• 제목/요약/키워드: osteoarthritis of knee

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관절염에 관한 국내 간호학 연구 논문 분석 (The Analysis of Research in Arthritis)

  • 박상연;백명화
    • 근관절건강학회지
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    • 제7권2호
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    • pp.227-240
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    • 2000
  • The purpose of this article was to identify trend in Arthritis research and to provide ba an approach of Arthritis research. The results of analysis of 69 Arthritis articles public year of between 1970-1999 found that most articles(27.6%, n=19) were published since few(10.1%, n=7) were before 1994. Vast majority of articles(79.8%, n=55) were printed in The Journal of Rheumatology Health, and 79.8%(n=55) of those were quantitative research, 8.7%(n=6) were qualitative research, and 14%(n=1) was methodological research. 29.0%(n=20) of quantitative research were carried in experimental design and over half(50.8%, n=35) in nonexperimental design. Having concerned the types of treatment(or intervention) used in experimental study, the most common treatment was 'exercise' (45.0%, n=9), and other less common were 'self-help education(15.0%, n=3), home care(10.0%, n=2) supportive care(10.0%, n=2), flexibility exercise combined with local heat therapy(5.0%, n=1), relaxation training(5.0%, n=1). Of the types of exercise, aquatic exercise was 30.0%(n=6). The effect of exercise on outcome variable was found to be most strong among the other types of treatment. 18 articles of nonexperimental research were correlational research. From the analysis of correlational research, 29 concepts were identified, and the relationship between depression and other variable were strongly reported. In descriptive studies, most commonly physiological variables were examined in 5 articles(29.5%). Only one study(5.9%) explored patient's perception of the causal factors and those causality. In qualitative researches, two study were carried out by the means of grounded theory. Majority of those subjects were RA patients, and the largest number of sample were 23 and the smallest was 1 In two studies, patient's perceived causality of RA was identified as a research problems, and an experience of ADL, fatigue Phenomenon, an experience of having a total knee replacement with osteoarthritis were each found in one study. Methodological research was carried out to test validity and reliability of the RA Fatigue Scale.

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대영전의 Monosodium Iodoacetate 유발 관절연골손상 억제 효과 (Inhibitory Effects of Daeyeoungjeon on the Injury of Articular Cartilage Induced by Monosodium Iodoacetate in Rats)

  • 서일복;정수현;박동수
    • 한방재활의학과학회지
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    • 제27권2호
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    • pp.9-17
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    • 2017
  • Objectives This study was aimed to evaluate the effects of Daeyoungjeon (hereinafter referred to DYJ) treatment on the injury of articular cartilage induced by monosodium iodoacetate in rats. Methods Twenty-four male rats were divided into normal, osteoarthritic control and DYJ group. Rats of normal group were injected with 0.1 ml physiological saline, rats of control and DYJ groups were injected with 0.1 ml monosodium iodoacetate (3 mg/ml) into each left and right knee joint cavities. Rats of DYJ group were administrated extracts of DYJ during 60 days per orally. At 60 days after treatment, gross lesions, area and proteoglycan contents of articular cartilage, histopathological lesions, immunohistochemistry on matrix metalloproteinases (MMP-2, MMP-3, MMP-7) were evaluated. Results Grossly, degenerative changes of articular cartilages were observed weak in DYJ group. The areas of articular cartilages were broader significantly in DYJ group. The proteoglycan contents in articular cartilages were lesser significantly in DYJ group. Histopathologically, the chondrocyte score was lesser significantly in DYJ group. MMP-3 expression in articular cartilages was observed weak in DYJ group. Conclusions From above results, DYJ treatment has inhibitory effects on the injuries of articular cartilage induced by monosodium iodoacetate in rats, and it's effects may be related with down regulation of MMP-3.

섬유조직염 환자에 대한 기초 조사연구 (Survey on Fibromyalgia Syndrome)

  • 한상숙;강현숙
    • 근관절건강학회지
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    • 제4권1호
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    • pp.74-86
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    • 1997
  • This investigation has been conducted based on the medical chart of 344 patients who have been diagnosed of fibromyalgia syndrome during Oct. 9, 1996 through Nov. 20 at the Rheumatism Hospital of H. University located in Seoul. 280 which have been included in the analysis. 1. Only one patient was male in 280 patients, age distribution was from 28 to 76, in which the average age was 52.4. 2. Percentage of treatment duration was 6 months in 46.1%, 3 years in 22.1% and 2 years in 12.5%. Considering these results, it can be predicted that the number of patients might be increased and accumulated in the future. 3. Percentage of patients having primary fibromyalgia syndrome was 39.3%, having combination with osteoarthritis was 36.7% and the rest case have combination with rheumatoid arthritis at the same time. 4. The percentage of cases having patients 10-12 tender points was 37.1%, while the most of cases have pain at 12-19 tender points. The common locations of the tender point were at lateral epicondyle of elbow in 92.0%, at midpoint of upper border Trapezius in 84.8%, at upper part of scapula Supraspinatus in 82.9%, at medial fat pad proximal to the joint line knee in 81.85%, at intertransverse of $C_{5-7}$ Low cervical in 73.4% and at 2nd distal costochondral Junction 2nd rib in 72.0%. And most of the patients had joint functional disability at all in 47.1% with average 2.41 joint functional disability. 5. Age was not a variable influencing the number of tender points and the number of joint functional disability.

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퇴행성 반월상 연골판 파열 환자의 한의학적 치료 효과와 Kellgren-Lawrence-grade, Body Mass Index의 상관성 (The Correlation between Korean Medical Treatment on Degenerative Meniscus Tear and Kellgren-Lawrence-grade, Body Mass Index)

  • 이기언;이건영;한시훈;김국범;김효준;장재원;장영우;조재흥
    • 한방재활의학과학회지
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    • 제28권4호
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    • pp.71-79
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    • 2018
  • Objectives The aim of this study is to observe the effectiveness of complex Korean medicine treatment applied to the patients with degenerative meniscal tear and the correlation among clinical effectiveness, body mass index (BMI) and Kellgren-Lawrence grade (KL-grade). Methods The study participants were 38 patients who had been diagnosed with degenerative meniscal tear. Participants were classified by BMI, KL-grade and treated with acupuncture, electroacupuncture and pharmacopuncture. Clinical outcomes were assessed using Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index) and EuroQol-5 Dimension Index (EQ-5D Index). Results Both NRS and WOMAC scores were significantly reduced after treatment (p<0.001). The EQ-5D for assessing quality of life showed further improvement (p<0.05). A statistically significant correlation was observed between the BMI and NRS, EQ-5D. KL-grade was correlated with WOMAC. Conclusions These results show that complex Korean medicine treatment to the patient with degenerative meniscal tear may be effective as a conservative therapy. Further research is required to confirm the effectiveness of Korean medicine treatment.

Hypoxic condition enhances chondrogenesis in synovium-derived mesenchymal stem cells

  • Bae, Hyun Cheol;Park, Hee Jung;Wang, Sun Young;Yang, Ha Ru;Lee, Myung Chul;Han, Hyuk-Soo
    • 생체재료학회지
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    • 제22권4호
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    • pp.271-278
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    • 2018
  • Background: The chondrogenic differentiation of mesenchymal stem cells (MSCs) is regulated by many factors, including oxygen tensions, growth factors, and cytokines. Evidences have suggested that low oxygen tension seems to be an important regulatory factor in the proliferation and chondrogenic differentiation in various MSCs. Recent studies report that synovium-derived mesenchymal stem cells (SDSCs) are a potential source of stem cells for the repair of articular cartilage defects. But, the effect of low oxygen tension on the proliferation and chondrogenic differentiation in SDSCs has not characterized. In this study, we investigated the effects of hypoxia on proliferation and chondrogenesis in SDSCs. Method: SDSCs were isolated from patients with osteoarthritis at total knee replacement. To determine the effect of oxygen tension on proliferation and colony-forming characteristics of SDSCs, A colony-forming unit (CFU) assay and cell counting-based proliferation assay were performed under normoxic (21% oxygen) or hypoxic (5% oxygen). For in vitro chondrogenic differentiation, SDSCs were concentrated to form pellets and subjected to conditions appropriate for chondrogenic differentiation under normoxia and hypoxia, followed by the analysis for the expression of genes and proteins of chondrogenesis. qRT-PCR, histological assay, and glycosoaminoglycan assays were determined to assess chondrogenesis. Results: Low oxygen condition significantly increased proliferation and colony-forming characteristics of SDSCs compared to that of SDSCs under normoxic culture. Similar pellet size and weight were found for chondrogensis period under hypoxia and normoxia condition. The mRNA expression of types II collagen, aggrecan, and the transcription factor SOX9 was increased under hypoxia condition. Histological sections stained with Safranin-O demonstrated that hypoxic conditions had increased proteoglycan synthesis. Immunohistochemistry for types II collagen demonstrated that hypoxic culture of SDSCs increased type II collagen expression. In addition, GAG deposition was significantly higher in hypoxia compared with normoxia at 21 days of differentiation. Conclusion: These findings show that hypoxia condition has an important role in regulating the synthesis ECM matrix by SDSCs as they undergo chondrogenesis. This has important implications for cartilage tissue engineering applications of SDSCs.

분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과 (Result of Staged Operation in Ruedi-Allgower Type II and III Open Tibia Pilon Fractures with Severe Comminution)

  • 최귀연;이준영;장현웅;김영욱
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.110-115
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    • 2019
  • Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

내측 사선 광근에 대한 EMG Biofeedback 훈련과 테이핑 적용이 슬개골 부정렬 환자의 기능향상에 미치는 효과 (Effect of EMG Biofeedback Training and Taping on Vastus Medialis Oblique for Function Improvement of Patient with Patella Malalignment)

  • 김동연;김수현;임영은;이동걸;김태열
    • The Journal of Korean Physical Therapy
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    • 제20권3호
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    • pp.35-43
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    • 2008
  • Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

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독일에서 수행된 대규모의 침 치료 임상연구 Acupuncture Randomized Trials와 the Acupuncture in Routine Care에 대한 고찰 (Review of the Acupuncture Randomized Trials(ART) and the Acupuncture in Routine Care(ARC): the Acupuncture Trials in Germany)

  • 한국인;윤주연;정진수;이승호;장인수
    • Journal of Acupuncture Research
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    • 제30권5호
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    • pp.117-123
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    • 2013
  • Objectives : The purpose is to review large-scale clinical researches, the acupuncture randomized trials(ART) and the acupuncture in routine care(ARC), concerning efficacy and effectiveness of acupuncture performed in Germany. Methods and Results : We have reviewed the studies that were searched by keyword 'acupuncture' as the title and'Witt CM' as one of the main authors in PubMed. Sixteen clinical reports focused on the ART and ARC studies were analyzed among all thirty six were searched. Six studies were related with the ART and eight were focused on the ARC, and other two were on both. Finally, across all researches except osteoarthritis of knee trials in the ART, compared the acupuncture group with the control were significantly improved. On the other hand, ARC showed that additional acupuncture plus routine care was more effective than routine care alone and the response to treatment of the non-randomized group did not differ the one of the randomized acupuncture group. Conclusions : The results may suggest that acupuncture treatment has obvious clinical effectiveness. These results are expected to inspire domestic research and clinical applications in Korea, and more rigorous research on the efficacy of acupuncture should be guaranteed.

거머리 요법에 대한 연구동향 (The literature review of Leech therapy)

  • 장효길;허동석
    • 대한약침학회지
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    • 제13권1호
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    • pp.103-120
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    • 2010
  • Objective : To review the trend of the study related to Leech therapy and to establish the hereafter direction for the study on Leech therapy. Methods : I reviewed and analyzed all the theses published in Domestic and Foreign research institution from 1990 to 2009. Results : The following results were obtained in this study. 1. Analyzed number of theses published, there was no significance per year. 2. Classified by theme of journal, journals related to surgery were most(41 journals, 75.92%) among 54 kinds. 3. Classified by theses by research method and thesis types, case report accounted for nearly twothirds (52 pieces, 68.42%) of all theses and consideration of document was next(9 pieces, 11.84%). 4. With the most case of venous congestion after plastic and reconstructive surgery(33 pieces, 63.46%), leech therapy was effective on illnesses such as haematoma, macroglossia, purpura, varicous vein, avulsion injury, neurovascular compression, diabetic neuropathy, penoscrotal oedema, buerger's disease, rheumatoid arthritis. 5. Two most appeared adverse effects were anemia and infection. Immediate blood transfusion was done for recovering anemia and prophylactic 3rd generation antibiotics to infection were emphasized in more than half of case reports. 6. All of consideration of documents was retrospective study of cases related leech therapy and 3 pieces of them emphasized prophyratic antibiotic treatment for preventing infection. 7. The study of clinical trail type started first in 2002 and osteoarthritis of knee and carpometacarpal joint were main target. As see above result, Leech therapy was effective cure and could be used in disease induced by venous congestion. And I think that it is necessary to perform additional study related to solution of problems about leech therapy and protocol for using in clinical practice.

개방형 근위경골절골술의 3차원 수술계획을 위한 절골해석모델 (Analytical Osteotomy Model for Three-dimensional Surgical Planning of Opening Wedge High Tibial Osteotomy)

  • 구본열;박병건;최동권;김재정
    • 한국CDE학회논문집
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    • 제18권6호
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    • pp.385-398
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    • 2013
  • Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.