• 동의생리병리학회지
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• 제26권4호
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• pp.539-545
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• 2012

To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

• 한국전문물리치료학회지
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• 제27권3호
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• pp.163-170
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• 2020

Background: The characteristics of lateral epicondylitis (LE) are muscle strength weakness and increased common extensor tendon (CET) thickness. Ultrasonography has recently been used to evaluate tendinopathy. Diamond taping (DT) is commonly used to manage patients with LE. However, no previous studies have investigated the effects of DT on CET thickness. Objects: The aim of this study was to investigate the effects of DT applied around the lateral elbow on CET thickness, grip strength, and wrist extension force in healthy subjects. Methods: The subjects were 26 adults (13 male) in their twenties. First, the CET thickness was measured at rest. The CET thickness was measured by using ultrasonography at two points. The subjects were then instructed to perform maximal grip activities or maximal wrist extension activities before and after DT around the lateral elbow. The DT technique was applied using non-elastic tape. While the subjects performed maximal grip activities, the investigator measured the maximum grip strength (MGS) and CET thickness. Likewise, while the subjects performed maximal wrist extension activities, the investigator measured the maximum wrist extension force (MWEF) and CET thickness. Results: The MGS showed a statistically significant improvement after DT taping application in men (p < 0.05). The MWEF showed a statistically significant improvement after DT application in male (p < 0.01) and female (p < 0.05). When performing the activities, the CET thickness increased compared to that at rest. However, CET thickness didn't show a statistically significant improvement before and after DT. Conclusion: This study shows that DT applied around the lateral elbow is effective in improving MGS and MWEF. However, it does not affect CET thickness.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of Ginseng Research
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• 제46권4호
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• pp.526-535
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• 2022

Background: During the pathogenesis of tendinopathy, the chronic inflammation caused by the injury and apoptosis leads to the generation of scars. Ginsenoside Rg1 (Rg1) is extracted from ginseng and has anti-inflammatory effects. Rg1 is a unique phytoestrogen that can activate the estrogen response element. This research aimed to explore whether Rg1 can function in the process of tendon repair through the estrogen receptor. Methods: In this research, the effects of Rg1 were evaluated in tenocytes and in a rat model of Achilles tendinitis (AT). Protein levels were shown by western blotting. qRT-PCR was employed for evaluating mRNA levels. Cell proliferation was evaluated through EdU assay and cell migration was evaluated by transwell assay and scratch test assay. Results: Rg1 up-regulated the expression of matrix-related factors and function of tendon in AT rat model. Rg1 reduced early inflammatory response and apoptosis in the tendon tissue of AT rat model. Rg1 promoted tenocyte migration and proliferation. The effects of Rg1 on tenocytes were inhibited by ICI182780. Rg1 activates the insulin-like growth factor-I receptor (IGF1R) and MAPK signaling pathway. Conclusion: Rg1 promotes injured tendon healing in AT rat model through IGF1R and MAPK signaling pathway activation.

• 한방재활의학과학회지
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• 제33권2호
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• pp.77-85
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• 2023

Objectives The aim of this study is to retrospectively evaluate the shoulder lesions in patients experiencing shoulder pain through the use of musculoskeletal ultrasound during Korean medicine intervention treatments. Methods A total of 20 cases were collected, including biceps tendinitis (n=4), calcification (n=3), SASD bursitis (n=4), partial tear (n=2), full-thickness tear (n=1), tendinopathy (n=5), and impingement syndrome (n=1). Musculoskeletal ultrasound was used by Korean medicine doctors to perform real-time scanning and to explain the patient's condition during treatment sessions. Results The use of musculoskeletal ultrasound allowed Korean medicine doctors to perform treatments such as pharmacoacupuncture, acupotomy, and acupuncture more safely and effectively. Patients were able to better understand their conditions through real-time imaging and explanations provided by the doctors. Conclusions Musculoskeletal ultrasound has the potential to enhance the safety and efficacy of Korean medicine intervention treatments for patients with shoulder pain. Institutional or governmental support is needed to further promote the use of medical devices by Korean medicine doctors, ultimately leading to an increase in cases and clinical evidence.

• 척추신경추나의학회지
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• 제18권2호
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• pp.43-52
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• 2023

Objectives This study aimed to investigate trends in domestic and international clinical approaches to the Korean medicine treatment of rotator cuff calcific tendinitis and to suggest future research directions. Methods We utilized nine electronic databases to identify domestic and international studies on Korean medicine treatment for rotator cuff calcific tendinitis. By analyzing the title, abstract, and main text, studies concerning Korean medicine treatment of rotator cuff tendinitis were included. Results Among the searched for studies, fourteen studies met our criteria. Eight of these were case reports and six were randomized controlled trials (RCTs). Across the studies, five treatment methods were employed, including acupuncture, herbal medicine, physical therapy, cupping therapy, and moxibustion. Acupuncture, used in all fourteen studies, was the most frequently utilized intervention. Thirteen evaluation tools were used to measure the effectiveness of Korean medicine treatment, and all studies reported positive outcomes. Conclusions We identified current trends in clinical approaches of Korean medicine treatment for rotator cuff calcific tendinitis and assessed the effectiveness of such treatment. However, further studies are warranted to establish a basis for Korean medicine treatment for rotator cuff calcific tendinitis.

• 대한관절경학회지
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• 제11권1호
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• pp.24-31
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• 2007

목적: 견관절 유착성 관절 낭염으로 진단된 환자들에서 회전근 개 병변의 동반 정도를 자기 공명 관절 조영술(magnetic resonance arthrography, MRA) 및 초음파 (ultrasonography, USG)를 이용해 평가해 보았으며, 검사 소견에 있어서 MRA 및 USG의 차이점을 알아보았다. 대상 및 방법: 2005년 6월부터 12월까지 견관절 유착성 관절 낭염으로 진단한 연속된 80명의 환자를 대상으로 전향적 연구를 시행하였다. 무작위로 나누어 MRA 혹은 USG를 시행하였으며, 견관절 유착성 관절 낭염 환자에서 극상근을 중심으로 한 회전근 개 병변의 동반 정도를 조사하였다. 결과: 여섯 예(MRA 4, USG 2, 8%)에서 극상근에 소규모(1cm 이하)의 전층 파열을 보였으며 극상근의 부분 파열은 21예(MRA 12, USG 9, 26%)에서 관찰되었다. 뿐만 아니라 극상근의 건 병증(tendinopathy)이 15예(MRA 7, USG 8, 19%)에서 관찰되어, 총 42예(53%)에서 극상근 병변을 동반하고 있었다(MRA 23, 68% USG 19, 41%). 견갑하근의 부분 파열을 동반한 경우는 9예(MRA 6, USG 3, 11%)로 관찰되었다. 두 군간 극상근 병변의 동반 정도에 유의한 차이는 없었다(p>0.5). 결론: 견관절 유착성 관절 낭염 환자들을 대상으로 하여 시행한 MRA 또는 USG검사 상, 약 반 수(53%)의 환자들에서 극상근의 병변이 동반된 소견을 보였다. 유의한 차이는 없었으나, USG군 보다 MRA군에서 다소 높은 회전근 개 병변의 동반소견을 보였으며 이는 MRA가 USG보다 해상도가 더 뛰어 난 데서 기인한 것으로 생각된다.

• 대한영상의학회지
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• 제84권3호
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• pp.627-637
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• 2023

목적 환자의 자세가 극하근의 힘줄병의 단계, 두께와 관찰가능 범위에 영향을 주는지 알아보고자 하였으며, 이로써 내전자세에서 초음파로 극하근을 평가하는 것이 가능한지 알고자 하였다. 대상과 방법 이 연구는 극하근을 세 가지 다른 자세(중립자세, 내전자세, 반대쪽 어깨에 손을 얹은 자세)로 평가한 48명의 환자의 52개의 어깨를 대상으로 하였다. 두 명의 영상의학과 전문의가 후향적으로 극하근의 힘줄병의 단계를 grade 0에서 grade 3까지, 관찰가능 범위를 grade 1에서 grade 4까지 판정하였다. 극하근의 두께는 다른 영상의학과 전문의가 단축 영상에서 측정하였다. 일반화추정방정식을 통계적 기법으로 사용하였다. 결과 반대쪽 어깨에 손을 얹은 자세에서 힘줄병의 단계는 내전자세보다 누적승산비가 2.087(p = 0.004, 95% 신뢰구간: 1.268-3.433)로 더 높았으나, 중립자세에서 힘줄병은 단계는 내전자세(p = 0.146)와 반대쪽 어깨에 손을 얹은 자세(p = 0.370)와 유의한 차이가 없었다. 극하근의 두께(p < 0.001)는 자세에 따라 유의한 차이가 있었으나, 관찰가능 범위(p = 0.530)는 유의한 차이가 없었다. 결론 환자의 자세는 극하근의 힘줄병의 단계와 두께에는 영향을 주었지만 관찰가능 범위에는 영향을 주지 않았다. 내전자세에서도 초음파로 극하근을 평가하는 것이 가능하다.