• Title/Summary/Keyword: joint disease

검색결과 882건 처리시간 0.282초

사지에서 전이성 골종양의 수술적 치료 (Surgical Treatment of Metastatic Bone Tumor in Extremity)

  • 이한구;이상훈;백구현;이창섭
    • 대한골관절종양학회지
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    • 제1권1호
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    • pp.45-51
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    • 1995
  • The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

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섬유성 골 이형성증의 치료 (Treatment of Fibrous Dysplasia)

  • 김태승;양문승;조재림
    • 대한골관절종양학회지
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    • 제2권1호
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    • pp.78-87
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    • 1996
  • The results of treatment of eighteen lesions of fibrous dysplasia which of them seventeen lesions were treated with surgery were reviewed at the Department of Orthopedic Surgery, College of Medicine, Hanyang University Hospital. We studied to evaluate the functional clinical results and the recurrence according to the type of disease, grafted bone, methods of treatment and location of lesion. We treated sixteen patients(five males and eleven females) and their mean age was 22.6 years. There was no association with skin pigmentation or dysfunction of endocrine system. Twelve patients had a monostotic pattern and four patients had a polyostotic pattern. Twelve lesions were treated with curettage and bone grafting and four lesions in the proximal femur were treated by internal fixation with curettage and bone grafting. One lesion was treated by en-bloc resection. There were eleven satisfactory results in twelve monostotic lesions and there were four satisfactory results in five polyostotic lesions, but the recurrence were four cases, respectively. The two unsatisfactory results were seen in two patients treated by autografting, but there were three recurrence of four lesions in autografting only, one of five in autografting and allografting, four of eight in allgrafting or xenografting. Four of six lesions in upper extremity were recurred after curettage and bone grafting and five of them showed satisfactory results. In pelvic and lower extremity lesions, the recurrence were occurred in two lesions after curettage and bone grafting and in two lesions after internal fixation and bone grafting. The recurrence does not always provide an unsatisfactory functional results and the recurrence showed higher rate in radiologic pattern of ground glass appearance with-out marginal sclerotic rim, but the recurrence according to grafted bone showed similar rates. Curettage and bone grafting is adequate for a symptomatic lesion and firm internal fixation is needed for a lesion in proximal femur. In use of grafted bone, xenograft or allograft may be preferable to autograft because of the disadvantage of autografting like a increased blood loss, prolonged operation times, etc.

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족부의 조갑하 외골종 (Subungual Exostosis of the Foot)

  • 안종철;신덕섭;손욱진;최준혁
    • 대한골관절종양학회지
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    • 제5권1호
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    • pp.56-62
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    • 1999
  • Purpose : This study was conducted to analyze the clinical materials and treatment results of 13 cases of subungual exostosis. Materials and Methods : Thirteen subungual exostoses of the foot treated from January 1991 to December 1997 were studied. We analyzed the clinical data and results of treatment to identify the clinical characteristics of this disease. We investigated the location, shape and relation of exostosis to phalanx with simple x-ray of the foot to identify the radiological characteristics. All the cases were sent to pathologic examination after resection to determine the pathological characteristics. Results : The results of physical examination on presentation were various. Most cases were located at the dorsomedial side of the distal phalanx and were involved in the toe nail. Eleven cases were located at great toes and one each at the 2nd and 3rd toe. Causes of exostosis were not clear, but 2 cases were related to trauma. For the type of exostosis, 7 cases were sessile and 6 were stalk type. On histologic examination, 9 cases showed a cartilaginous portion with overlying proliferating fibrous tissue and underlying bone formation. There was a gradual maturation of spindle cell proliferation from cartilage to cancellous bone. The cartilage was moderately cellular with some pleomorphism, but true anaplasia was not present. Conclusion : The clinical presentation and findings of simple x-rays were most helpful in diagnosing subungual exostosis. Complete excision of the mass achieved complete relief of symptoms and recovery without recurrence in all cases.

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광범위 골막외 절제 후 유리 생비골 이식술로 치료한 재발성 골섬유성 이형성증 -1예 보고- (Recurrent Osteofibrous Dysplasia Treated with Wide Extraperiosteal Resection and Vascularized Fibular Graft -A Case Report-)

  • 옥인영;정양국;김형민;강현택
    • 대한골관절종양학회지
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    • 제12권1호
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    • pp.47-51
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    • 2006
  • 골섬유성 이형성증은 10세 이전에 드물게 발생하는 골종양으로 소파술이나 변연부 절제 후 흔한 재발 및 활성의 증가를 보이며 광범위 골막외 절제술 후에도 재발하는 경우가 있어 치료에 어려움이 따른다. 저자들은 소파술 후 거듭된 재발을 보인 경골의 골섬유성 이형성증에 대하여 광범위 골막외 절제와 함께 유리 생비골 이식술을 시행하여 치유를 얻은 골섬유성 이형성증 1예를 치험 하였기에 문헌 고찰과 함께 보고하고자 한다.

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부피바카인이 류마티스 관절염환자의 섬유모세포양 활막세포 배양시 세포증식과 금속단백분해효소 생산에 미치는 실험실적 영향 (In Vitro Effects of Bupivacaine in Cell Proliferation and Matrix Metalloproteinase of Cultured Fibroblast Like Synoviocytes from Rheumatoid Arthritis from Rheumatoid Arthritis)

  • 한태형;장혜진
    • The Korean Journal of Pain
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    • 제13권1호
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    • pp.1-7
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    • 2000
  • Background: Intraarticular local anesthetic injection has been therapeutically applied for pain control in various arthritis patients. However, little physiologic effects of local anesthetics on their tissue were known. This study was conducted to determine its effects on the cell proliferation and matrix metalloproteinases (MMP) production of cultured fibroblast like synoviocytes (FLS) derived from synovial tissues of rheumatoid arthritis patients. Methods: Bupivacaine with varying concentrations 0 (control), 0.1, 0.25, 0.5% was applied to experimental cell groups growing as monolayers in culture plates for varying durations 0 (control), 30, 90, 180 seconds in the presence and absence of interleukin-$1\beta$. Results: No statistical significances were noted in thymidine incorporation between 0, 30, 90 and 180 seconds exposure groups with 0.5% bupivacaine after 1 day and 2 days. Thymidine incorporation between 0, 0.1, 0.25, 0.5% exposure groups 1 day and 2 days after 90 seconds exposure did not show any differences. After exposure to bupivacaine, there were statistically significant increases in MMP-1 (p=0.025) and MMP-3 productions (p=0.000) of FLS in the absence of IL-$1\beta$, but no differences among the groups in the presence of IL-$1\beta$. Conclusion: We concluded that in this short-term in vitro study, bupivacaine does not have injurious effect on cultured rheumatoid arthritic joint tissues. The long-term effect cannot be known from this investigation.

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우슬(牛膝)의 관절염(關節炎) 치료(治療) 효능(效能)에 관(關)한 서지학적(書誌學的) 고찰(考察) (A Bibliographic Study on the Therapeutic Effects of Achyranthis Radix in Arthritis)

  • 박희수;신선호;장통영
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.697-704
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    • 2000
  • According to herbalogical bibligraphy and literature, therapeutic effects of Achyranthis Radix on arthritis was as follows, 1. Achyranthis Radix of Amaranthaceae is divided into five species-Achyranthes japonica, A. bidentata, A. longifolia, A. fauriei, Cyathula capitata, C. officialis and the characteristic, taste, channel entry, effects and main treatments were alike. 2. Winefrying stood for repairing treatement method for Achyranthis Radix Before repairing treatment method, Achyranthis Radix had three tastes(bitter, sour, and sweet) and calm and not poisoning characteristic. After repairing treatment method, the bitter taste was disappeared, and calm and not poisoning characteristic was changed into warm characteristic. 3. Effects of Achyranthis Radix were quicking the blood and dispelling stasis, liver-kidney supplement and strengthening musculo-skeletal system. Main treatments were relief of lumbar and knee joint pain, static menstrural block and wind-cold- damp impediment. 4. Contraindication of Achyranthis Radix was sympthom caused by spleen-kidney yang vacuity, upper burner disease and lower burner hemorrhage etc. Being used in pregnant woman, it could incur abortion. 5. Contraindication of Achyranthis Radix was beef, milk and mutton. It's fear was Radix Cynanchi Stauntonii and Semen Plantaginis. It's aversion was the firefly. Herba Taraxaci, Carapax Amydae, Carapax Testudinis and Radix Cynanchi Stauntonii. From above results, I suppose Achyranthis Radix has enough herbalogical foundation and could be used to treat arthritis and it is necessary to make a profound study of it.

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연부 조직 육종의 예후 인자 (Prognostic Factors of Soft Tissue Sarcomas - A Review of 94 Cases of Soft Tissue Sarcoma -)

  • 김재도;정철윤;손정환;홍영기;손영찬;박정호
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.210-219
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    • 1995
  • Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.

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골성 유잉 육종의 비 수술적 치료 (A Clinical Study of Ewing's Sarcoma)

  • 서승우;임홍철;문우남;김형석;최성태;김경수
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.164-170
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    • 1995
  • Eight patients with Ewing's sarcoma were treated between September 1983 and September 1992 at medical college, Department of Orthopaedic Surgery, Guro Hospital, Korea University. There were 5 males and 3 femails, with mean age of 28.2 years(ranging from 2-66 years). Three patients with soft tissue Ewing's tumor were excluded from the study. Of the eight patients, two patients presented with multiple metastasis, two cases occurred in the rib, and in the distal femur, mandible, scapular, 3rd, 4th thoracic spine in each patients. Chemotherapy alone was applied in 3 patients, radiotherapy alone in 1 patient, 2 patients were treated with chemotherapy and radiotherapy. Four patients died from the disease itself. Remissions were achieved in the other 4 patients. However, among them two patients relapsed 5 and 36 months later, I patient was not able to be followed, I patient died due to sepsis. The poor prognosis observed for patients with axial lesions should encourage other methods of managing these tumors.

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다발성 골 침습과 병적 골절을 동반한 단일조직 랑게르한스 세포 조직구증: 증례 보고 (Single System Langerhans' Cell Histiocytosis with Multifocal Bone Lesions and Pathologic Fracture: A Case Report)

  • 허재승;김홍식;박용욱;표주연;이영호;박예수
    • 대한골관절종양학회지
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    • 제19권2호
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    • pp.78-82
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    • 2013
  • 랑게르한스 세포 조직구증(Langerhans' cell histiocytosis)은 단핵구계에 속하는 정상 조직구들이 과도하게 증식하여 다양한 임상 경과와 치료결과를 보이는 질환 군으로 알려져 있다. 특히, 척추에 침범하는 경우에는 단발 혹은 다발성의 골 용해를 특징으로 한다. 병변의 침범 부위, 진행 정도 및 동반 증상에 따라 단순 경과 관찰에서부터 방사선 치료, 화학요법 및 수술적 치료에 이르기까지 다양한 치료법들이 적용되어 왔으나, 아직까지 확립된 치료법은 없는 것으로 알려져 있다. 저자들은 경추와 요추를 동시에 침범하면서 척추 내 골수 파괴 소견과 병적 골절을 동반한 단일조직 랑게르한스 세포 조직구증 환자에 대해 수술적 치료 및 전신화학요법을 시행한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

마음챙김 명상관련 국내 임상연구 동향 분석 (Clinical Research Trends on Mindfulness Meditation in Korea)

  • 양영필;송익수;문진석;한창현;박지하;이상남
    • 한국한의학연구원논문집
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    • 제16권2호
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    • pp.57-64
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    • 2010
  • Background : Meditation is one of the healing therapies used to prevent and cure ailments and to improve health through regular practice. Although Meditation is within the paradigm of modern Western medical science, effects on the human body could be possible. Objectives : This study performed a systematic review of the literature published in Korea focused on mindfulness meditation (MM), which is being applied as mind-body therapy around the USA lately. Method : Three hundred sixty six articles were found after searching with keyword, 'mindfulness meditation (MM)' in 6 journals and web databases. Ninety papers related MM were analyzed trend, Seventeen randomized controlled trials (RCTs) and 38 controlled clinical trials (CCTs) were researched by systematic review. Result : Most of them were studies about relationship between MM and syndrome such as stress, depression, anxiety and MM was also applied to some disease like hypertension, temporomandibular joint disorder in some cases. In 55 studies, It was shown that MM has positive effects on various symptoms and sometimes the effect of MM showed at post and follow-up study although there was no significant difference between control group and experimental group in some cases according to outcome measurement. Interestingly, there was no study reported about side effects of MM after the application. Conclusions : MM is being clinically applied at both western and oriental hospital in Korea, but more clinical trials with the high quality are needed to support its scientific basis.