• 제목/요약/키워드: knee joint

검색결과 1,678건 처리시간 0.034초

자기공명분석기에 의한 반사성 교감신경성 위축증의 치험 (Experience with the Application of Magnetic Resonance Diagnostic $Analyser^{(R)}$ -A case of reflex sympathetic dystrophy-)

  • 김진수;곽수달;김정순;옥시영;차영덕;박욱
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.275-279
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    • 1993
  • Reflex sympathetic dystrophy is a syndrome characterized by persistent, burning pain, hyperpathia, allodynia & hyperaesthesia in an extremity, with concurrent evidence of autonomic nervous system dysfunction. It generally develops after nerve injury, trauma, surgery, et al. The most successful therapies are directed towards blocking the sympathetic intervention to the affected extremity by regional sympathetic ganglion block or Bier block with sympathetic blocker; other traditional treatments include transcutaneous electrical stimulation, immobilization with cast & splint, physical therapy, psychotherapy, administration of sympathetic blocker, calcitonin, corticosteroid and analgesic agents. The purpose of this report is to evaluate and describe the effects of magnetic resonance following unsatisfactory results with traditional treatments of RSD. A 17 year old female patient, 1 year earlier, had received excision and drainage of pus at the right femoral triangle due to an injury caused by a stone. Afterwards, she experienced burning pain, knee joint stiffness, and muscle dystrophy of the right thigh, especially when standing and walking. Despite a year of number of traditional treatments such as: lumbar sympathetic block, continuous epidural analgesia, transcutaneous electrical stimulation, & administration of predisolone, her pain did not improve. Surprisingly, the patients was able to walk free from pain and difficulty after just one application of magnetic resonance. The patient has been successfully treated with further treatment of two to three times a week for approximately ten weeks. More recently, magnetic resonance has been demonstrated to produce effective results for the relief of pain in a variety of diseases. From our experiences we recognize magnetic resonance as a therapeutic modality which can provide excellent results for the treatment of RSD. It has been suggested that polysynaptic reflex which are disturbed in RSD may be modulated normally on the spinal cord level through the application of magnetic resonance.

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변형된Inside-Out 술식을 이용한 반월상 연골 봉합술 (Modified Inside-Out Suture Technique for Meniscus Repair)

  • 안진환;왕준호;유재철;김형건
    • 대한정형외과스포츠의학회지
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    • 제1권2호
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    • pp.118-123
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    • 2002
  • 목적: 저자들은반월상연골후내각부에사용되던기존의inside-out 의수술수기를변형하여수직봉합이가능하면서충분한고정력을얻을수있는수술수기를보고하는바이다. 수술수기: 관절경을전외측도달법으로위치시키고봉합용갈고리를전내측도달법으로위치시켜봉합용갈고리를돌려서내측반월상연골후내각부에파열된부분의내측의대퇴골쪽표면에서경골쪽표면으로통과시킨다. 갈고리내로PDS $\#0$을통과시킨후봉합용갈고리를빼내고전내측도달법입구로PDS$\#0$의양끝을뽑아낸다. 전내측도달법입구에관절경을위치시킨후전외측도달법입구로Zone specific cannula를통과시켜반월상연골파열면의경골면에위치시키고저자가고안한Looped Needle을통과시킨 후 경골면의PDS $\#0$을Looped Needle의loop 사이를통과시킨후관절밖으로빼낸다.대퇴골면의PDS $\#0$도같은방법으로관절밖으로빼낸다. 2개의PDS 봉합사가나온입구근처에약1cm가량의incision 을넣고PDS 봉합사사이에연부조직이끼지않음을확인하고결찰을시행한다. 고찰: 변형된inside-out 봉합술은기존의inside-out 봉합술에비해수술시간의지연이있을수있으나, 수직봉합을할수있고견고한고정력을얻을수있으며해부학적인정복으로파열부위의접촉면을증가시켜후내각반월상연골의파열을봉합하는우수한방법으로판단되어보고하는바이다.

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후방 십자 인대 단독 손상 환자의 기능적 분석 (Functional analysis of isolated posterior cruciate ligament deficient subjects)

  • 김진구
    • 대한정형외과스포츠의학회지
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    • 제3권1호
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    • pp.66-72
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    • 2004
  • 목적: 후방 십자 인대 손상 환자의 포괄적 기능적 검사를 시행한 후 동일 조건의 정상인과 비교 분석함으로써 생체 내의 보상기전을 알아보고 향후 치료에 유용한 지침을 개발하는데 있다. 연구대상 및 방법: 10명의 후방 십자 인대 손상 환자와 10명의 정상 대조군을 대상으로 운동 범위, 후방 전위 검사, KT-1000을 이용한 후방 전위 검사, 텔로스 스트레스 및 30도 굴곡 전 체중 부하 방사선 검사, 보행 분석, 근전도 검사, 등 운동성 근력 검사 등을 시행하였다. 결과: 이학적, KT-1000, 텔로스 후방 전위 검사에서는 양군 간에 의미 있는 차이를 보였으나 30도 굴곡 전 체중 부하 방사선검사, 굴곡 및 신전건의 근력 검사에서는 차이가 없었다. 보행 시 후방십자인대 결손 군은 초기 착지 시 슬관절 굴곡을 더 적게 하고 입각기 시 슬관절 최대 외반 관성력은 감소하였다(p=0.027). 수직 착지 시 초기 접촉이 일어나는 순간 더 큰 족저 굴곡을 보이므로(p=0.014) 슬관절의 하중 부담을 감소시켰고(p=0.020) 근전도 검사 및 근력에서는 유의한 차이가 없었다. 결론: 후방 십자 인대 손상 후 환자들은 슬관절의 불안정 요소를 줄이고 충격을 최대로 흡수하는 보상 작용을 수행하여 훌륭한 임상적, 기능적 결과를 나타내며 향후 지속적인 연구가 필요하다.

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강황(薑黃)약침이 CFA로 유발된 류마티스성 관절염에 미치는 영향 (Effects of Curcuma longa $L_{INNE}$ Pharmacopuncture at $ST_{36}$ on Adjuvant Induced Arthritis in Rats)

  • 이욱재;이동근;이주희;이정훈;이상현;박근희;신정철
    • Journal of Acupuncture Research
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    • 제30권4호
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    • pp.95-105
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    • 2013
  • Objectives : The objective of this study was to investigate the effects of Curcuma longa $L_{INNE}$ pharmacopuncture at $ST_{36}$ on Complete Freund's Adjuvant(CFA)-induced arthritis in rats. Materials and methods : Arthritis was induced by injecting CFA subcutaneously into the left knee joint and paw, and Curcuma longa $L_{INNE}$ pharmacopuncture(CLL-A. $0.0343{\mu}g/kg$; CLL-B. $0.171{\mu}g/kg$; CLL-C. $0.343{\mu}g/kg$) was injected at $ST_{36}$ each other day for 5 times beginning on day 10 after the CFA injection. Paw edema, withdrawal response, hematological, serological and histological observation were assessed. Results : In paw edema volume all 3 groups(CLL-A, CLL-B, CLL-C) showed significant decrease compared to the CFA control group. In withdrawal response to reaction time and withdrawal response to force all 3 groups(CLL-A, CLL-B, CLL-C) showed significant increase compared to the CFA control group. In serum AST, group CLL-C showed significant decrease compared to the CFA control group. In histological observations, in all 3 groups, more normal chondrocytes were observed compared to the CFA control group and safranin O stain showed high positive reaction in the cartilage tissue close to the bone tissue. Conclusions : The results suggest that Curcuma longa $L_{INNE}$ Pharmacopuncture at $ST_{36}$ has a suppressing inflammation effect on Freund's adjuvant arthritis in rats.

가미계작지모탕약침(加味桂芍知母湯藥鍼)이 퇴행성관절염 병리인자 및 동물병태 모델에 미치는 영향 (Anti-inflammation and Anti-oxidation Effects of Gamikyejakjimo-tang Herbal Acupuncture on Pathologic Factor and MIA-induced Osteoarthritis Rat)

  • 이현재;박정오;오민석
    • 한방재활의학과학회지
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    • 제25권4호
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    • pp.1-20
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    • 2015
  • Objectives This study was intended to clarify the anti-inflammation and anti-oxidation effects of gamikyejakjimo-tang herbal acupuncture (GKHA) for osteoarthritis. Methods Osteoarthritis was induced by injection of MIA into right knee joint cavities of rats. Rats were divided into a total of 4 groups (n=8). The 4 groups were normal group, control group, positive comparison group and expeimental group. Indomethacin and GKHA were medicated for a total of 4 weeks. After that, functions of liver and kidney by AST, ALT, creatinine, BUN, DPPH and ABTS free radical scavenging activity, ROS (reactive oxygen species) production, NO (Total Nitric oxide), IL-$1{\beta}$, IL-6, TNF-${\alpha}$ production, weight changes in the hind legs of MIA-induced osteoarthritis rat, serum PGE2, TIMP-1, MMP-2, MMP-9, LTB4, hs-CRP, and white blood cells, neutrophils, lymphocytes, monocytes were measured. The volume of cartilage was observed by micro CT arthrography. H&E and Safranin-O staining were used to examine the injury of synovial tissue. Results 1. In the hind leg weight bearing measurement, level of weight was increased. 2. AST, ALT, BUN, creatinine were decreased. 3. The production of total white blood cell was decreased, and the production of neutrophils, lymphocytes, monocytes were significantly decreased. 4. The production of NO, PGE2, TIMP-1, MMP-2, MMP-9, LTB4 were significantly decreased, and the production of hs-CRP was also decreased but with no significance. 5. The cartilage volume was significantly increased. 6. In H&E staining and Safranin-O staning, the cartilage cell appeared to be proliferated, and proteoglycans appeared to be increased. Conclusions Based on the results above, Gamikyejakjimo-tang Herbal Acupuncture has anti-oxidation and anti-inflammation effects, which leads to suppressing the underlying causes and the progression of osteoarthritis.

경골과 골절의 수술적 치료 결과 (Operative Treatment of Tibial Plateau Fractures)

  • 신덕섭;성병년;김동원
    • Journal of Yeungnam Medical Science
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    • 제18권2호
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    • pp.187-198
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    • 2001
  • 저자들은 1991년 1월부터 1997년 12월까지 7년간, 수술적으로 치료한 경골과 골절 환자 중 최단 1년에서 최장 8년까지 장시 추시 관찰이 가능했던 29예를 대상으로 치료 예후에 관여하는 인자를 조사하여 다음과 같은 결과를 얻었다. 1. 20대부터 40대까지가 15명(51.7%)을 차지해 활동기 연령층에서 발생 빈도가 높았고, Schatzker의 분류에 의해 2형 골절이 11예(37.9%)로 가장 많았다. 동반 연부 조직 손상은 18예(62.1%)에서 발생되었으며, 외측 반월상 연골 손상이 6예(33.3%), 내측 측부 인대손상이 4예(22.2%)로 많았다. Blokker 평가 기준에 의해 29예 중 23예(79.3%)가 양호하였다. 2. 불량한 결과와 관련 있는 요인으로는 30대 이전의 연령층, 고 에너지 손상의 Schatzker 분류 IV형 이상의 골절, 전방 십자 인대 손상과 반월상 연골 손상 등의 동반 손상이었다. 또한 각 골절의 양상과 손상의 정도에 따라 골절면의 정확한 해부학적 정복과 견고한 내고정을 시행하여, 조기에 슬관절 운동을 시행하여야 슬관절의 기능을 향상시킬 수 있을 것으로 사료되었다.

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진교${\cdot}$위령선${\cdot}$하고초 복합방이 MIA 유발 골관절염 모델에서 중추신경내 통증관련물질에 미치는 영향 (GCP Treatment on the Expression of NOS, C-fos, Serotonin and Substance-P in Central Nerve System of Monosodium Iodoacetate-Induced Osteoarthritic Pain Model)

  • 박원태;정수현;서일복;김순중
    • 동의생리병리학회지
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    • 제21권6호
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    • pp.1483-1490
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    • 2007
  • This study was carried out to investigate the effects of GCP treatment on the expression of NOS, c-fos, serotonin and substance P in central nerve system of monosodium iodoacetate(MIA)-induced osteoarthritic pain model. Arthritis was induced by injection of MIA(0.5 mg) into knee joint cavities of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was taken distilled water for 20 days. Treated group was taken extracts of GCP by oraly for same duration. Normal group(n=8) was infected with normal saline and was taken distilled water for 20 days. The numbers of NADPH-d positive cells in superficial dorsal horn of spinal cord of treated group($21{\pm}5$) was significantly (p<0.01) decreased compared with control($33{\pm}5$). The numbers of NADPH-d positive cell in dorsolateral periaqueductal gray matter of treated group($111{\pm}16$) was significantly(p<0.01) decreased compared with control($143{\pm}14$). The numbers of c-fos positive cells in dorsal periaqueductal gray matter of treated group($57{\pm}16$) was significantly(p<0.01) decreased compared with control($78{\pm}13$). The numbers of c-fos positive cells in paraventricular thalamic nucleus of treated group($60{\pm}15$) was significantly decreased compared with control($88{\pm}27$). The numbers of serotonin positive cells in median raphe nucleus of treated group($171{\pm}31$) was significantly(p<0.05) decreased compared with control($217{\pm}48$). On the basis of these results, we concluded that GCP treatment has inhibiting effects on the pain transmission in monosodium iodoacetate-induced osteoarthritic pain model in rat.

타박(打撲)에 의한 활액낭종(滑液囊腫)의 치험례(治驗例) (Treatment Example of Bursitis Caused by Stroke)

  • 이수경;이용양;김영환;박원환
    • 대한한의진단학회지
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    • 제14권1호
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    • pp.79-95
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    • 2010
  • Background and Purpose : By preventing diseases caused by exogenous evil, disorder of internal organs, and seven modes of emotions and adapting to mother nature when the mind is unsettled, and keeping the body and mind relaxed diseases can be avoided, but there can be unpredicted situations caused accidentally by stroke. Currently the general prescription is regulating the flow of vital energy including drugs eliminating blood stasis. Even though the stroke is resulted from diseases caused by exogenous evil, by observing the patient's physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart to clear the upper body and invigorate the functions of the spleen and stomach and purge with drugs of warm nature is a closer approach than simply prescribing vital energy regulating drugs with eliminating blood stasis to the main purpose of treatment. Methods : 1) The subject of the study are 2 cases of patients who have visited the private hospital of the person who is announcing the results of the study. These patients have been given a diagnosis of edema or cystoma caused by bursitis in the knee joint through perception or medical examination and were waiting for operational application. 2) Sources related to stroke from Dong Eui Bo Gwam(東醫寶鑑) were used as the general standard of Korean Traditional Medicine, and to promote the understanding the original text and the translation has been given. 3) By observing the whole body such as the patient's usual physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart, or partly using the "Yin is even and well while Yang is firm" theory of "Plain Questions" as the background to present the results of the clinical study. Results and Conclusion : Generally the prescriptions from the first volume of Dong Eui Bo Gwam(東醫寶鑑) are mostly drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating blood circulation. Also prescriptions for bone fracture or fracture of bones and sinews are mostly to eradicate blood stasis with drastic drugs or coaptation drugs added to drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating vital energy, possessing warm properties for the Xue system.

토끼에서 후방십자인대 손상 후 후방십자인대의 기계적 수용기의 변화 (The change of the Mechanoreceptor of Posterior Cruciate Ligament after Posterior Cruciate Ligament Injury in the Rabbit)

  • 정영복;이재성;김경환
    • 대한정형외과스포츠의학회지
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    • 제1권1호
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    • pp.55-60
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    • 2002
  • 목적 : 토끼후방십자인대의절단뒤후방십자인대의치유와기계적수용기의수적변화에대해관찰하고자하였다. 대상및방법 : 골성숙이완료된열마리의뉴질랜드산흰토끼를 이용하여각각에서양측슬관절중한쪽슬관절에서는후방십자인대를절단하고, 다른한쪽에는샴술기를시행한후20주후에생검하여후방십자인대의치유가이루어진9례에서조직학적검사를시행하여후방십자인대를절단한슬관절과샴술기를시행한슬관절을비교하였다. 결과 : 후방십자인대절단후치유가이루어진조직들에서샴술기를시행하였던조직보다기계적수용기가약간감소한것으로관찰되었으나통계적유의성은없었다. 결론 : 후방십자인대가손상된슬관절에서비록기계적수용기가감소한다할지라도고유감각이유지될수있을것으로사료되나기계수용기의손상된후방십자인대에대한작용과생역학적기능에대해서는좀더연구가이루어져야될것으로사료된다.

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스쿼트 운동 시 적용된 중주파 전기자극이 안쪽빗넓은근과 가쪽넓은근의 근활성도 및 근활성비에 미치는 영향 (Effects of Interfering Current Stimulation on Vastus Medialis Oblique and Vastus Lateralis Activity and Ratio during Squat Exercise)

  • 김충유
    • 대한통합의학회지
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    • 제9권4호
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    • pp.283-289
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    • 2021
  • Purpose : The purpose of this study is to investigate the effect of mid frequency electrical stimulation during squat exercise on the muscle activity and muscle activity ratio of vastus medialis oblique and vastus lateralis, and to prepare scientific basic data for exercise intervention using mid frequency electrical stimulation. Methods : This study was conducted with students from University C located in Busan, and among a total of 123 subjects, 12 subjects who complained of knee joint dysfunction between 80 and 90 points using the Kujala patellofemoral score (KPS) were used. All subjects participated in the experiment for 3 days, and MVIC values were measured for normalization of muscle activity values on the first day. For the two days, participants participated in the experiment and performed squat exercise or squat exercise receiving mid-frequency electrical stimulation in random order. Measurements were taken in the squat position immediately after the squat exercise, and muscle activities of vastus medialis oblique and vastus lateralis were measured. The measured data were compared through the dependent t test, and the statistical significance level was set to .05. Results : According to the results of this study, in the case of applying mid-frequency electrical stimulation together in the ratio of vastus medialis oblique and vastus lateralis muscle activity during squat exercise, higher values were observed compared to the case of not applying mid-frequency electrical stimulation together, and statistically significant. Also, when mid-frequency electrical stimulation was applied to both vastus medialis oblique and vastus lateralis activities during the squat exercise, higher values were shown compared to the case where the mid-frequency electrical stimulation was not applied together, but there was no statistically significant difference. Conclusion : The results of this study reported that mid-frequency electrical stimulation provided to vastus medialis oblique increased the muscle activity ratio of vastus medialis oblique and vastus lateralis. Therefore, the improvement of coordination due to the enhancement of the activity of vastus medialis oblique through mid-frequency electrical stimulation will be more helpful in the treatment of patellofemoral pain syndrome patient. In addition, it is hoped that the electrical stimulation method applied to exercise will be widely used.