• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.7-14
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• 2011

Purpose: The purpose of this study was to analyze the correlation between the medial joint space on weight bearing simple X-ray and the ultrasonographic articular cartilage thickness. Materials and Methods: The articular cartilage thickness of 91 osteoarthritic knees of 73 patients were measured with weight bearing simple X-ray and ultrasonography between June 2010 and September 2010. Male were 13 and female were 60. Right knees were 35, left knees were 20 and bilateral involvements were 18. Medial joint spaces on X-ray were measured in full extension view and $45^{\circ}$ PA(Rosenberg) view. Femoral cartilage thicknesses at and those at the point between the middle 1/3 and posterior 1/3 area were measured by ultrasonography, that were scanned coronally at $30^{\circ}$ flexion and $130^{\circ}$ flexion respectively. The results were analyzed statistically by Pearson correlation test and Bland-Altman plot test. Results: Medial joint spaces measured in full extension view and femoral articular cartilage thicknesses at the point between the anterior 1/3 and middle 1/3 area measured with sonography were statistically correlated and medial joint spaces measured in $45^{\circ}$ PA view and those at the point between the middle 1/3 and posterior 1/3 area measured with sonography were also correlated (P<0.05, $SD{\pm}2$). Conclusion: The measurement of articular cartilage thicknesses by the ultrasonography was easy even in the patient who are unable to take weight bearing view and was thought to be a useful diagnostic and follow up method to examine the degenerative change in addition to simple radiographic examination in the knee osteoarthritis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.440-449
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• 2020

This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.13-17
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• 2009

Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.5
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• pp.631-640
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• 2014

The inhibitory effects of Boswellia serrata (BW) extracts on degenerative osteoarthritis were investigated in primary-cultured rat cartilage cells and a monosodium-iodoacetate (MIA)-induced osteoarthritis rat model. To identify the protective effects of BW extract against $H_2O_2$ ($800{\mu}M$, 2 hr) in vitro, cell survival was measured by MTT assay. Cell survival after $H_2O_2$ treatment was elevated by BW extract at a concentration of $20{\mu}g/mL$. In addition, BW extract treatment significantly reduced and normalized the productions of pro-inflammatory factors, nuclear transcription factor ${\kappa}B$, cyclooxygenase-2, tumor necrosis factor-${\alpha}$, and interleukin-6 at a concentration of $20{\mu}g/mL$. Treatment of chondrocytes with BW extract significantly reduced 5-lipoxygenase activity and production of prostaglandin E2, especially at a concentration of $10{\sim}20{\mu}g/mL$. For the in vivo animal study, osteoarthritis was induced by intra-articular injection of MIA into knee joints of rats. Consumption of a diet containing BW extract (100 and 200 mg/kg) for 35 days significantly inhibited the development and severity of osteoarthritis in rats. To determine the genetic expression of arthritic factors in articular cartilage, real-time PCR was applied to measure matrix metalloproteinases (MMP-3, MMP-9, and MMP-13), collagen type I, collagen type II, and aggrecan, and BW extract had protective effects at a concentration of 200 mg/kg. In conclusion, BW extract was able to inhibit articular cartilage degeneration by preventing extracellular matrix degradation and chondrocyte injury. One can consider that BW extract may be a potential therapeutic treatment for degenerative osteoarthritis.

• Biomolecules & Therapeutics
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• v.23 no.5
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• pp.442-448
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• 2015

We evaluated the chondroprotective effects of wogonin by investigating its effects on the gene expression and production of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as on production of MMP-3 in the rat knee. Rabbit articular chondrocytes were cultured in a monolayer, and RT-PCR was used to measure interleukin-$1{\beta}$ (IL-$1{\beta}$)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and type II collagen. In rabbit articular chondrocytes, the effects of wogonin on IL-$1{\beta}$-induced production and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of wogonin on MMP-3 protein production was also examined in vivo. In rabbit articular chondrocytes, wogonin inhibited the expression of MMP-3, MMP-1, MMP-13, and ADAMTS-4, but increased expression of type II collagen. Furthermore, wogonin inhibited the production and proteolytic activity of MMP-3 in vitro, and inhibited production of MMP-3 protein in vivo. These results suggest that wogonin can regulate the gene expression and production of MMP-3, by directly acting on articular chondrocytes.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.310-316
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• 2021

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm³ (32,400-203,904/mm³), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

• Journal of Life Science
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• v.27 no.10
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• pp.1207-1214
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• 2017

Schisandrae Fructus (SF), the fruit of Schisandra chinensis (Turcz.) Baill., is widely used in traditional medicine for the treatment of a number of chronic diseases. SF extracts have been recently reported to attenuate the inflammatory responses in SW1353 human chondrocyte cells in in vitro and monosodium iodoacetate (MIA)-induced cartilage degradation in in vivo osteoarthritis (OA) models. However, their protective and therapeutic potentials against OA in primary culture chondrocytes and animal models remain unclear. Therefore, we investigated the effects of the ethanol extract of SF on the activity of matrix metalloproteinases (MMPs), biomarkers for diagnosis of OA, on interleukin $(IL)-1{\beta}-induced$ primary cultured rat cartilage chondrocytes and MIA-induced osteoarthritis in a rat model. Our data indicated that SF treatment significantly reduced the mRNA expression and enzyme activity of MMP-1, -3 and -13 in $IL-1{\beta}-induced$ primary cultured rat cartilage chondrocytes. The chondro-protective effects of SF were then analyzed in a rat OA model using a single intra-articular injection of MIA in the right knee joint. According to our results, the elevated levels of MMP-1 and -3 were markedly ameliorated by SF administration. Collectively, these findings indicate that SF could be a candidate for the treatment of OA.

• Journal of the Institute of Electronics Engineers of Korea SP
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• v.47 no.6
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• pp.75-81
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• 2010

The segmentation of cartilage is crucial for the diagnose and treatment of osteoarthritis (OA), and has mostly been done manually by an expert, requiring a considerable amount of time and effort due to the thin shape and vague boundaries of the cartilage in MR (magnetic resonance) images. In this paper, we propose a fully automatic method to segment cartilage in a knee joint on MR images. The proposed method is based on a small number of manually segmented images as the training set and comprised of an initial per patch segmentation process and a global refinement process on the cumulative per patch results. Each patch for per patch segmentation is positioned by classifying the bone-cartilage interface on the pre-segmented bone surface. Next, the shape and intensity priors are constructed for each patch based on information extracted from reference patches in the training set. The ratio of influence between the shape and intensity priors is adaptively determined per patch. Each patch is segmented by graph cuts, where energy is defined based on constructed priors. Finally, global refinement is conducted on the global cartilage using the results of per patch segmentation as the shape prior. Experimental evaluation shows that the proposed framework provide accurate and clinically useful segmentation results.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.216-223
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• 2009

Background: There have been limited reports on the effectiveness of 5% lidocaine patches (L5Ps) for treating a few types of chronic pain. We utilized L5Ps for chronic pain patients with various diagnoses and who had incompletely responded to their current treatment regimen. This study aimed at describing the results of a retrospective review of an open-label L5P trial to assess L5Ps' effectiveness and safety for treating various chronic pain patients. Methods: The chronic pain patients with pain lasting longer than 6-month duration were offered a 2-week L5P treatment trial. The patients were maintained on their other analgesic regimens. The treatment effect was measured according to the change from the baseline visual analog scale (VAS) to the week 2 VAS. After a 2-week trial, the patients were asked if they perceived pain improvement with L5Ps by using a four-item Pain Relief Scale (1 = a lot of relief, 2 = slight relief, 3 = no change, 4 = worse pain). Results: In the combined patient population (n = 177), 2-week treatment with the L5Ps significantly improved the week 2 VAS (P = 0.000). Significant improvement in the VAS was reported by the chronic pain patients with postherpetic neuralgia, intercostal neuralgia, degenerative osteoarthritis at knee joint, and other maladies. A higher proportion of the chronic pain patients reported improving their pain by the L5Ps. Seven patients experienced mild or moderate patch-related adverse events. Conclusions: The L5P provided clinically meaningful pain relief in some refractory chronic pain patients without any severe adverse events.

• Herbal Formula Science
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• v.29 no.2
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• pp.81-91
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• 2021

Objectives : This study was conducted to evaluate the efficacy of a complex mixture of natural substances of ginseng and baeknyeoncho on the arthritic rats. Methods : In vitro experiments were conducted to ensure the stability of the complex. After setting toxicity and concentration by MTT assay, the antioxidant effect was measured through DPPH and ABTS radical scavenging activity. To confirm the anti-inflammatory effects of the complex, levels of nitric oxide (NO) and pro-inflammatory cytokines (IL-1β, TNF-α) were measured in LPS-treated macrophage cell lines (RAW264.7). We injected monosodium iodoacetate (MIA) 50 μl (60 mg/ml) into knee joints of rats to induce osteoarthritis. The rats were divided into three groups (normal (n=5), control (n=5), and OR (n=5) group). The control group consumed 2 mg/kg of physiological saline once a day for 4 weeks, and the OR group was mixed at a concentration of 416.5 mg/kg of Baengnyeoncho (O) and 208.25 mg/kg of red ginseng (R) and ingested 1 mL each 5 days a week. Results : This complex increased the DPPH and ABTS radical scavenging rate. The complex decreased NO production and pro-inflammatory cytokine production of macrophages. In the OR group, the secretion of cytokine in serum was decreased. In histopathological examination, the joint tissue of the composite showed less damage to the synovial membrane, cartilage, and fibrous tissue than the control group. Conclusions : As a result of this study, natural complexes have antioxidant, anti-inflammatory and cartilage protection effects. Therefore, we expect the complex to be effective in treating osteoarthritis.