• Title/Summary/Keyword: Degenerative

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Controversy in Pathophysiology of Rotator Cuff Tear: Degenerative Tear (회전근 개 파열의 병리 생태학에서의 논쟁점: 퇴행성 파열)

  • Kim, Young-Kyu
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.71-76
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    • 2008
  • The pathophysiology of rotator cuff tears and the progression of asymptomatic tears to symptomatic tears are yet unclear and much controversy. It is likely to involve a number of factors such as a genetic predisposition, extrinsic impingement from structures surrounding the cuff and intrinsic degeneration from changes within the tendon itself. Degenerative changes in the rotator cuff with aging seem to be related to the anatomic and mechanical environment of the rotator cuff. The histopathologic appearance of rotator cuff tendon rupture specimens demonstrates a consequence of degenerative changes at the site of tendon insertion into bone. It weakens the tensile strength of the tendon. Is the process of degeneration intrinsic or extrinsic in nature? I suggest that degeneration is intrinsic and not caused by extrinsic factors. Even though, rotator cuff tear may be secondary to multiple factors, I believe that primary cause of rotator cuff tears is preexisting degenerative change.

Effects of Sea Tangle (Laminaria japonica) and Fucoidan Components on Chronic Degenerative Diseases (만성퇴행성 질환에 미치는 다시마(Laminaria japonica)와 후코이단 성분의 영향)

  • 최진호;김대익;박수현;김동우;이종수;유종현;정유섭
    • Journal of Life Science
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    • v.9 no.4
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    • pp.430-438
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    • 1999
  • This study was designed to investigate the effects of sea tangle (Laminaria japonica) extract and fucoidan components on chronic degenerative diseases. Sprague-Dawley(SD) male rats (210$\pm$5g) were fed experimental diets: Dasi-Ex group: dasima extract powder of 4.0% added to control diet; Fuco-I, II and III groups: fucoidan powder of 1, 2 and 3% added to Dasi-Ex group for 45 days. Triglyceride (TG) levels in serum were significantly lower (10~15%) in Fuco-I, II and III groups compared with control group. Total cholesterol levels were significantly decreased (7~10% and 15~ 35%) in brain mitochondria and microsomes of Fuco-II and III group compared with control group. LDL-cholesterol levels were remarkably decreased (20~30%) in Dasi-Ex and Fuco-I, II, III groups, but HDL-cholesterol levels were significantly increased (10~12%) in Fuco-II and III groups only compared with control group. The ratios of HDL/total cholesterol resulted in a marked increase (3 5~55%) in Dasi-Ex and Fuco-I, II, III groups, but atherogenic indices were remakably decreased (40~50%) in Dasi-Ex and Fuco-I, II, III groups compared with control group. Membrane fluidities were remarkably increased (45~70% and 38~42%, respectively) in brain mitochondria and microsomes of Fuco-II and III groups compared with control group. Administrations of fucoidan added to dasima effectively decreased TG, total and LDL-cholesterol, and atherogenic index, while also effectively increased HDL-cholesterol, HDL/total cholesterol ratio, and membrane fluidity, suggesting chronic degenerative diseases were very effectively prevented by the administration of fucoidan component.

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Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 3 : Cervical and Lumbar Relationship

  • Kim, Sang Jin;Lee, Tae Hoon;Yi, Seong
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.167-173
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    • 2013
  • Objective : There are many cases in which degenerative changes are prevalent in both the cervical and lumbar spine, and the relation between both spinal degenerative findings of MRI is controversial. The authors analyzed the prevalence of abnormal findings on MRI, and suggested a model to explain the relationship between cervical and lumbar disc in asymptomatic Korean subjects. Methods : We performed 3 T MRI sagittal scans on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). Scores pertaining to herniation (HN), annular fissure (AF), and nucleus degeneration (ND) were analyzed. The total scores for the cervical and lumbar spine were analyzed using correlation coefficients and multiple linear regression with various predictive parameters, including weight, height, sex, age, smoking, occupation, and sedentary fashion. Results : The correlation coefficients of HN, AF, and ND were 0.44, 0.50, and 0.59, respectively. We made the best model for relationship by using multiple linear regression. Conclusion : The results of the current study showed that there was a close relationship between the cervical score (CS) and lumbar score (LS). In addition, the correlation between CS and LS, as well as the LS value itself, can be altered by other explanatory variables. Although not absolute, there was also a linear relationship between degenerative changes of the cervical and lumbar spine. Based on these results, it can be inferred that degenerative changes of the lumbar spine will be useful in predicting the degree of cervical spine degeneration in an actual clinical setting.

Posterior Transvertebral Extension Osteotomy - A Case Report - (후방 추체 경유 신전 절골술 - 증 례 보 고 -)

  • Jung, Ho;Kim, Yong-Seog;Park, Moon-Sun;Ha, Ho-Gyun;Lee, Jong-Sun;Kim, Ju-Seung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1262-1266
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    • 2000
  • Objective : Flat back syndrome constitutes a syndrome complex characterized by the loss of normal lumbar lordosis. Various techniques of correction for flat back syndrome have been reported. Posterior extension osteotomy has certain drawbacks. Forceful hyperextension of the spine may result in vascular complications such as rupture of the aorta or the inferior vena cava and stretching of superior mesenteric artery, and pseudoarthrosis. We describe a rationale and technique of transvertebral posterior extension osteotomy to avoid complications of posterior extension osteotomy and to achieve an correction of 30 degrees of flat back syndrome. Method : A 63-year-old woman with degenerative lumbar kyphosis presented with low back pain, thigh pain, knee pain and walking difficulty. Transpedicular fixation from L1 vertebra to S1 vertebra was accomplished for lumbar degenerative kyphosis. After 6 months, the patient presented with flat back syndrome. A second operation was performed with transvertebral posterior extension osteotomy. Result : With short segemental fusion, early bone fusion and correction of 30 degrees were achieved. Conclusion : Transvertebral posterior extension osteotomy provide an 30-60 degrees of correction of flat back syndrome. This technique is considered to be good method for the revision of lumbar degenerative kyphosis.

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Comparison of Fusion with Cage Alone and Plate Instrumentation in Two-Level Cervical Degenerative Disease

  • Joo, Yong-Hun;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.342-346
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    • 2010
  • Objective : This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods : Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. Results : VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p= 0.654). Conclusion : In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.

Effects of Moxibustion and Theraband Exercise on Physical and Psychological Variables of the Aged with Degenerative Osteoarthritis (뜸요법과 세라밴드운동이 퇴행성 골관절염 노인의 신체적, 심리적 변수에 미치는 효과)

  • Han, Sang-Sook;Kim, Won-Oak;Kim, Yeon-Jung;Back, Yong-Hyun;Lee, Myung-Hee
    • Journal of East-West Nursing Research
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    • v.14 no.2
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    • pp.16-23
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    • 2008
  • Purpose: To examine the effects of a nursing intervention including moxibustion and theraband exercise on pain, fatigue, flexibility, and depression in aged patients with degenerative osteoarthritis. Methods: This study had a one group pretestposttest design. Thirty people over 60 yr-of-age with degenerative osteoarthritis were recruited from a community health center from November 1, 2005 to June 14, 2006. The 6 week treatment intervention included twice weekly 60 min sessions of of theraband exercise (30 min) and moxibution (30 min). Data was analyzed by SPSS Ver. 12.0. Results: Intervention was associated with significant decreases in pain (t=8.28, p<.001) and fatigue (t=5.19, p<.001), and significant increases in knee flexibility (t=-3.54, p=.001), dorsal flexibility (t=-9.05, p<.001), and plantar flexibility (t=-4.09, p<.001). Depression was significantly decreased after intervention (t=-4.09, p<.001). Conclusions: Moxibustion and theraband exercise should be utilized as an effective nursing intervention for the aged with degenerative oateoarthritis.

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The Effect of Individualized Nutritional Education on Adults having two or more Symptoms of Chronic Degenerative Disease (만성질환 증상을 두 가지 이상 보유한 성인에 있어서 개인 단위의 영양교육 효과)

  • 윤진숙;정영혜;박정아;오현미
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.794-802
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    • 2002
  • This study was intended to evaluate the overall effects of nutritional education on adults having two or more symptoms of chronic degenerative disease. A nine week nutritional education program was provided for 65 adults with chronic diseases. We assessed the changes in dietary knowledge, eating behavior and socio-psychological factors. When we evaluated the nutrient intakes of the subjects, their energy intake was 79.4% of the Korean Recommended Dietary Allowances (RDA). Their dietary intake of other nutrients was also below the RDA level except for Vitamin C. Their knowledge of dietary therapy was slightly improved after the implementing of nutritional education. The dietary behavior of ‘night snacks before sleep’was significantly improved. While the overall fear due to disease was significantly increased, self-efficacy was not improved. Self-efficacy for eating “three regular meals” and “choosing fruit, vegetable and grain” were significantly decreased. Family support for “buying food which is good for my health” was also significantly increased, whereas “advises me to eat appropriate foods for health” was decreased. Biochemical analysis indicated that blood levels of triglyceride, cholesterol and blood pressure improved after nutrition education. Therefore, we concluded that nutritional education program for people with chronic degenerative diseases could change the diet therapy knowledge, dietary behavior, and the fear due to disease, support from family and behavior intention toward the direction to improve the chronic disease condition. However, it did not improve self-efficacy. Our study also indicated that nutritional education strategies to improve self-efficacy should be an important aspect in a long term education plan for patients to establish desirable eating habits.

Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis (퇴행성 관절질환을 앓고 있는 노인환자를 위한 한방과 양방을 적용한 통합의료 서비스의 효과)

  • Lee, Ji-A;Ji, Eun-Sun
    • Journal of Korean Academy of Nursing
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    • v.41 no.1
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    • pp.18-25
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    • 2011
  • Purpose: This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis. Methods: A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks. Results: Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035). Conclusion: The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

Magnetic Resonance Imaging Analysis of Intervertebral Disc Change of Several Spondylolisthesis Patients in Fifties : Comparison Lytic and Degenerative Spondylolisthesis (일부 50대 척추전방전위증 환자의 유형별 자기공명영상상 추간판 변형 형태 고찰)

  • Kim, Seok;Bahn, Hyo-Jung;Yoon, Hyun-Seok;Han, Kyung-Wan;Woo, Jae-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.13-22
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    • 2011
  • Objectives : The purpose of this study is to find out the characteristics of intervertebral disc changes and relative factors of the spondylolisthesis patients in fifties by type of spondylolisthesis. Methods : We investigated 69 cases of patients who visited one Korean traditional medicine hospital and were diagnosed as spondylolisthesis on L-spine X-ray and L-spine magnetic resonance imaging(MRI). We selected 37 lytic spondylolisthesis patients and 32 degenerative spondylolisthesis patients. We analysed the relativity between the numbers of changed discs, types of changed disc, locations of nerve compression and types of spondylolisthesis. Results : 1. The number of changed discs increase in lytic type, but there is no statistically significant difference. 2. Bulging disc is the dominant type of disc change. There is no significant difference between two types. 3. Both foraminal type was shown dominantly in lytic spondylolisthesis, diffuse type in degenerative spondylolisthesis by the analysis of the location of the nerve compression. But the symptoms of patients and dermatome did not match in most of the cases. Conculsions : The direction of nerve compression is different while the disc changing aspects are similar in both types. In several spondylolisthesis patients in fifties, symptoms of patient are related to degeneration of vertebrae, not to the type of spondylolisthesis.

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The Effect of Korean Medicinal Admission Treatment and Radiological Characteristics on 25 Cases of Spondylolysis (척추분리증 환자 25예의 한방 입원치료 효과와 영상의학적 특성)

  • Lee, Sang-Won;Kim, Yang-Sun;Kim, Yong-Wha;Kim, Yu-Gon;Park, Han-Sol;Lee, Ji-Eun;Lim, Jin-Woong;Jeong, Hyeon-Gyo;Choi, In-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.1
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    • pp.95-103
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    • 2020
  • Objectives The purpose of this study is to assess the effect of korean medicinal admission treatment for degenerative lumbar diseases with spondylolysis and analyze their radiological findings. Methods This study was performed on 25 cases' medical records of spondylolysis patients with both X-rays and MRI images. Their general characteristics, morphologies of intervertebral discs, grades of spondylolisthesis, grades of intervertebral foraminal stenosis were analyzed. The efficacy of treatment was evaluated by numeric pain rating scale (NPRS) changes and statistically assessed by paired t-test using program R Studio. Results After admission treatment, NPRS scores significantly decreased from 6.76±2.07 to 2.38±1.22 (p<0.01). Spondylolysis was associated with degenerative disc change and intervertebral foraminal stenosis at the same or adjacent vertebral level. In spondylolisthesis cases (76%), forward slippage occurred at the same level of spondylolysis in every case. Conclusions Spondylolysis could play a key role in the lumbar degenerative mechanism and korean medicinal admission treatment is effective on pain relief of degenerative lumbar diseases with spondylolysis.