• Journal of Veterinary Clinics
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• v.33 no.3
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• pp.172-175
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• 2016

An 11-month-old, 19.5 kg, intact male Border collie was referred with intermittent left forelimb lameness to the Gyeongsang Animal Medical Center. The symptom was first discovered about 6 months ago, and it has gotten worse for the last 10 days with non-weight bearing on the left forelimb. During the physical examination, the patient showed painful reaction when the left shoulder was abducted. On radiographic assessment, a radiolucent line and some osteophytes were found in both humeral heads. Based on patient's clinical signs and radiographic findings, osteochondritis dissecans (OCD) was very suspicious. So, we decided to perform an arthroscopic surgery on left shoulder for definitive diagnosis and treatment because the right forelimb revealed no clinical signs. During arthroscopic technique, we found a large OCD flap on the caudo-central area of humeral head, and observed severe synovitis over a wide range on posterior area of the articular capsule. The large OCD flap was removed by a grasping forceps, and many joint mice were removed either. Curettage was performed using a curette on the articular surface until hemorrhage occurred, and articular capsule flushed with a lactated-ringer's solution. The patient was discharged on the same day without any specific abnormal status. Antibiotic, anti-inflammatory and analgesic drugs were administered. Mild lameness on left forelimb was observed in 2 weeks after surgery, but after 4 weeks, the patient showed complete normal gait without any lameness. Although surgical removal of OCD flap with arthroscopic was previously reported, We would like note that a large OCD flap can also be removed by arthroscopic surgery in this report.

• Journal of Microbiology and Biotechnology
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• v.24 no.1
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• pp.119-126
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• 2014

Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disorder that primarily affects the flexible joints and may also affect a number of tissues and organs. The progression of RA involves an inflammatory response of the capsule around the joint, swelling of synovial cells with excess synovial fluid (SF), and the development of fibrous tissue in the synovium. Since the progressive pathology of the disease often leads to the irreversible destruction of articular cartilage and ankylosis of the joint, early diagnosis of RA is essential. Thus, we undertook a comparative proteomic approach to investigate novel biomarkers for early diagnosis using SFs and serums from RA patients. As a result, we identified 32 differentially expressed spots in SFs and 34 spots in serums. The differential expression of the STEAP4 and ZNF 658 proteins were validated using immunoblotting of the SFs and serums, respectively. These data suggest that differentially expressed proteins in SFs and serums could be used as RA-specific biomarkers for the diagnosis and monitoring of RA. Furthermore, these findings advance our understanding of the molecular etiopathogenesis of RA.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.46-52
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• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.54-58
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• 2007

Purpose: Luciferase is one of the most commonly used reporter enzymes in the field of in vivo optical imaging. D-luciferin, the substrate for firefly luciferase has very high cost that allows this kind of experiment limited to small animals such as mice and rats. In this current study, we validated local injection of D-luciferin in the articular capsule for bioluminescence imaging in rabbits. Materials and Methods: Chondrocytes were cultured and infected by replication-defective adenoviral vector encoding firefly luciferase (Fluc). Chondrocytes expressing Fluc were injected or implanted in the left knee joint. The rabbits underwent optical imaging studies after local injection of D-luciferin at 1, 5, 7, 9 days after cellular administration. We sought whether optimal imaging signals was could be by a cooled CCD camera after local injection of D-luciferin. Results: Imaging signal was not observed from the left knee joint after intraperitoneal injection of D-luciferin (15 mg/kg), whereas it was observed after intraarticular injection. Photon intensity from the left knee joint of rabbits was compared between cell injected and implanted groups after intraarticular injection of D-luciferin. During the period of imaging studies, photon intensity of the cell implanted group was 5-10 times higher than that of the cell injected group. Conclusion: We successfully imaged chondrocytes expressing Fluc after intraarticular injection of D-luciferin. This technique may be further applied to develop new drugs for knee joint disease.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.54-58
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• 2007

Either absorbable or nonabsorbable sutures can be used in meniscal repair. Some surgeons prefer nonabsorbable sutures because they believe that nonabsorbable sutures improve meniscal healing as compared with absorbable sutures. But, permanent existence of sutures in the lesion could make problems. We report a case of Inside-Out meniscus repair that nonabsorbable sutures came out of the joint capsule tearing the substance of the meniscus.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.10-19
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• 2000

The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.72-78
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• 2010

Purpose: Too develop a flexible drill device that can be inserted into the shoulder joint so that arthroscopic transosseous suture repair for Bankart lesion is possible. Materials and Methods: We created a device composed of a flexible drill unit and a guide pipe unit. The flexible drill unit was made of flexible multifilament wires (1.2 mm in diameter) that was twisted into one cord so that it can flex in any direction and a drill bit (1.2 mm in diameter) that is attached onto one end of the flexible wire. The guide pipe unit was a 150 mm long metal pipe (2.0 mm in inner diameter and 3.0 mm in outer diameter), with one end bent to 30 degrees. The flexible drill set was inserted into the shoulder joint through the posterior portal of the joint. The guide pipe component was placed onto the medial wall of the glenoid so that the pipe was placed 5 mm posterior to the margin of the anterior glenoid rim. The flexible drill was driven through the glenoid by the power drill so that holes were made in the glenoid. A non- absorbable suture was passed through the hole. Tying of a sliding knot tying was accomplished over the capsule and labrum after making a stitch through the capsule and labrum with a suture hook loaded with suture passer. The same procedures were done at the 2 and 4 O'Clock positions of the glenoid. Results: Five cases with Bankart lesion received arthroscopic transosseous repair with our flexible drill device. There were no intraoperative problems. Neither redislocation nor subluxation was reported at final follow-up. Conclusion: Arthroscopic transosseous suture repair without suture anchors and easy tying of a sliding knot are possible with a flexible drill set.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.286-292
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• 2010

Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

• Journal of dental hygiene science
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• v.15 no.6
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• pp.800-806
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• 2015

The aim of this study was to investigate whether intracisternal administrations of triptolide and N-nitro-L-arginine Methyl Ester (L-NAME) are involved in the regulation of temporomandibular joint (TMJ) pain. The TMJ pain was induced by the injection of 5% formalin ($30{\mu}l$) into TMJ capsule of rats. The pain behavioral responses was recorded the number of grooming or scratching on the left TMJ area for 9 successive 5 minutes intervals. Triptolide and L-NAME were administrated intracisternally 10 minutes before formalin injection. The intra-articular injection of formalin produced a biphasic pattern of pain response (first phase: 0~10 minutes and second phase: 11~45 minutes). The intracisternal administration of triptolide ($1{\mu}g/10{\mu}l$) and L-NAME ($0.1{\mu}g/10{\mu}l$) suppressed the TMJ pain behavior in each experiment. Co-administration of two drugs was shown the enhanced effect than the analgesic effect by single-administration of triptolide ($1{\mu}g/10{\mu}l$). The triptolide could be a useful analgesic agent for the treatment of TMJ pain, and it is expected to reduce the substantial amount of it via co-administration of synthetic chemical compound and natural products.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.9-14
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• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.