• 제목/요약/키워드: chronic instability

검색결과 204건 처리시간 0.037초

외과 점액낭염에서 발생한 2차적 화농성 관절염 -증례보고 1예- (Secondary Septic Arthritis Due to Lateral Malleolar Bursitis -A Case Report-)

  • 지종훈;김원유;이연수;박상은;라기항;권오수
    • 대한족부족관절학회지
    • /
    • 제10권2호
    • /
    • pp.274-278
    • /
    • 2006
  • Lateral malleolar bursitis rarely progresses to septic arthritis. In our case, the 27 year old man visited due to progressive left ankle pain, despite the antibiotics treatment of lateral malleolar bursitis. 8 years ago, modified Brostrom procedure was performed owing to chronic ankle instability. Previous surgery altered anatomical structure of lateral ankle bursa, so it may cause the infection to spread to the ankle joint. We reported rare case of secondary septic arthritis caused by lateral malleolar bursitis.

  • PDF

중증 족관절 관절염: 족관절 전치환술 (Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty)

  • 정비오;정혁
    • 대한족부족관절학회지
    • /
    • 제22권1호
    • /
    • pp.8-15
    • /
    • 2018
  • Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

Immediate Effects of Joint Mobilization Techniques on Clinical Measures in Individuals with CAI

  • Kim, Byong Hun;Kim, Chang Young;Kang, Tae Kyu;Cho, Young Jae;Lee, Sae Yong
    • 한국운동역학회지
    • /
    • 제28권4호
    • /
    • pp.219-225
    • /
    • 2018
  • Objective: Epidemiological research shows that 47 to 73% of athletes suffer from recurrent ankle sprains. Joint mobilization techniques (JMT) implemented in correcting may be beneficial in the management of ankle injuries. The purpose of this study is to examine the immediate JM on ankle complex as clinical measures in individuals with chronic ankle instability (CAI) through intervention. Method: Thirteen subjects with CAI (8 males and 5 females) participated in this study. Each subject tried total four alignments (Navicular drop test: NDT, Standing rearfoot angle: SRA, Tibia torsion: TT, and dorsiflexion range of motion: DFROM). The participants were performed the 10 meter shuttle run after JMT for post-task. Finally, it was tried to compare between pre-post tasks after shuttle run. Results: SRA and DFROM after intervention showed significant differences. SRA (p=.026), and DFROM (p=.034). Conclusion: We concluded that the JMT has resulted in improvement in SRA, DFROM. Increased DFROM and varus shapes of foot would be closed kinetic chain, indicating that reduce the risk factors of ankle sprain. Future study needs to be conducted in order to measure the effects of prolonged intervention of JMT.

Performance of DNA Methylation on the Molecular Pathogenesis of Helicobacter pylori in Gastric Cancer; targeted therapy approach

  • Vahidi, Sogand;Mirzajani, Ebrahim;Norollahi, Seyedeh Elham;Aziminezhad, Mohsen;Samadani, Ali Akbar
    • 대한약침학회지
    • /
    • 제25권2호
    • /
    • pp.88-100
    • /
    • 2022
  • Gastric cancer (GC) is a significant cause of cancer mortality which has led to focused exploration of the pathology of GC. The advent of genome-wide analysis methods has made it possible to uncover genetic and epigenetic fluctuation such as abnormal DNA methylation in gene promoter regions that is expected to play a key role in GC. The study of gastric malignancies requires an etiological perspective, and Helicobacter pylori (H. pylori) was identified to play a role in GC. H. pylori infection causes chronic inflammation of the gastric epithelium causing abnormal polyclonal methylation, which might raise the risk of GC. In the last two decades, various pathogenic factors by which H. pylori infection causes GC have been discovered. Abnormal DNA methylation is triggered in several genes, rendering them inactive. In GC, methylation patterns are linked to certain subtypes including microsatellite instability. Multiple cancer-related processes are more usually changed by abnormal DNA methylation than through mutations, according to current general and combined investigations. Furthermore, the amount of acquired abnormal DNA methylation is heavily linked to the chances of developing GC. Therefore, we investigated abnormal DNA methylation in GC and the link between methylation and H. pylori infection.

경골 내재술식을 이용한 이중 다발 후방 십자 인대 재건술 - 수술 기법 - (Double Bundle Posterior Cruciate Ligament Reconstruction by the Tibial Inlay Method - Technical note -)

  • 이영현;남일현;문기혁;안길영;이상충
    • 대한관절경학회지
    • /
    • 제12권2호
    • /
    • pp.139-146
    • /
    • 2008
  • 목적: 아킬레스 동종 이식건을 사용하여 경골 내재술식으로 시행한 이중 다발 후방 십자 인대 재건술을 소개하고, 이 방법으로 수술하여 2년 이상 추시 관찰한 11예의 임상 결과를 보고하고자 한다. 대상 및 방법: 슬관절 만성 후방 불안정성과 급성 후방 십자 인대 파열이 있는 11예에서 후방 십자 인대 재건술을 시행하였고, 임상적 분석 방법으로는 IKDC(International Knee Documentation Committee) 평가법을 사용하였으며, 후방 전위 방사선 소견 및 KT-1000TM arthrometer를 이용한 전위 검사법을 이용하여 평가 하였다. 결과: 90도 굴곡위 후방 전위 방사선 사진 및 10도 굴곡위 KT-1000TM arthrometer 에서의 결과는 술 전 평균 각각 13.4 mm, 11.4 mm에서 술 후 평균 각각 4.4 mm, 3.9 mm로 호전되었다. 또한 IKDC 평가법에서는 9예에서 만족할 만한 결과를 얻었다. 1예에서 굴곡 시 경미한 관절 강직이 발생하였고, 나머지 1예에서 후방 불안정성이 충분히 교정되지 못하였다. 동종 이식건으로 인한 합병증은 없었다. 결론: 아킬레스 동종 이식건을 사용하여 경골 내재술식으로 시행한 이중 다발 후방 십자 인대 재건술은 급격한 경골 터널로 인해 발생할 수 있는 이식건의 마모를 피할 수 있고, 슬관절 굴곡위 뿐만 아니라 신전위에서도 후방 안정성을 유지할 수 있으므로 슬관절의 후방 십자 인대의 급성 파열 및 후방 십자 인대 재건술 후 재발된 불안정성을 포함한 만성 후방 불안정성에서 유용하게 사용할 수 있는 방법이다.

  • PDF

Multi-Parameter Approach for Evaluation of Genomic Instability in the Polycystic Ovary Syndrome

  • Sekar, Nishu;Nair, Manju;Francis, Glory;Kongath, Parvathy Raj;Babu, Sandhya;Raja, Sudhakaran;Gopalakrishnan, Abilash Valsala
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권16호
    • /
    • pp.7129-7138
    • /
    • 2015
  • Background: The polycystic ovary syndrome (PCOS), characterized by hyperandrogenism and chronic anovulation, is a common endocrine disorder in women. PCOS, which is associated with polycystic ovaries, hirsutism, obesity and insulin resistance, is a leading cause of female infertility. In this condition there is an imbalance in female sex hormones. All the sequelae symptoms of PCOS gradually lead to cancer in the course of time. It is heterogeneous disorder of unknown etiology so it is essential to find the exact cause. Materials and Methods: In this study both invasive and non-invasive techniques were employed to establish the etiology. Diagnosis was based on Rotterdam criteria (hyperandrogenism, ovulatory dysfunction, PCOM) and multiparameters using buccal samples and dermatoglypic analysis and cytogenetic study for 10 cases and four age and sex matched controls. Results: In clinical analysis we have observed the mean value of total testosterone level was 23.6nmol/L, total hirsutism score was from 12-24, facial acne was found in in 70% patients with 7-12 subcapsular follicular cysts, each measuring 2-8 mm in diameter. In dermatoglypic analysis we observed increases in mean value ($45.9^{\circ}$) of ATD angle when compared with control group and also found increased frequency (38%) of Ulnar loops on both fingers (UU), (18%) whorls on the right finger and Ulnar loop on left finger (WU) and (16%) arches on right and left fingers (AA) were observed in PCOS patients when compared with control subjects. Features which could be applied as markers for PCOS patients are the presence of Ulnar loops in middle and little fingers of right and left hand. The buccal micronucleus cytome assay in exfoliated buccal cells, we found decrease in frequency of micronuclei and significant increases in frequency of karyolysed nuclei in polycystic ovarian syndrome patients. Chromosome aberration analysis revealed a significant increase in frequency of chromosome aberrations (CAs) in PCOS patients when compared with controls. Conclusions: From this present work it can be concluded that non-invasive technique like dermatoglypics analysis and buccal micronucleus cytome assays with exfoliated buccal cell can also be effective biomarkers for PCOS, along with increased CAs in lymphocytes as a sign of genetic instability. There is a hypothesis that micronuclei and chromosomal aberrations could have a predictive value for cancer. From this present work it can be concluded to some extent that non-invasive technique like dermatoglypics and buccal cell analysis can also be effective for diagnosis.

반월상 연골의 관절경적 봉합시 관절안정성에 따른 결과 (Clinical results of arthroscopic meniscal repair according to joint stability)

  • 경희수;인주철;백승훈
    • 대한관절경학회지
    • /
    • 제6권1호
    • /
    • pp.37-42
    • /
    • 2002
  • 목적 : 관절경적 반월상 연골 봉합술시 인대 손상 동반 여부에 따른 결과를 분석하였다. 대상 및 방법 : 20례를 대상으로 하였으며 평균 추시 기간은 59.7개월이었다. 환자의 연령은 평균 32.3세였다. 동반 인대 손상이 없는 경우와 동반 손상인대를 치료한 17례를 안정 관절군으로, 동반 손상을 치료하지 않은 3례를 불안정 관절군으로 비교하였다. 안정 관절군은 급성기와 만성기로 분류하였다. 결과는 Lysholm 및 IKDC 평가법으로 판정하였다. 정상 및 아정상군은 만족으로, 비정상 및 장애군은 불만족으로 구분하였다. 통계적인 방법은 Wilcoxon rank sum test, fisher's exact test(p<0.05)를 이용하였다. 결과 : 동반 손상인대를 동시에 치료한 8례는 만족 $87.5\%$, Lysholm score는 평균 90.9을 보였고, 동반 손상을 치료하지 않은 3례는 만족 $66.7\%$, Lysholm score는 평균 77.7을 보였다 동반 인대 손상이 없는 9례는 만족 $88.9\%$, Lysholm score는 평균 91.4을 보였다. 급성기에 치료한 12례는 만족 $91.7\%$, Lysholm score는 평균 92.5를 보인 반면, 만성기의 5례는 만족 $80\%$, Lysholm score는 평균 88.6을 보였다. 결론 : 수상 후 급성기에 파열된 반월상 연골 및 동반 손상인대의 관절경적 복원술을 동시에 시행하는 것이 좋은 결과를 얻을 수 있을 것으로 사료된다.

  • PDF

상완골 대결절의 미세전위골절의 관절경적치료 (Arthroscopic Treatment of Symptomatic Shoulders with Minimally Displaced Greater Thberosity Fracture)

  • 김승호;하권익
    • Clinics in Shoulder and Elbow
    • /
    • 제2권2호
    • /
    • pp.178-186
    • /
    • 1999
  • 상완골의 대결절 골절 후, 6개월 이상 지속되는 만성견관절 동통을 호소하는 총 23명의 환자에 대해 관절경적 치료를 시행하였고 평균 29개월(22~40개월) 후에 후향적 평가를 시행하였다. 환자군의 연령은 24세에서 61세까지로 평균 39세였으며 남자가 18례 여자가 5례였다. 이중 14례는 단독골절 이였고 9례는 급성전방 불안정성과 연관이 있었다. 단순방사선 전후방 사진상에서 골절의 평균 전이는 2.3mm(0∼4mm)였다. 관절경을 시행하였을 때 모든 환자에게 관절면 쪽으로 치전근개의 부분 파열이 있었고,그 깊이는 Ellman I도에서 Ⅱ도였다. 관절경적 견봉하 감압술과 함께, 파열된 정도에 따라 관절경적 변연 절제술 또는 봉합술을 시행한 후 UCLA 점수로 평가했을 때 20례에서 우수(good) 또는 매우 우수(excellent), 3례에서는 양호(fair)를 나타냈다. 19례에서는 수상 이전 활동으로 복귀하였고, 많은 활동량을 가졌던 환자에서는 활동복귀 정도가 낮았다(p=0.034) 미세하게 전이된 대결절 골절 후에 만성견관절 동통을 호소하는 환자에서는 반드시 회전근개의 부분 파열을 고려해야 하며 이때 관절경적 변연 절재술 또는 봉합술이 적절한 치료법이다.

  • PDF

족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과 (Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome)

  • 이진우;문은수;김성재;한수봉;강응식
    • 대한족부족관절학회지
    • /
    • 제7권2호
    • /
    • pp.208-217
    • /
    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

  • PDF

유리 생비골 및 생비골 피부편 이식 후 공여부의 평가 (The Evaluation of Donor Site after Transfer of Free Osseous and Osteocutaneous Flap of Fibula)

  • 이광석;한승범;황인철;송형석
    • Archives of Reconstructive Microsurgery
    • /
    • 제10권2호
    • /
    • pp.75-80
    • /
    • 2001
  • Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

  • PDF