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Arthroscopic Evaluation of Allogenic Meniscal Transplantation (반월상 연골 동종 이식술 후 이차 관절경 소견)

  • Choi Jeong-Ki;Son Il-Jin;Lee Chun-Tek;Kim Sung-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.147-152
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    • 2003
  • Purpose : The purpose of this study was to evaluate the arthroscopic findings of the transplanted human allogenic meniscus including MRI changes at follow up. Materials and Methods : From Oct. 1999 to Jun. 2002, nine patients underwent arthroscopic evaluation at follow-up. We used nonirradiated cryopreserved meniscus allograft for 6 cases and fresh-frozen for 3 cases. We used bone-plug method for medial meniscus and bone-bridge method for lateral meniscus to fix the transplanted meniscus. The average follow-up time was 13 months. We evaluated the result by lysholm score, MRI and second-look arthroscopic finding. Results : The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were well incorporated with surrounding capsular tissue. But one case showed wear on the post horn and the other case which was operated at other local clinic showed tear of the anterior hem due to non-anatomic placement of bone bridge. There was improvement of average Lysholm score form 64 to 87. Conclusion : Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment and early clinical results are satisfactory. But further studies are necessary to assess whether meniscal transplantation can prevent progressive degenerative changes.

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'Lumbar Degenerative Kyphosis' Is Not Byword for Degenerative Sagittal Imbalance : Time to Replace a Misconception

  • Lee, Chang-Hyun;Chung, Chun Kee;Jang, Jee-Soo;Kim, Sung-Min;Chin, Dong-Kyu;Lee, Jung-Kil;Korean Spinal Deformity Research Society
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.125-129
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    • 2017
  • Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

A Comparative Study of the Effect of Two Analgesic Administration Methods on Post Operative Pain (수술환자에 었어서 마약성 진통제의 자가투여 방법과 근육주사 방법의 효과에 대한 비교연구)

  • 이정화
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.401-410
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    • 1997
  • An acute pain is the common experience following surgery. Pain is a most miserable experience in person and most preoperative patients have fear o! postoperative pain. In nursing, it is very important to understand and relieve the pain of post oprative patients as much as possible. This study was designed to compare the descriptive patterns of pain between group of Patient Controlled Analgesia and group of traditional Muscular Injection in surgcal patients. This information can be utilited as data of understanding nursing care and treatment planning for pain in surgical patients. The subjects in this study were 45 post-hysterectomy patients in Gynecology ward in C. N. U. H., in Taejon. Data was collected from May 12 to June 27. 1996. The instrumants used for this study were subjective Visual Analog Scale, Objedive nonverbal pain scale composed of Facial Apperance. Vocal Sound Change, and Sweating score. and the Melzack's Mcgill pain Qusetionaire. nine Items of Developmental Pain Intensity Scale by Lee En Ok. Analysis of data was done by using S. P. S. S. percentage, t-test, x²-test. ANOVA, and Repeated measure ANOVA. Results were obtained as follows. 1. Hypothesis 1 : There was very highly statistically significant difference in subjective self-report pain score(Visual Analog Scale) between PCA Group and IM Group(P=0.0001). 2. Hypothesis 2 : There was very highly statistically significant difference in muscle strength score (Visual Analog Scale) between PCA Group and IM group(P0.0001). 3. Hypothesis 3 : There was very highly statistically significant difference in facial appearance score between PCA Group and IM group(P=0.0001). 4. Hypothesis 4 : There was very highly statistically significance difference in vocal sound change score between PCA Group and IM group(P=0.0001). 5. Hypothesis 5 : There was no statistically significant difference sweating scores between PCA group and IM group(F=2.50, P=0.1220). But, postoperation time of 12, 24 was statistically difference between two groups(P=0.0001). So, it was partially supported. 6. Hypothesis 6 : There was very highly statistically significant difference in vocabulary pain score between PCA Group and IM group. 7. Hypothesis 7 : There was very highly statistically significant difference in amounts of total analgesic between PCA Group and IM group. There was very highly statistically significant difference in Visual Analog Pain Score, Facial Appearance Score, Vocal Sound Change Score, Vocabulary Score, amounts of total analgesic between PCA group and IM group. So, It is verified to asses of postoperative pain with VAS, Checklist of facia appearance, vocal sound change, and sweating, and Vocabulary Scale.

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The Diagnosis and Treatment of Anterior Openbite Malocclusion (전치부 개방교합의 진단과 치료)

  • Chang, Young-Il;Moon, Seong-Cheol
    • The korean journal of orthodontics
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    • v.28 no.6 s.71
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    • pp.893-904
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    • 1998
  • There are varieties of severe malocclusions, which can be treated orthodontically, but with a great deal of effort. Anterior openbite, in particular, is one malocclusion thought to be more difficult to treat, and therefore, most of them have to be corrected by means of surgical intervention. To solve these problems, numerous studies pertinent to treatment modalities have been introduced with controversies on the effectiveness of treatment. Suggested treatment modalities for anterior openbite are based directly or indirectly on the neuromuscular and morphological features and on the etiologic and/or the environmental factors. Even though the vertical relationship of the face is increased due to the growth variation, the normal occlusal relationship can be achieved by the adequate dentoalveolar compensatory mechanism, but in the case of inadequate or negative dentoalveolar compensation, openbite is likely to be present. If the skeletal dysplasia is too severe to be solved by orthodontic treatment alone, combined treatment with surgery should be done to restore the function and the esthetics of the orofacial complex. In many cases, however, orthodontic alteration of the dentition pertinent to the given skeletal pattern with the proper diagnosis and treatment planning can bring satisfactory results. The treatment changes with the Multiloop Edgewise Archwire(MEAW) therapy occurred mainly in the dentoalveolar region and showed a considerable similarity to the natural dentoalveolar compensatory mechanism. In other words, the MEAW technique allows orthodontists to produce the natural dentoalveolar compensation orthodontically. Even if an openbite is corrected by the orthodontic dentoalveolar compensation suitable for the skeletal pattern, relapse may still occur by the persisting etiologic factors which originally prohibited the natural dentoalveolar compensation. The etiologic factors should be determined at the time of initial diagnosis and should be controlled during treatment and retention.

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Mechanism underlying Chios gum mastic-induced apoptosis on SCC25 human tongue squamous cell carcinoma cell line

  • Lee, Seung-Eun;Hur, Young-Joo;Kim, In-Ryoung;Kwak, Hyun-Ho;Kim, Gyoo-Cheon;Shin, Sang-Hun;Kim, Chul-Hoon;Park, Bong-Soo
    • International Journal of Oral Biology
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    • v.34 no.2
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    • pp.61-72
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    • 2009
  • Chios gum mastic (CGM) is a resin produced from the stem and leaves of Pistiacia lentiscus L var chia, a plant which grows only on Chios Island in Greece. CGM has been used for many centuries as a dietary supplement and folk medicine for stomach and duodenal ulcers in many Mediterranean countries and is known also to induce cell cycle arrest and apoptosis in some cancer cells. In this study, we further investigated the induction and mechanisms underlying the apoptotic response to CGM treatment in the SCC25 human tongue squamous cell carcinoma cell line. The viability of SCC25 cells, human normal keratinocytes (HaCaT cells) and human gingival fibroblasts (HGF-1 cells), and the growth inhibition of SCC25 cells were assessed by MTT assay and clonogenic assay, respectively. Staining with Hoechst and hemacolor dyes and TUNEL assays were employed to detect SCC25 cells undergoing apoptosis. SCC25 cells were treated with CGM, and this was followed by western blotting, immunocytochemistry, confocal microscopy, FACScan flow cytometry, MMP activity and proteasome activity analyses. CGM treatment of SCC25 cells was found to result in a time- and dosedependent decrease in cell viability, a dose-dependent inhibition of cell growth, and apoptotic cell death. Interestingly, CGM showed a remarkable level of cytotoxicity in SCC25 cells but not in normal cells. Tested SCC25 cells also showed several lines of apoptotic manifestation. Taken together, our present findings demonstrate that CGM strongly inhibits cell proliferation by modulating the expression of G1 cell cycle-related proteins and induces apoptosis via the proteasome, mitochondria and caspase cascades in SCC25 cells.

Microvascular Decompression for Hemifacial Spasm Associated with Vertebrobasilar Artery

  • Kim, Joo-Pyung;Park, Bong-Jin;Choi, Seok-Keun;Rhee, Bong-Arm;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.131-135
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    • 2008
  • Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

Diurnal fluctuations of vision in myopes (근시안의 일일 시럭변동에 관한 연구)

  • Park, Sang-Chul;Sung, A-Young;Kim, Tae-Hyun;Kim, Douk-Hoon
    • Journal of Korean Ophthalmic Optics Society
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    • v.10 no.1
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    • pp.35-40
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    • 2005
  • Subjective and objective visions were measured on young adults(mean 21 yrs, 126 eyes) who were free of any ocular diseases and laser surgery and none wore contact lenses. The aim of this study was to investigate the diurnal variation of vision through subjective and objective measurements. Subjective visual acuity were measured at 5 m three times a day, morning(8:00 AM-10:00 AM), noon(12:00 PM-2:00 PM) and afternoon(4:00 PM-6:00 PM). The instrument used for objective refraction right after visual acuity measurement was Nvision-K 5001(shin-nippon) which unique in being able to disregard subject's accommodation because of its unrestricted viewing conditions. Also, we measured that three times and then calculated the average values. The result showed that an average subjective visual acuity in the morning, noon, afternoon were 0.256(${\pm}0.263$), 0.266(${\pm}0.276$), 0.242(${\pm}0.249$) respectively. Average spherical equivalent power in objective refraction of right eyes showed -3.416 D(${\pm}2.907$), -3.359 D(${\pm}2.735$), -3.297 D(${\pm}2.709$) respectively and dioptric power was decreased from morning to afternoon. Vision changed throughout the day in both subjective and objective measurements nevertheless its variations were statistically insignificant(p<0.05). Therefore it does not seem to matter of time for either visual acuity test or refraction.

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The Noxiousness of Aldosterone Analogue-induced Senile Disease-related Hypertension and Inhibition of the Aldosterone by Silver Spike Point Electrical Stimulation in Elderly People -The Approach of Basic Physical Therapy for the Study of Cardiovascular Disease-related Specialized Physical Therapy- (알도스테론 동족체-유도 노인성질환-연관 고혈압의 유해와 노인에 적용한 은침점전기자극의 알도스테론 억제 -심혈관질환전문물리치료 연구를 위한 기초물리치료학적 접근을 중심으로-)

  • Lee, Sook-Hee;Kang, Joon-Hwan;Lee, Sang-Bin;An, Ho-Jung;Kim, Moo-Gi;Kim, Soon-Hee;Kim, Jung-Hwan
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.67-83
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    • 2006
  • The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.

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A Micro Finite Element Analysis on Effects of Altering Monomer-to-Powder ]Ratio of Bone Cement During Vertebroplasty (골 시멘트 중합 비율 변경이 척추성형술 치료에 미치는 영향에 대한 비교 분석)

  • 김형도;탁계래;김한성
    • Journal of Biomedical Engineering Research
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    • v.23 no.6
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    • pp.451-458
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    • 2002
  • Osteoporosis is a systemic skeletal disease caused by low bone mass and the decrease of bone density in the microstructure of trabecular bone. Drug therapy(PTH Parathyroid hormone) may increase the trabecular thickness and thus bone strength. Vertebroplasty is a minimally invasive surgery foy the treatment of osteoporotic vertebral compression fracture. This Procedure includes Puncturing vertebrae and filling with Polymethylmethacrylate(PMMA). Although altering recommended monomer-to-Powder ratio affects material properties of bone cement, clinicians commonly alter the mixture ratio to decrease viscosity and increase the working time. The Purposes of this study were to analyze the effect of 4he monomer-to-powder ratio on the mechanical characteristics of trabecular. In this paper, the finite element model of human vertebral trabecualr bone was developed by modified Voronoi diagram, to analyze the relative effect of hormone therapy and vertebroplasty at the treatment of osteoporotic vertebrae. Trabeuclar bone models for vertebroplasty with varied monomer-to-Powder ratio(0.40∼1.07 ㎖/g) were analyzed. Effective modulus and strength of bone cement-treated models were approximately 60% of those of intact models and these are almost twice the values of hormone-treated models. The bone cement models with the ratio of 0.53㎖/g have the maximum modulus and strength. For the ratio of 1.07㎖/g, the modulus and strength were minimum(42% and 49% respectively) but these were greater than those for drug therapy. This study shows that bone cement treatment is more effective than drug therapy. It is found that in vertebroplasty, using a monomer-to-powder ratio different from that recommended by manufacturer nay significantly not only reduce the cement's material Properties but also deteriorate the mechanical characteristics of osteoporotic vertebrae.

Pre-seasonal Physical Examination of Professional Soccer Team (프로 축구팀의 시즌 전 체력검사)

  • Lee, Kyung-Tai;Choi, Byung-Ok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.129-134
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    • 2006
  • Purpose: In the professional soccer team, we performed pre-seasonal physical examination and analyzed the results to establish a standardization data in relation to their position. Materials and Methods: We performed physical examination to the professional soccer team, consisted 34 player's average age 24.9 years. The examination performed were questionnaire on history, musculoskeletal examination, muscle power test, physiologic test, functional test. Results: According to the relationship between player position and injury pattern,. Knee injuries are most frequent on history. Physical examination outcome was that forward were prone to flexor hallucis longus tendinitis, midfielder for chronic ankle instability, defender for achilles tendinitis. Isokinetic test was done at dominant side, Peak torque to body weight ratio was 55.1%. Physiologic test checked body fat percentage was midfielder was superior as 19.8 (SD 2.9). Functional test out-come was that back strength 125 N. sergeant jump 59.6 cm, reaction time 208.5 sec, flexibility 19.2 m/s, side step 39.9 cm. Conclusion: Pre-seasonal physical examination gave us the standardization data and preventive measurement could be advocated from this results.

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