• Biomaterials Research
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• v.22 no.4
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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.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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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.

• Journal of Pharmacopuncture
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• v.13 no.1
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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.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.159-166
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• 2008

Articular cartilage is a unique tissue with no vascular, nerve, or lymphatic supply. This uniqueness may be one of the reasons why chondral injuries will hardly heal and may progress to osteoarthritis over time. Currently, there are several surgical options for the treatment of articular cartilage lesions. Although there is some discrepancy as to which procedures work best in certain patients. The spectrum of treatment alternatives for articular cartilage defects can range from simple lavage and debridement, drilling, micro-fracturing, and abrasion to osteochondral grafting and autologous chondrocyte implantation. In 1984, for the first time, results of autologous chondrocyte implantation in a rabbit model were presented, showing hyaline cartilage repair. Clinical study using autologous cultured chondrocyte implantation in chondral defects of the human knee has been reported in 23 patients in 1994. In 14 out of 16 patients treated for chondral injuries on the femoral condyles, the results were good to excellent. It is important for the surgeon to understand the autologous chondrocyte implantation technique and to be aware on the postoperative management. Attention to surgical technique and selection of appropriate patient for the autologous chondrocyte implantation will provide with the best results.

• Journal of muscle and joint health
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• v.4 no.1
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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.

• Journal of muscle and joint health
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• v.7 no.2
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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.

• Korean Journal of Computational Design and Engineering
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• v.18 no.6
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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.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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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.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.18-28
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• 2005

Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.83-91
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• 2011

Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.