• 제목/요약/키워드: knee joint

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FasT-Fix를 이용한 All-Inside 반월연골판 봉합술 (All-Inside Meniscal Repair Using FasT-Fix)

  • 정유훈;최남홍;김병연
    • 대한정형외과스포츠의학회지
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    • 제12권1호
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    • pp.24-28
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    • 2013
  • 목적: FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA)를 이용하여 all-inside 방법으로 반월연골판을 봉합하는 방법은 흔히 시행되고 있으나, 국내에서는 수술 후 임상적 결과를 발표한 논문이 전무하다. 따라서 본 후향적 연구 논문의 목적은 FasT-Fix를 이용한 all-inside 봉합술로 반월연골판을 봉합한 후 임상적 결과를 보고하는 것이다. 대상 및 방법: 슬괵건을 이용한 전방십자인대 재건술을 시행한 환자 중에서 내측 또는 외측 반월연골판 후각 파열이 동반되어 FasT-Fix를 이용하여 반월연골판 봉합술을 시행한 25명의 환자를 대상으로 하였다. 수술 후 Lysholm 점수, Tegner 활동도를 이용하여 수술 후 상태를 평가하였다. 삼출이나 관절선의 압통이 없었고, McMurray 검사가 음성이며 어긋나는 느낌이 없는 경우에 봉합한 반월연골판이 치유된 것으로 판정하였다. 결과: 평균 추시 기간은 47.9 개월(40.0~61.0개월) 이었다. 추시간 평균 Lysholm 점수는 91.8 그리고 평균 Tegner 활동도는 5.6이었다. 봉합한 반월연골판은 임상적인 기준에 의해 20명(80%)에서 치유되었고, 5명(20%)에서 치유가 되지 않은 것으로 판정하였다. 결론: 슬괵건을 이용한 전방십자인대 재건술 환자에서 FasT-Fix를 이용한 all-inside 반월연골판 봉합술은 만족할만한 결과를 보여주었다.

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류마티스 관절염에서 우슬과 전침자극의 항관절염 효과 (Effects of Achyranthes Radix and Electroacupuncture on Type II Collagen-Induced Arthritis)

  • 김계엽;성락선;김용억;장미경;유영대;최기복;정현우
    • 동의생리병리학회지
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    • 제21권2호
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    • pp.425-431
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    • 2007
  • The purpose of this study was to observe the effects of Achyranthes Radix(AR) and electroacupuncture(EA) in rats with rheumatoid arthritis induced by type II collagen for 28 days. Control group was daily administered 0.9% NaCl 0.5 $m{\ell}$, Group I was daily administered 0.9% NaCl 0.5 $m{\ell}$ to arthritic rats, Group II was orally administered with Achyranthes Radix 500 mg/kg 0.5 $m{\ell}$ to arthritic rats. Group III was given 2 Hz EA of chok samni acupoint(ST36) in the test group for 30 min/days to arthritic rats. Group IV was daily orally administered with Achyranthes Radix 500 mg/kg 0.5 $m{\ell}$ and 2 Hz EA of chok samni acupoint(ST36) in the test group for 30 min/days to arthritic rats. This studies have been designed to evaluate the hind paw edema, assessment of arthritis indices, analgetic effects by analysis of blood chemistry(WBC, CRP, ALP, AST). In each group, histologic observations, Safranin O-fast green stain were observed and analyzed. The following results were obtained. Group II, III, IV were significantly decreased arthritis indices and the rate of paw edema compared with Group I . Especially group IV was the most significantly decreased. The WBC, CRP, AST, ALT was that Group II, III, IV were significantly decreased compared with Group I . In conclusion, Achyranthes Radix and Ea contribute to the improvement of blood chemistry and change in safranin O-fast green by knee joint of arthritic rats.

내과(內科) 영역(領域)의 요통(腰痛)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Bibliographical study on Lumbago in Oriental Internal Medicine)

  • 윤철호;정지천
    • 대한한방내과학회지
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    • 제15권2호
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    • pp.318-346
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    • 1994
  • A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

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연결형(반구속형) 주관절 인공 관절 치환술 (Linked (Semi-constrained) Total Elbow Arthroplasty)

  • 정홍준;전인호;전재명;이태균
    • Clinics in Shoulder and Elbow
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    • 제16권2호
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    • pp.170-177
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    • 2013
  • 주관절 인공 관절 치환술은 고관절이나 슬관절 인공 관절 치환술에 비해 아직은 발전 단계에 있는 수술이다. 많은 임상 경험을 통해 여러 형태의 치환물이 개발되어 사용되고 있지만, 이에 대한 장기 추시 결과는 여전히 부족한 실정이다. 현대의 주관절 치환물은 크게 두 가지 디자인 범주로 나누어지는데, 연결형 치환물과 비연결형 치환물이 그것이며, 이들은 다른 말로 반구속형과 비구속형으로 불리기도 하며, 이에 추가적으로 비구속형/구속형 전환 가능한 치환물도 사용되고 있다. 연결형 치환물과 비연결형 치환물의 선택은 우선적으로 주관절의 안정성 및 골성 구조물의 적절성에 의해 결정된다. 연결형 치환물의 경우 전통적으로 마모, 조기 이완, 해리 등과 같은 합병증으로 인해 장기 추시 결과가 좋지 않았던 것이 사실이다. 하지만, 최근 들어 적절한 환자의 선택, 새로운 디자인의 개발, 수술 술기의 발달, 그리고 수술 후 적절한 재활 치료 등으로 인해 이러한 문제점이 많이 해결되었다. 하지만, 여전히 신체적인 활동에 대한 요구가 높은 환자에 있어서는 마모나 이완 등과 같은 문제점으로 인해 연결형 치환물이 적절한 선택이 되지 못하는 경우가 있다. 본 종설에서는 연결형 (반구속형) 주관절 인공 관절 치환물에 대해서 자세히 살펴보고자 한다.

임상적으로 진단된 다발성 골단이형성증 1례 (A Clinically Diagnosed Case of Multiple Epiphyseal Dysplasia)

  • 김선자;조성윤;김진섭;허림;권영희;이지은;심종섭;김옥화;진동규
    • 대한유전성대사질환학회지
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    • 제15권1호
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    • pp.49-54
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    • 2015
  • 다발성 골단이형성증은 비교적 흔한 골이형성증으로 소아기에 관절통과 관절 강직, 뒤뚱거리면 걸어가는 보행 및 일부에서 경한 저신장을 특징으로 하며 영상의학적 검사에서는 여러 관절에서 골단의 불규칙한 소견과 골화 지연을 보인다. 본 증례 환자는 임상적, 영상의학적으로 다발성 골단이형성증을 진단 할 수 있었으며 환자의 넓적다리 관절 영상 검사는 MATN3 유전자 변이를, 무릎 관절 영상 검사는 COMP 유전자 변이를 시사하였기에 MATN3과 COMP 유전자 변이에 대해 시퀀싱(sequencing)을 하였으나, 변이는 발견되지 않았다. 이후 엑솜시퀀싱(exomesequencing)을 시행하였으나, 기존에 다발성 골단이형성증과 관련이 있는 것으로 알려진 유전자에 대한 변이가 발견되지 않았다. 본 증례와 같이 임상적, 영상의학적으로 다발성 골단이형성증으로 진단가능 하였으나 분자유전학적으로 기존에 알려진 변이 유전자가 발견되지 않은 환자들을 위해 추가적인 연구가 필요할 것으로 보인다.

동작에 따른 피부변화 분석을 통한 동작센서 부착의 최적위치 탐색: 조정 동작을 중심으로 (An Exploratory Study of Searching Human Body Segments for Motion Sensors of Smart Sportswear: Focusing on Rowing Motion)

  • 한보람;박선형;조현승;강복구;김진선;이주현;김한성;이해동
    • 감성과학
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    • 제20권1호
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    • pp.17-30
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    • 2017
  • 하이테크놀로지를 여러 가지 다른 영역과 융합하고자 하는 노력이 다양한 연구 분야에서 시도되고 있으며, 스포츠웨어를 개발함에 있어 운동선수의 운동능력을 향상시키기 위한 분야에 이러한 첨단 기술들이 도입되고 있다. 본 연구는 스포츠 훈련에 도움이 되는 동작 센싱 스마트 스포츠웨어를 개발하기 위한 기초 연구로서, 조정 동작 시 관절의 움직임을 측정할 수 있는 동작 센서를 부착하기 위한 인체상의 최적 위치를 탐색하는 것을 목적으로 한다. 본 연구에서는 일관된 동작을 반복적으로 수행할때 관절의 변화가 큰 조정을 대상 스포츠로 선정하였으며, 조정 선수의 대표 체급인 중량급과 경량급의 피험자를 선정하여 동작에 따른 피부의 변화율을 측정하여 체급별 차이를 분석하였다. 먼저, 3차원 모션캡처 시스템을 이용하여 조정 동작 시 등, 팔꿈치, 엉덩이, 무릎 부위의 피부 변화를 촬영하고, 각 마커 간 거리의 변화율을 분석함으로써 체급에 따른 차이를 보이지 않으면서 동작에 따라 피부의 변화가 큰 부분을 인체 상에 도시하였다. 이를 바탕으로 동작 센싱용 스마트 스포츠웨어를 위한 센서 부착의 가이드라인을 제시하였다.

당귀사역탕(當歸四逆湯)이 MIA로 유발된 골관절염 흰쥐에 미치는 영향 (Effects of Danggwisayeok-tang (Dangguisinitang) on MIA-Induced Osteoarthritis Rats)

  • 양두화;우창훈;김정민;안희덕
    • 한방재활의학과학회지
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    • 제25권2호
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    • pp.37-50
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    • 2015
  • Objectives The purpose of this study was to know the effects of Danggwisayeok-tang (Dangguisinitang) extract (DGSYT) on monosodium iodoacetate (MIA)-induced rat osteoarthritis. Methods For this purpose, rats were divided into 5 groups. Normal group was not injected with MIA and orally administered any medication. Control group was injected with MIA and not orally administered any medication. DGSYT100 group was injected with MIA and orally administered 100 mg/kg of DGSYT. DGSYT300 group was injected with MIA and orally administered 300 mg/kg of DGSYT. JoinsT group was injected with MIA and orally administered 20 mg/kg of Joins tablet. DGSYT100 and DGSYT300 groups were orally administered DGSYT during a week before and 3 weeks after based on the day MIA injected. The changes of hepatotoxicity, nephrotoxicity, relative hind paw weight distribution, cytokine in serum, cytokine messenger ribonucleic acid (mRNA) in joint tissue and histopathological observation (Hematoxylin & Eosin and Safranin-O staining) were measured. Results Alanine aminotransferase (ALT) levels of DGSYT100, DGSYT300 and JoinsT groups were increased significantly, but these results were within normal range. Aspartate aminotransferase (AST) and creatinine levels of all groups were not changed significantly. In the change of relative hind paw weight distribution, DGSYT300 and JoinsT groups were decreased significantly 14 and 21 days after MIA injected. Interleukin-$1{\beta}$ (IL-$1{\beta}$) and Interleukin-6 (IL-6), Leukotriene $B_4$ and Osteocalcin levels of DGSYT300 and JoinsT groups were decreased significantly. In measurement of IL-$1{\beta}$ and nitric oxide synthase-II mRNA relative quantitative of control, DGSYT100, DGSYT300 and JoinsT groups were decreased significantly. In measurement of TNF-${\alpha}$, IL-6 and Cyclooxygenase-2 mRNA relative quantitative of control, DGSYT300 and JoinsT groups was decreased significantly. In histopathological observation of knee, synovial tissue, cartilage and proteoglycan of DGSYT100, DGSYT300 and JoinsT were well preserved compared with control group. Conclusions According to the results, DGSYT has anti-inflammation and pain relief effects. So it should be suppressed progression of arthritis in MIA-induced osteoarthritis rat.

DA-7911, $^{188}Rhenium-tin$ Colloid, as a New Therapeutic Agent of Rheumatoid Arthritis

  • Shin, Chang-Yell;Son, Miwon;Ko, Jun-Il;Jung, Mi-Young;Lee, In-Ki;Kim, Soon-Hoe;Kim, Won-Bae;Jeong, Jae-Min;Song, Yeong-Wook
    • Archives of Pharmacal Research
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    • 제26권2호
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    • pp.168-172
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    • 2003
  • Radiation synovectomy is one of the most useful methods for treating patients with refractory synovitis because of its convenience, long-term effects, repeatability and the avoidance of surgery. In this study, we investigated the toxicity, stability and biodistribution of a rhenium-188 ($^{188}$Re)-tin colloid to evaluate its suitability as a synovectomy agent. Twenty four hours after injecting the $^{188}$Re-tin colloids (74 KBq/0.1 mL) into the tail vein of ICR mice, most of the $^{188}$Retin colloidal particles was found in the lungs. In addition, there were no particle size changes at either room temperature or at $37^{\circ}C$ after injecting the $^{188}$Re-tin colloids in human plasma and synovial fluid. In vitro stability tests showed that the $^{188}$Re-tin colloid remained in a colloidal form without a critical size variation over a 2-day period. We investigated the leakage of $^{188}$Retin colloids from the intraarticular injection site with gamma counting in New Zealand white rabbits. The $^{188}$Re-tin colloids (55.5 MBq/0.15 mL) were injected at the cavum articular and the mean retention percentage of the $^{188}$Re-tin colloid was 98.7% for 1 day at the injection site, which suggests that there was neither change in the particle size nor leakage at the injection sites. In the biodistribution study with the SD rats, the liver showed the highest radioactivity (0.0427% ID/organ) except for the injected knees (99.49%). In the SD rats, mild toxicities including the skin or a synovium inflammation were observed as a result of a radioactivity of 15 mCi/kg at the intraarticular injection site. However, there was no systemic toxicity. In the Ovalbumin (OVA)-induced arthritic rabbits, the $^{188}$Re-tin colloid improved the macroscopic, the histological score and reduced the knee joint diameter when compared to the arthritic control. In conclusion, a $^{188}$Re-tin-colloid is considered as a strong candidate for radiation synovectomy with a superior efficacy and safety.

탁구 포핸드 카운터 드라이브 동작의 운동학적 변인 및 지면 반력 분석 (Kinematic and Ground Reaction Force Analyses of the Forehand Counter Drive in Table Tennis)

  • 이용식;이종훈
    • 한국운동역학회지
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    • 제20권2호
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    • pp.155-165
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    • 2010
  • The purpose of this study was to analyze kinematic quantitative factors required of a forehand counter drive in table tennis through 3-D analysis. Four national table tennis players participated in this study. The mean of elapsed time for total drive motion was $1.009{\pm}0.23\;s$. At the phase of impact B1 was the fastest as 0.075 s. This may affect efficiency in the initial velocity and spin of the ball by making a powerful counter drive. The pattern of center of mass showed that it moved back and returned to where it was then moved forward. At the back swing, lower stance made wide base of support and a stronger and safer stance. It may help increasing the ball spin. Angle of the elbow was extended up to $110.75{\pm}1.25^{\circ}$ at the back swing and the angle decreased by $93.75{\pm}3.51^{\circ}$ at impact. Decreased rotation range of swinging arm increased linear velocity of racket-head and impulse on the ball. Eventually it led more spin to the ball and maximized the ball speed. Angle of knee joint decreased from ready position to back swing, then increased from the moment of the impact and decreased at the follow thorough. The velocity of racket-head was the fastest at impact of phase 2. Horizontal velocity was $7796.5{\pm}362\;mm/s$ and vertical velocity was $4589.4{\pm}298.4\;mm/s$ at the moment. It may help increase the speed and spin of the ball in a moment. The means of each ground reaction force result showed maximum at the back swing(E2) except A2. Vertical ground reaction force means suggest that all males and females showed maximum vertical power(E2), The maximum power of means was $499.7{\pm}38.8\;N$ for male players and $519.5{\pm}136.7\;N$ for female players.

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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