나타났다. 4. 악관절 도약술과 sodium hyaluronate의 주입 직후 만성 폐구성 과두걸림 환자군의 경우 평균 8.3mm의 추가적인 개구 증가로 유의한 차이가 관찰되었고 퇴행성 관절질환의 경우 평균 1.3mm의 추가적인 개구증가가 있었으나 유의한 차이가 관찰되지 못했다. 5. 시술전, 시술 1주후 및 4주후의 여러 검사항목을 비교한 결과 두 군에서 모두 시간의 경과에 따라 기능이상 및 동통 감소의 경향을 나타내었으나 유의하지는 않았으며 만성 폐구성 과두걸림의 경우 기능장애지수(dysfunction index) 와 최대개구시 동통의 정도는 시술전과 시술 4주후간에 유의한 차이가 관찰되었다.

• 대한족부족관절학회지
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• 제13권1호
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• pp.7-13
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• 2009

Purpose: The purpose of this study was to evaluate the effect of Sodium hyaluronate-Sodium carboxymethyl cellulose (HA-CMC) on tissue adhesion after tenorrhapy in tenotomized Achilles tendon of the Sprague-Dawley rat. Materials and Methods: Twenty-eight legs of 14 Sprague-Dawley rat were used in study. After tenotomy of the Achilles tendons, tenorrhaphies were performed. Simple tenorrhaphy without any other procedures were performed on the left Achilles tendons (control group), and additional HA-CMC injections were done prior to the tenorrhaphy on the right Achilles tendons (HA-CMC group). Gross and histological examinations were made to identify differences between the two groups, 1, 2, 6, 8, 10, 12 and 14 weeks respectively. Results: Distinct decrease in granulation tissues and adhesions were seen in the HA-CMC group during gross inspection at 6 and 8 week after the operation. On histological analysis of the HA-CMC group, although increased infiltrations of inflammation cells were observed during 1 week, less adhesion were seen at 6, 8 and 10 weeks after the operation. In HA-CMC group, superior healing processes were seen at 6, 8 and 10 weeks and less fibrotic changes, compared to control group, were seen at 2 and 6 weeks. Conclusion: Prevention of adjacent tissue adhesion was made possible through decrease in collagen deposition and fibrosis by injecting HA-CMC before tenorrhaphy of Achilles tendon. Also, histologically faster healing process of the collagen fibers within the Achilles tendon was observed.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.543-547
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• 2009

Purpose: Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix$^{(R)}$, sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits. Methods: Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix$^{(R)}$(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation at 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed. Results: There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group at 4, 8, 12 weeks (p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group at 12 weeks after surgery. There were no significant differences in breaking strength. Conclusion: Our results indicate that Guardix$^{(R)}$ is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.

• Journal of Radiation Protection and Research
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• 제33권4호
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• pp.143-150
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• 2008

In this study, we examined the effect of hydroxyl radical generated by $\gamma$-ray and UV irradiation on shrinkage of vitreous body. Change in gel ratio of vitreous body and change in the properties of its components (collagen, sodium hyaluronate) were analyzed. By comparing these results, the amount of hydroxyl radical, which induces the considerable shrinkage of vitreous body, was evaluated from theoretical calculation based on experimental condition and some reported kinetic parameters. It was concluded that the integrated amount of hydroxyl radical required to liquefy half of the vitreous body (Vitreous body gel ratio = 50%) was estimated as $140\;{\mu}molg^{-1}$ from $\gamma$-ray irradiation experiment. Also, from UV irradiation experiment result, it was confirmed that the effect of hydroxyl radical is larger than that of other reactive species. The causes of shrinkage of vitreous body are supposed as follows, 1) decrease in viscosity by cleavage of glycoside bond in sodium hyaluronate, 2) leaching of collagen from vitreous body and 3) leaching of crosslinked products and scission products of collagen.

• 한국임상수의학회지
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• 제8권1호
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• pp.11-26
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• 1991

The effects of intra-articula. sodium hyaluronate(SH) and polysulfated glycosaminoglycan(PSGAG) on degenerative joint disease of the carpus were compared each other In 20 racehorses. Ten horses were dosed with intra-articula. injection of 20mg SH(2 times/2 weeks interval) and ten horses were dosed with intra-articular injection of 250mg of PSGAG(4 times/1 week into.val). Synovial fluid analysis and clinical examination were made to evaluate the effects of the drugs on degenerative joint disease at before injection and 2 weeks after the last injection, respectively. Appearance and mucinous precipitate quality oi synovial fluids of the group injected with 58 and PSGAG were improved by 40～50% and 60～80%, respectively. The chemical values of alkaline phosphatase, lactic dehydrogenase, aspartate aminotransferase, total protein, A/G ratio and glucose of synovial fluid in the group injected with PSGAG were more clearly returned to the normal values than those of the group injected with SH. Relative viscosity and total white blood cells of synovial fluid were returned to the normal walues after the treatments in both groups. Clinical symptoms(swelling, heat and pain on carpal joint, and lameness) of the horses in the group injected with SH and PSGAG were disappeard by 56～67% and 67～80%, respectivelty. Conclusively, the PSGAG was superior to SH in the effects on treatment of the degenerative joint disease in the horses.